COVID-19疫情下某三甲医院1066例发热门诊患者临床资料分析

1066 outpatients with fever in a 3A hospital under COVID-19 epidemic:analysis of clinical data

目的:了解COVID-19疫情下发热门诊患者的临床特征、诊疗流程,为COVID-19防治工作提供数据参考。方法:通过医院电子病历系统、HIS系统、PACS系统,提取某三甲医院2020年1月27日至3月9日所有发热门诊患者的病历资料并进行分析。结果:共纳入患者1066例,以21~30岁居多(31.33%);首发症状排名前5位分别是发热、咳嗽、咽痛、头痛、腹泻;完善了血常规、超敏C反应蛋白、胸部CT检查者分别占84.90%、83.86%、73.55%;发现28例COVID-19疑似病例,17例有流行病学史(60.71%)。血常规主要表现为白细胞正常或减少、淋巴细胞减少,胸部CT以肺部多发斑片状影、多发磨玻璃影为主。最终确诊1例。结论:COVID-19疫情下,详细了解发热门诊患者的流行病学史、临床表现,并结合血常规特征、胸部CT及核酸检查结果,可有效识别COVID-19疑似病例和确诊病例。

Objective:To understand the clinical characteristics and diagnosis and treatment process of outpatients with fever under COVID-19 epidemic,so as to provide a data reference for prevention and treatment of COVID-19.Methods:Through the hospital electronic medical record system,HIS system and PACS system,the medical records of all outpatients with fever in a 3A hospital from January 27 to March 9,2020 were extracted and analyzed.Results:A total of 1066 patients were included,most of them were 21-30 years old(31.33%);the top five first symptoms were fever,cough,sore throat,headache and diarrhea;blood routine examination,high-sensitivity C-reactive protein and chest CT examination were performed in 84.90%,83.86%and 73.55%of the patients,respectively;28 suspected cases of COVID-19 were found,and 17 cases had epidemiological history(60.71%).Blood routine examination showed normal or decreased white blood cells;chest CT showed multiple patchy shadows and multiple ground glass shadows in the lung.One case was finally diagnosed.Conclusion:Under COVID-19 epidemic,detailed understanding of epidemiological history and clinical manifestations of outpatients with fever,combined with blood routine characteristics,chest CT and the results of nucleic acid examination,can effectively identify suspected cases and confirmed cases of COVID-19.