蚌埠地区79例新型冠状病毒肺炎患者临床特征

Clinical characteristics of 79 COVID-19 patients in Bengbu District

目的提高对新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者临床特征及早期转归的认识。方法回顾性分析2020年1月25日—3月4日蚌埠医学院第一附属医院收治经新型冠状病毒核酸检测确诊的79例资料完整的COVID-19出院患者病例资料及出院后3个月43例患者的随访资料。结果79例患者中45例重症、危重型患者(重症组),34例普通型患者(普通组)。重症组平均年龄大于普通组,合并高血压病、糖尿病、合并基础疾病>1种者比例均高于普通组(P均<0.05)。重症组表现胸闷、气促、呼吸困难,且双肺病变范围>3叶者比例均高于普通组(P均<0.05)。重症组淋巴细胞计数低于普通组患者,而中性粒细胞、血小板、D-二聚体、血糖、乳酸脱氢酶、肌钙蛋白I、C反应蛋白、白细胞介素-6水平均较普通组升高,差异均具有统计学意义(P均<0.05)。随访的43例患者中,2例(8.0%)重症组患者偶有胸闷,1例(4.0%)嗅觉障碍,其他患者均无不适;与COVID-19康复患者影像学吸收良好组相比,吸收不良组中的重症患者比例更高(P<0.05)。结论重症COVID-19患者临床特征有一定特异性,对于年龄大、合并基础疾病及其他重症特征的患者应提高警惕,重视临床观察和动态评估,有助于发现潜在临床不良事件。本地区COVID-19康复患者早期无明显临床后遗症状,重症患者仍应加强随诊,是重点关注人群。

Objective To improve the understanding of clinical characteristics and early outcome of coronavirus disease 2019(COVID-19)patients.Methods The medical information of 79 COVID-19 discharged patients with complete data and the follow-up data of 43 patients at 3 months after discharge were retrospectively analyzed.All the patients were diagnosed with confirmed COVID-19 by nucleic acid test and were treated in the First Affiliated Hospital of Bengbu Medical College from January 25,2020 to March 4,2020.Results Among 79 patients with COVID-19,there were 45 severe patients(severe group)and 34 mild patients(common group).Compared with the common group,the mean age was higher,and the proportion of patients with hypertension,diabetes or more than one underlying disease was higher in the severe group(P<0.05).In the severe group,the proportion of patients with chest distress,shortness of breath,dyspnea,and bilateral lung lesions in more than 3 lobes was higher than that in the common group(P<0.05).The levels of lymphocyte count in patients with severe COVID-19 were lower than those in mild patients,while the levels of neutrophil count,platelet,D-dimer,blood glucose,lactate dehydrogenase,cardiac troponin I,C-reactive protein and interleukin-6 in patients with severe COVID-19 were significantly higher than those in mild patients(P<0.05).Among 43 follow-up patients,2 cases(8.0%)of severe COVID-19 occasionally had chest tightness,1 case(4.0%)had dysosmia,and other cases had no discomfort.Compared with the good imaging absorption group,the proportion of severe patients in the poor absorption group was higher(P<0.05).Conclusions The clinical characteristics of severe COVID-19 patients are specific.We should pay more attention to the patients with older age,underlying diseases and other severe features.Clinical observation and dynamic assessment should be emphasized to discover clinically potential adverse events.The convalescent patients with COVID-19 in this region have no obvious clinical sequelae symptoms in the early stage,and the severe patients should strengthen the follow-up,who are the population of great interest.