4例重型新型冠状病毒肺炎患者临床及实验室检查特点分析

Analysis on the clinical features and laboratory findings of severe COVID-19 in 4 cases

目的:总结重型新型冠状病毒肺炎(COVID-19)患者的临床特征、实验室检查特点及转归,为更好地防治重型COVID-19提供科学依据。方法:整理2020年1月23日~2月22日在弋矶山医院治愈出院的4例重型COVID-19患者的临床资料,对其一般资料、临床体征、实验室检查、治疗措施及转归情况进行分析。结果:患者平均年龄为(52.0±3.92)岁,主要临床症状为发热、干咳、乏力、胸闷及呼吸困难等,4例患者中性粒细胞与淋巴细胞比值(NLR)分别为19.5、11.0、15.0、4.7;CD3+T淋巴细胞(318.75±166.58)×10^6 g/L、CD3+CD4+T淋巴细胞(189.75±128.77)×10^6 g/L、CD3+CD8+T淋巴细胞(107.25±43.22)×10^6 g/L均较正常水平下降,胸部CT表现为双肺外带多发斑片状阴影。4例患者住院期间接受了高流量氧疗(HFNC)、免疫调节、抗病毒等综合治疗后均好转出院。结论:早期识别重症患者,及时有效的呼吸支持、免疫调节等综合治疗有助于降低不良后果的发生。

Objective:To analyze the clinical features,laboratory findings and therapeutic outcomes of severe COVID-19 patients for scientific evidences to plan better prevention and treatment of this infection.Methods:The clinical data,including general information,clinical manifestations,laboratory studies,treatment strategies and outcomes,were obtained from 4 cases of severe COVID-19 treated in our hospital between January 23 th and February 22 th,2020,and analyzed.Results:The median age of the patients was(52.0±3.92)years.Common symptoms included fever,dry cough,fatigue,chest tightness and dyspnea.Peripheral blood neutrophil-lymphocyte ratio(NLR)was 19.5,11.0,15.0 and 4.7,respectively for the 4 patients.CD3+T,CD3+CD4+T and CD3+CD8+T lymphocytes were(318.75±166.58)×10^6 g/L,(189.75±128.77)×10^6 g/L and(107.25±43.22)×10^6 g/L,respectively,which was lower than normal levels.Chest CT was distinguished by multiple patchy shadows,distributed at bilateral lung fields.The four patients were cured and discharged after treatment with HFNC,immune regulation and antiviral.Conclusion:Early identification of severe patients,timely and comprehensive treatment measures such as respiratory support and immune regulation can reduce the occurrence of adverse consequences.