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温岭市家庭聚集性新型冠状病毒肺炎初期的临床特征与胸部CT表现的分析

Clinical characteristics and chest CT findings of family clusters of coronavirus disease 2019 cases in Wenling
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摘要 目的回顾性分析温岭市新型冠状病毒肺炎(COVID-19)家庭聚集性发病患者流行病学史、临床症状、实验室检查和胸部CT表现的时间变化规律,为发热门诊、隔离病房及疾病预防控制提供借鉴与参考。方法回顾性分析温岭市第一人民医院2020年1月19日—2月5日收治确诊的43例家庭聚集性发病的COVID-19患者(涉及9组家庭,男24例,女19例),收集相关信息:包括基本情况,流行病学史,症状与体征,实验室检查结果,胸部CT表现和临床转归。结果9组家庭均有明确的流行病学史和家庭暴露史,其中与来自武汉疫区有关的家庭有8组(一代病例),另外1组为武汉疫区回来继发的本地病例(二代病例)。其中发热33列、10例无发热,干咳21例,5例无明显临床症状。其中42例患者初次就诊时就存在肺部病灶,以双肺受累多见(36例),单肺病灶6例,1例初诊时肺部无病灶,42例胸部CT征象均符合早期表现。结论家庭聚集性发病COVID-19患者早期阶段的临床症状、核酸检测和CT表现存在时间上的差异,临床行胸部CT筛查及早期识别密切接触者至关重要,可能成为疫情控制的关键节点。 Objective This study retrospectively analyzed the epidemiological history,clinical symptoms,laboratory tests,and chest CT findings of family clusters of coronavirus disease 2019(COVID-19).Methods The clusters of COVID-19 cases involved 9 families,including 24 males and 19 females who were treated in Wenling First People's Hospital from January 19,2020 to February 5,2020.The relevant information such as demographic data,epidemiology,symptoms and signs,laboratory results,chest CT findings,and clinical outcomes were reviewed.Results Clear epidemiological exposure and family contact were confirmed for all the 9 families.The first generation patients were identified in 8 families who were related to Wuhan epidemic area.The remaining one family had only local cases,i.e.,second generation patients.Fever was reported in 33 cases,dry cough in 21 cases.Five patients had no apparent clinical symptoms.Lung lesions were identified in 42 patients at their first visit.The most common finding was bilateral lung involvement,which was found in 36 cases.Unilateral lung lesion was found in 6 cases.One patient had no lung lesions at the first visit.Chest CT signs were consistent with the early clinical manifestations in 42 cases.Conclusions There a gap between the onset time of clinical symptoms,positive nucleic acid assay,and CT signs at early stage of the family clusters of COVID-19 patients.Chest CT screening and early identification of close contacts at early stage are very crucial and key steps for successful epidemic control.
作者 洪金晶 梁丽丽 马春莲 HONG Jinjing;LIANG Lili;MA Chunlian(Department of Infectious Diseases,Wenling First People's Hospital,Taizhou Zhejiang 317500,China)
出处 《中国感染与化疗杂志》 CAS CSCD 北大核心 2022年第3期295-300,共6页 Chinese Journal of Infection and Chemotherapy
基金 2020年温岭市社会发展科技项目(2020S0180104) 2021年浙江省卫生健康科技计划项目(2021KY1229)。
关键词 新型冠状病毒肺炎 家庭聚集性 临床特点 体层摄影术 coronavirus disease 2019 family cluster clinical characteristic computed tomography
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