320例COVID-19临床特征分析

Analysis of the clinical characteristics of the 320 COVID-19 cases in Tonghua City

目的2021年1月,吉林省通化市出现新型冠状病毒肺炎新冠输入性病例。本文以通化市COVID-19病例资料为基础,分析此次疫情临床症状,以期为早期识别病例,总结经验和调整防控措施提供数据支持。方法将通化市中心医院COVID-19病例资料经逻辑核对后一般资料采用构成比,频数分析;计量资料用均数±标准差(x±s)表示。结果本次疫情型重型及危重型62例(19.07%),其中重型患者34例,平均年龄(70.25±8.84)岁;危重型患者27例,平均年龄(73.48±10.31)岁。症状上,咳嗽出现频次258人次(80.63%),发热184人次(57.50%)、咳痰173人次(54.06%)、乏力69人次(21.56%);首发为单一发病形式87例(52.18%),首发单一发热患者42例,占首发病例24.70%;发热在发病3 d内出现患者67例(63.21%)。淡红舌127例(39.69%),苔白腻106例(33.13%)、黄腻57例(17.81%);脉滑数74例(23.13%)、滑脉61例(19.06%)、弦滑36例(11.25%);寒湿郁肺证120例(37.50%);低钾患者96人(31.48%),正常低值血钾129人(42.29%)。结论通化市疫情COVID-19重型及危重型比例较高,以高龄为主要特征。临床表现出咳嗽多,发热少的特点;腹泻为呼吸系统以外的主要临床表现;乏力出现频率较低,或为中医药早期介入整体调控有关。初始辨证以寒湿郁肺证为主要证型;多见舌淡,苔腻,脉滑,均为寒湿特征。血钾偏低患者普遍,低钾可能反映感染程度,应密切监测并及时治疗。

Objective In January 2021,imported cases of the novel coronavirus pneumonia were reported in Tonghua City,Jilin Province.Based on the COVID-19 case data in Tonghua City,this article means to analyze the clinical symptoms of the epidemic,with a view to providing data support for early case identification,summarizing experience and adjusting prevention and control measures.Methods The data of the Covid-19 cases in Tonghua Central Hospital were logically checked,and the general data were analyzed by composition ratio and frequency,while the measurement data were expressed as mean±standard deviation(sx±).Results 62 cases(19.07%)were severe or critical in this epidemic,including 34 severe patients(mean age 70.25±8.84)and 27 critical patients(mean age 73.48±10.31).In terms of symptoms,the frequency of coughing was the highest in 258 cases(80.63%),followed by fever in 184(57.50%),expectoration in 173(54.06%),fatigue in 69(21.56%).87 cases(52.18%)had the first onset of a single symptom,among which 42 patients had a single fever,accounting for 24.70%.67 patients(63.21%)had fever within 3 days of onset;127 cases(39.69%)with pink tongue,106 cases(33.13%)with white and greasy fur,57 cases(17.81%)with yellow and greasy fur,74 cases(23.13%)with slippery and rapid pulse,61 cases(19.06%)with slippery pulse and 36 cases(11.25%)with stringy and slippery pulse;120 cases(37.50%)with the cold-damp stagnated in lungs syndrome;96 cases(31.48%)with hypokalemia,and 129(42.29%)with normal low potassium.Conclusion The COVID-19 epidemic in Tonghua City has a relatively high proportion of severe and critical cases,who are mainly characterized by advanced age.Their clinical manifestations are characterized by more coughing and less fever,while diarrhea is the second main clinical manifestation besides those in the respiratory system,and the frequency of fatigue is relatively low,which may be related to the early overall regulation intervention of traditional Chinese medicine.The cold-damp stagnated in lungs syndrome is the main type in the initial syndrome differentiation.Pale tongue,greasy fur and slippery pulse are common,all of which embody the characteristics of cold and dampness.Patients with hypokalemia are common,and the low blood potassium may reflect the degree of infection and should be closely monitored and treated in time.