77例境外输入性COVID-19病例临床特点分析

Clinical characteristics of 77 COVID-19 cases imported from abroad

目的探讨复旦大学附属浦东医院境外输入性2019冠状病毒病(coronavirus disease 2019,COVID-19)确诊病例的临床特点,为疫情防控提供有效依据。方法收集本院2020年3月14日至2020年7月3日期间境外输入性COVID-19确诊病例77例,分析其流行病学史、血常规、C反应蛋白(C-reactive protein,CRP)和胸部CT。结果确诊病例中约63.64%(49/77)为聚集性发病,务工人员占54.55%(42/77),为群居居住;其次为留学生,占25.97%(20/77例),大部分为单独居室居住。男性54例,女性23例,发病年龄14~62岁。18.18%(14/77)的患者为无症状感染者,36.36%(28/77)的患者有发热,75.32%(58/77)的患者有干咳、咽痛、流涕等呼吸道感染症状,少数有胸闷、乏力、腹泻等症状。血常规检查提示65例外周血白细胞计数正常,4例白细胞计数减少,8例白细胞计数升高,淋巴细胞绝对计数均在正常范围内,67例嗜酸性粒细胞绝对计数减少,35例单核细胞绝对计数升高,61例CRP指标正常、16例轻度升高。胸部CT检查显示50例患者均有不同程度的肺部异常表现,27例患者未见异常。27例为轻型,50例为普通型,无重型及危重型。结论境外输入性COVID-19病例有明确的流行病学史,居住条件拥挤是发病率增加的危险因素,一部分为无症状感染者或轻型患者,多数为普通型患者,实验室检查多未见明显异常,胸部CT影像学表现多样。应综合考虑流行病学史、症状、实验室及影像学检查,才能避免漏诊,做到早发现、早治疗、早隔离,有效控制COVID-19疫情。

Objective To investigate the clinical characteristics of coronavirus disease 2019(COVID-19)imported from abroad in Pudong Hospital Affiliated to Fudan University so as to provide evidence for epidemic prevention and control of COVID-19.Methods We extracted data regarding 77 patients with laboratory-confirmed COVID-19 in Pudong Hospital from Mar 14 to Jul 3,2020.We then collected and analyzed their epidemic history,blood routine,C-reactive protein(CRP)and chest CT.Results About 63.64%(49/77)of the confirmed cases showed characteristics of clustering onset,with migrant workers accounting for a large proportion(54.55%,42/77),whom living in groups;followed by overseas students(25.97%,20/77),most of whom lived in separate rooms.There were 54 males and 23 females,aged from 14 to 62 years old.Among them,18.18%(14/77)were asymptomatic,36.36%(28/77)had fever and 75.32%(58/77)had dry cough,sore throat,runny nose and other respiratory tract infection symptoms;and a few had chest tightness,fatigue,diarrhea and other symptoms.White blood cell counts were normal in 65 cases,decreased in 4 cases,increased in 8 cases;Lymphocyte absolute counts were all in the normal range and eosinophil absolute counts were decreased in 67 cases,and mononuclear cell absolute counts were increased in 35 cases.CRP was increased in 16 cases,and normal in 61 cases.CT scan of the chest revealed that 50 patients had different degrees of pulmonary abnormalities,and 27 had no abnormalities.There were 27 mild type cases,50 common type cases,and no severe or critical type.Conclusion COVID-19 imported from abroad has epidemiological history.Crowded living conditions are a risk factor for the increased incidence of COVID-19.Some of them were asymptomatic or mild type,and most of them were common type.Laboratory examination showed no obvious abnormalities,and chest CT imaging showed various manifestations.To avoid missed diagnosis,overall consideration of the epidemiological history,symptoms,laboratory examination and imaging is needed,so as to achieve early detection,early treatment and early control for imported COVID-19.