新冠疫情初期住院病例临床特征和治疗方法及重症影响因素

Clinical characteristics,treatment measures and influencing factors of hospitalized patients during primary state of COVID-19 epidemic

目的 探讨疫情防控期间新冠住院患者的临床特征与核酸转阴及病情程度的影响因素.方法 回顾性分析2020年1月15日-4月3日武汉某新冠定点收治医院收治的新冠患者1919例的临床资料,分析核酸转阴时间及病情程度的影响因素.结果 患者以轻型和普通型为主,中位年龄60岁,男性44.8%;相较于非重症患者,重症和危重症患者的年龄、男性比例、基础疾病负担、首发症状呼吸困难与胸闷和氧气支持治疗的比例均更高,核酸转阴时间也更长;核酸转阴时间延长与首发症状发热和磷酸氯喹治疗相关,男性、清肺排毒汤和泰康克冠复元饮(协定处方)治疗与核酸转阴时间缩短相关;患者重症风险随基础疾病数量增加而升高,此外,首发症状发热和呼吸困难、男性及高龄是重症的危险因素.结论 对重症的高危人群应加强关注和预防,同时清肺排毒汤等中成药对促进患者恢复有重要作用,可用于新冠患者治疗.

OBJECTIVE To explore the clinical characteristics of patients hospitalized with COVID-19 during the first wave of COVID-19 epidemic in Wuhan,as well as the risk factors influencing nucleic acid negative conversion and the degree of disease.METHODS A retrospective observational analysis was conducted on the clinical data of 1919 patients with SARS-CoV-2 admitted to a specialized hospital designated for COVID-19 in Wuhan from Jan.15,2020,to Apr.3,2020 were retrospectively analyzed for risk factors influencing the time of nucleic acid conversion and the extent of the disease.RESULTS The majority of patients were classified as mild or moderate,with a median age of 60 years and 44.8%of male.Compared with non-severe patients,severe and critical patients had higher rate of older,proportion of males,burden of underlying disease,initial symptoms of dyspnea and chest tightness,and oxygen support therapy,as well as longer time to nucleic acid conversion.Prolonged negative conversion time was associated with initial symptom of fever and chloroquine phosphate therapy,while male,treatment with Qingfei Paidu decoction and Taikang Keguan Fuyuan drink were associated with shorter time to nucleic acid conversion.The risk of serious illness in patients was elevated with the number of underlying diseases.Additionally,initial symptoms of fever and respiratory distress,male gender,and advanced age were risk factors for serious illness. CONCLUSION It is necessary to strengthen the concern and prevention of the high-risk population.Qingfei Paidu decoction shows remarkable effect on recovery of the patients and can be used for treatment of thepatiens wihtCOVID-19.