新型冠状病毒肺炎伴咽部症状126例患者临床特征分析

Clinical analysis of 126 patients with coronavirus disease 2019 with pharyngeal symptoms

目的探讨伴有咽部症状的新型冠状病毒肺炎(COVID-19)患者的临床特征。方法回顾性分析2020年1月10日至5月15日在武汉大学人民医院就诊的1228例COVID-19患者的临床资料,其中男554例,女674例,年龄10~95岁,平均55.2岁。根据是否伴随有咽痛、咽干、咽痒、咽喉异物感等咽部症状,分为咽部症状组126例和无咽部症状组1102例,统计两组患者的年龄、性别、病史、症状持续时间、治疗时间、临床分型、肺部影像学检查结果、全血细胞计数、血清超敏C反应蛋白、C反应蛋白、降钙素原等临床指标,分析各组数据的差异性。采用χ2检验、Fisher确切概率法和Mann-Whitney U检验进行统计学分析。结果咽部各症状占比分别为咽痛59.52%(75/126)、咽异物感23.02%(29/126)、咽干8.73%(11/126)以及咽痒8.73%(11/126)。咽部症状组与无咽部症状组比较,中位年龄较低(51.50岁比57.50岁);女性较多[65.08%(82/126)比53.72%(592/1102)],肺部CT出现双肺磨玻璃影较少[73.81%(93/126)比83.48%(920/1102)],差异均有统计学意义(P值均<0.05)。两组患者的各临床分型比例、治疗天数、症状持续时间、白细胞计数、淋巴细胞计数、淋巴细胞百分比、嗜酸性粒细胞计数、嗜酸性粒细胞百分比、超敏C-反应蛋白、C-反应蛋白、D-二聚体、降钙素原等指标差异无统计学意义(P值均>0.05)。结论COVID-19患者的咽部症状发生率为10.26%,大部分于该疾病常见症状之前或同时发生,患者因此类症状就诊时可能给耳鼻咽喉头颈外科医生带来较大的感染风险。按照目前临床分型标准,咽部症状与病情程度无明显相关性;但伴有咽部症状可提示患者会有较轻的临床表现及更好的预后。

Objective To investigate the clinical characteristics of patients with coronavirus disease 2019(COVID-19)with pharyngeal symptoms.Methods From January 10 to May 15,2020,clinical data of 1228 patients with COVID-19 in Renmin Hospital of Wuhan University was collected(554 males and 674 females,with the range of age from 10 to 95 years old,the average age was 55.2 years old).The patients were divided into pharyngeal symptoms group(PS,126 cases)and non-pharyngeal symptoms group(Non-PS,1102 cases)according to the presence or absence of pharyngeal symptoms such as pharyngalgia,pharyngeal dryness,pharyngeal itching,and pharyngeal foreign body sensation.The clinical data in terms of age,sex,medical history,duration of symptoms,treatment time,clinical classification,pulmonary imaging findings,whole blood cell count,serum hypersensitivity C-reactive protein,C-reactive protein,procalcitonin were statistically analyzed between the two groups.Chi-square,Fisher's exact test and Mann-Whitney U test were used for statistical analysis.Results The most common pharyngeal symptoms were pharyngalgia(59.52%,75/126),followed by foreign body sensation(23.02%,29/126),pharyngeal dryness(8.73%,11/126),and itching(8.73%,11/126).The median age of the patients in the PS group was 51.50 years old,which was less than 57.50 years old in the non-PS group,showing a significant difference(P<0.05).The female cases accounted for 65.08%(82/126),which was higher than 53.72%(592/1102)of the non-PS group(P<0.05).The incidence of bilateral lung inflammation confirmed by CT images was 73.81%(93/126),which was significantly lower than 83.48%(920/1102)in the non-PS group(P<0.05).No significant differences were shown in the proportion of patients with clinical types,treatment days,duration of symptoms,white blood cell count,lymphocyte count,lymphocyte percentage,eosinophil count,eosinophil percentage,hypersensitive C-reactive protein,C-reactive protein,D-dimer,procalcitonin and other indicators(P>0.05).Conclusions The incidence of pharyngeal symptoms in patients with COVID-19 is 10.26%.Most of these symptoms occur before or at the same time as the common symptoms of the disease.Therefore,patients with such symptoms may bring a greater risk of infection to otolaryngologist.According to the current clinical classification criteria,pharyngeal symptoms have no obvious correlation with the degree of the disease;but the presence of pharyngeal symptoms may suggest a milder clinical presentation and a better prognosis.