228例新型冠状病毒肺炎住院患者临床分析

Clinical characteristics of 228 hospitalized patients with COVID-19

目的:描述新型冠状病毒肺炎(COVID-19)的流行病学和临床特征。方法:收集2020年1月27日至2月29日在武汉大学附属同仁医院(武汉市第三医院)确诊为COVID-19的228例住院患者资料,分析其临床特点及转归。结果:住院患者平均年龄为58岁,其常见症状包括发热(88.2%)、疲劳(69.7%)和干咳(59.2%);存在以消化道不适为首发症状的患者(7.9%)。重型患者淋巴细胞减少明显(P<0.05),白蛋白降低(P<0.05),D-二聚体升高(P<0.05),乳酸脱氢酶(P<0.05)和肌酸激酶同工酶(P<0.05)升高。所有患者胸部CT显示斑片状阴影或毛玻璃样混浊。重型患者更可能伴有合并症(P<0.05),且更可能出现并发症包括急性呼吸窘迫综合征(ARDS)[19(8.3%)],心律失常[13(5.7%)]和休克[5(2.2%)],其中7%因病情加重转至重症监护病房,死亡率4.4%。结论:重型患者在发病年龄、基础疾病、症状、实验室检查及并发症等方面均有差异,需早期识别;同时要警惕以消化道不适为首发症状的非典型COVID-19患者,做好防护,减少传播。

Objective: To describe the epidemiological and clinical features of coronavious disease 2019(COVID-19). Methods: The data of 228 inpatients diagnosed as COVID-19 in the Third Hospital of Wuhan from January 27, 2020, to February 29, 2020 were collected,and their clinical characteristics and outcomes were analyzed. Results: The average age of inpatients was 58 years old. Common symptoms included fever(88. 2%), fatigue(69. 7%), and dry cough(59. 2%). There were patients with gastrointestinal discomfort as the first symptom(7. 9%). In severe patients, lymphocytes decreased significantly, albumin decreased, D-dimer increased, lactate dehydrogenase and creatine kinase isoenzyme increased(all P<0. 05). Chest CT of all patients showed patchy shadows or frosted glass opacity of both lungs. Severe patients were more likely to have comorbidities(P<0. 05), and more likely to have complications including acute respiratory distress syndrome(ARDS)(19 cases,8. 3%), arrhythmia(13 cases, 5. 7%), and shock(5 cases, 2. 2%), and 7% COVID-19 cases were transferred to the ICU due to the worsening of the disease, and the patients’ mortality rate was 4. 4%.There were no specific drugs for treatment, and supportive treatment was the mainstay. Conclusion:Severe patients had differences in age of onset, underlying diseases, symptoms, laboratory tests, and complications, etc., and needed to be identified earlier.