广州市205例新型冠状病毒肺炎临床特征

Analysis of 205 cases of COVID-19 in Guangzhou

目的回顾分析广州市新型冠状病毒肺炎病例的流行病史、临床症状、影像学以及实验室指标改变,从而为临床快速筛查及诊治提供参考依据。方法采集2020年1月21日—2020年2月5日在广州市八人民医院收治的205例新型冠状病毒肺炎病例的病史资料,分析其流行病史、临床症状、影像学及实验室指标的变化特点。结果205例患者中男性101例(49%),女性104例(51%),年龄范围2~83岁,平均(48.64±16.74)岁,其中20岁及以下仅有5人。194例(95%)有疫区居住或旅游等接触史。55例(27%)有慢性基础疾病,以高血压41例(20%),糖尿病11例(5%),心血管疾病8例(4%)为主。入院时发热175例(85%),其余临床症状以干咳80例(39%)、咳嗽咳痰54例(26%),咽部不适55例(27%),畏寒50例(24%)多见。实验室检查发现白细胞正常或偏低197例(96%),淋巴细胞正常或偏低202例(98%)。中性粒细胞百分比升高24例(12%),C反应蛋白升高85例(42%),降钙素原升高73例(37%),56例样本中血清淀粉样蛋白A升高44例(79%)。D二聚体、凝血功能以及肝肾功能部分病例异常。计算机化X线体层照相术显示192例(94%)有肺炎表现。结论广州市新型冠状病毒肺炎病例男女比例接近。儿童或青少年感染少,以中老人,有基础病为主。首发症状以发热为主,白细胞和淋巴细胞绝对值正常或偏低,对新型冠状病毒肺炎的早期筛查和诊断有重要的辅助作用。计算机化X线体层照相术对新型冠状病毒肺炎的初步临床诊断价值大。

Objective The epidemic history,clinical symptoms,imaging and laboratory index changes of COVID-19 cases in Guangzhou were reviewed and analyzed,to provide reference basis for rapid clinical screening,diagnosis and treatment.Methods By collecting the medical history data of 205 cases of COVID-19 in Guangzhou Eighth People’s Hospital from January 21 to February 5 in 2020,we analyzed the changes of epidemic history,clinical symptoms,imaging and laboratory indicators features.Results Among the 205 cases,101 were males(49%)and 104 were females(51%).The age of the patients ranged from 2 to 83 years old,with an average of(48.64±16.74)years,only 5 of them are 20 years old and below.194 cases(95%)had contact history of living or traveling in epidemic areas.55 cases(27%)had chronic underlying diseases,including 41 cases(20%)of hypertension,11 cases(5%)of diabetes and 8 cases(4%)of cardiovascular diseases.On admission,fever occurred in 175 cases(85%).The remaining clinical symptoms were common in 80 cases(39%)of dry cough,54 cases(26%)of cough and sputum,55 cases of pharyngeal discomfort(27%),and 50 cases of chills(24%).Laboratory examination revealed the white blood cells were normal or decreased in 197 cases(96%),and the lymphocytes were normal or decreased in 202 cases(98%).The percentage of neutrophils increased in 24 cases(12%),C reactive protein increased in 85 cases(42%),procalcitonin increased in 73 cases(37%),and serum amyloid A increased in 44 cases(79%)of 56 cases.D-dimer,blood coagulation,liver and kidney function were abnormal in some cases.Computerized X-ray tomography showed pneumonia in 192 cases(94%).Conclusions The ratio of male and female of COVID-19 cases in Guangzhou is similar.There are few infections in children or adolescents,mainly in the middle-aged,elderly and with underlying diseases.The first symptom was fever,and absolute value of white blood cells and lymphocytes is normal or low,which plays an important role in the early screening and diagnosis of COVID-19.Computerized X-ray tomography is of great value in the preliminary clinical diagnosis of COVID-19.