济南市41例新型冠状病毒肺炎患者的临床资料分析

Clinical features of 41 patients with coronavirus disease 2019 in Jinan city

目的:分析本院41例新型冠状病毒肺炎的临床资料,为临床诊治提供参考依据。方法:回顾性分析2020年1月至4月41例新型冠状病毒肺炎患者的流行病学、临床、出院后新型冠状病毒核酸随访等资料。结果:共有普通型40例、重型1例纳入研究。患者临床症状主要为发热、咳嗽,也有咽痛、腹泻、乏力等不适。感染性指标升高较明显,25例(61.0%)C-反应蛋白增高,20例(48.8%)前降钙素增高,部分患者也可出现血沉增快,乳酸脱氢酶增高,肝功能或凝血功能异常,CD4+T淋巴细胞下降等。最易并发肺炎,多累及双肺,尤其是肺下叶,病变基本特征为早期双肺多发磨玻璃样、多发斑片状、条索状等改变,41例患者肺部CT好转的中位数为10(6,12.5)天;核酸转阴时间中位数为12(9,23)天。结论:患者临床症状主要为发热、咳嗽;感染性指标升高最明显;新型冠状病毒可致全身多器官损害,最易累及肺。

Objective To analyze the clinical features of 41 patients with coronavirus disease 2019(COVID-19),so as to provide references for clinical diagnosis and treatment.Methods Retrospective analyses were applied for epidemiological and clinical data as well as the follow-up results of nucleic acid testing for severe acute respiratory syndrome virus 2(SARS-CoV-2)among 41 patients with COVID-19 from January to April 2020.Results A total of 40 mild type cases and 1 severe type case of COVID-19 were enrolled in the stuty.The main clinical symptoms were fever and cough while sore throat,diarrhea and fatigue also existed.The indexes of infection increased obviously,including elevated C-reactive protein(CRP)in 25 patients(61.0%)and procalcitonin(PCT)in 20 patients(48.8%).Elevated erythrocyte sedimentation rate(ESR)and lactate dehydrogenase(LDH),abnormalities in indexes of liver function and coagulation,declined CD4+T cells were also observed in some patients.Pneumonia was the most common complication,affecting both lungs,especially lower lobes.The lesions were characterized by multiple ground-glass opacity,patch-like changes and striate-like changes in both lungs at early stage of the disease.The median value of lung CT recovery of the 41 patients was 10(6,12.5)days.The median time of nucleic acid negative conversion was 12(9,23)days.Conclusions The main clinical synptoms of patients with COVID-19 were fever and cough along with elevated indexes of infection.SARS-CoV-2 may cause multiple organ damages in the body.The most common complication was pneumonia.