2019冠状病毒病轻症患者的临床特点回顾
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(1.南华大学附属第一医院急诊科,湖南省衡阳市 421001;2.南华大学心血管疾病研究所 动脉硬化学湖南省重点实验室 湖南省动脉硬化性疾病国际科技创新合作基地,湖南省衡阳市 421001;3.南华大学附属第一医院感染科,湖南衡阳市 421001)

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彭正良,博士,副主任医师,研究方向为急性心衰和脓毒症,E-mail为pengzhl-2001@163.com。通信作者姜志胜,博士,教授,博士研究生导师,从事动脉粥样硬化病因发病学以及心肌缺血损伤的细胞分子机制与防治研究,E-mail为zsjiang2005@163.com。

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国家自然科学基金项目(91839103、81670429);湖南省卫生健康委课题(20201927);2020年度创新型省份建设专项抗击新冠肺炎疫情应急专题(2020SK3010,NO.2020-20)


Aü retrospective analysis of clinical features of moderate patients with COVID-19
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1.Emergency Department, the First Affiliated Hospital of University of South China, Hengyang, Hunan 421001, China;2.Institute of Cardiovascular Disease & Key Laboratory for Arteriosclerology of Hunan Province & International Laboratory for Scientific Innovation and Co-operation of Hunan Province, University of South China, Hengyang, Hunan 421001, China;3.Department of Infection, the First Affiliated Hospital of University of South China, 421001, Hunan Province)

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    目的 研究2019冠状病毒病(COVID-19)轻症患者的临床特点和核酸转阴时间。方法 回顾性纳入2020年2月12日至2月29日武汉黄陂方舱医院的2019新型冠状病毒(2019-nCoV)核酸阳性的患者,分为轻型和普通型,随访至2020年3月10日,分析患者的临床特点和核酸检测结果。结果 本研究共纳入75例患者,平均年龄41.2±11.5岁,男性占52.0%。患者中有发热表现者44.0%,CT影像阳性者54.7%。首次核酸检出阳性率69.3%,核酸转阴天数中位数为9.0天(6.0~14.0天)。随访至2020年3月10日,无患者转为重型或死亡。轻型(34例)和普通型(41例)患者的年龄、白细胞计数差异无显著性。与普通型组比较,轻型组女性占61.8%,显著高于男性(P<0.05);两组患者核酸转阴天数差异无显著性[8.5天(7.0~13.8天) 比9.0天(5.0~14.0天),P=0.973]。亚组分析发现轻型患者中,女性的核酸转阴时间少于男性(P=0.020),服用连花清瘟胶囊亚组核酸转阴时间缩短(P=0.026)。结论 相同治疗下轻型和普通型患者核酸转阴时间差异无显著性,轻型患者中女性和服用连花清瘟亚组核酸转阴时间缩短;根据临床表现和影像学诊断COVID-19可能漏诊部分轻症患者,急需准确及时的核酸检测或其它病原学、血清学检测方法。

    Abstract:

    Aim To study the clinical characteristics and the time of nucleic acid conversion to negative in patients with Corona Virus Disease 2019 (COVID-19). Methods This study is a retrospective study. Patients with laboratory-confirmed COVID-19 from a hospital in Wuhan from February 2,0 to February 9,0 were divided into mild and common types, followed up to March 0,0, the clinical characteristics and nucleic acid test results of the patients were analyzed. Results A total of 75 patients were included in this study, with an average age of 41.2 ± 11.5 years, and 52.0% were male. Among the patients, 44.0% had fever and 54.7% had positive CT images. The positive rate of the first nucleic acid detection was 69.3%, and the median time of nucleic acid conversion to negative was 9.0 days (6.0~14.0 days). Follow-up to March 0,0, no patients became severe or died. There were no significant differences in age and white blood cell count between patients with mild type (34 cases) and patients with common type (41 cases). Compared with the common group, women in the wild group accounted for 61.8%, which was significantly higher than men (P<0.05); there was no statistical difference in the time required for nucleic acid conversion to negative between the two groups (8.5 (7.0~13.8) vs 9.0 (5.0~14.0), P=0.973). The subgroup analysis found that in mild patients, women had less nucleic acid conversion time than men (P=0.020), and the Lianhuaqingwen capsule subgroup had less nucleic acid conversion time (P=0.026). Conclusions There was no significant difference in the time of nucleic acid conversion to negative between mild and common patients under the same treatment, and the time of nucleic acid conversion for females and the patients taking Lianhuaqingwen was shortened in mild group. Many patients with moderate COVID-19 may be missed based on clinical manifestations and imaging findings, and accurate and prompt nucleic acid testing or other etiological determination methods are needed.

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彭正良,于紫英,唐海波,雷正文,黄华勇,张宗荣,姜志胜.2019冠状病毒病轻症患者的临床特点回顾[J].中国动脉硬化杂志,2020,28(5):405~409.

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  • 收稿日期:2020-03-16
  • 最后修改日期:2020-03-23
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  • 在线发布日期: 2020-05-26