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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2020年05期

页码:

659-662

栏目:

论著

出版日期:

2020-10-20

文章信息/Info

Title:

Prevention and control of 52 suspected COVID-19 patients and analysis of their clinical characteristics

作者:

杨家盛¹; 何耀为¹; 刘华盛²; 龚金如¹; 王 燕¹; 林国辉¹; 孙瑞琳¹

510317 广州,广东省第二人民医院呼吸与危重症医学科¹ 510317 广州,广东省第二人民医院耳鼻喉头颈外科²

Author(s):

Yang Jiasheng¹;  He Yaowei¹;  Liu Huasheng²;  Gong Jinru¹;  Wang Yan¹;  Lin Guohui¹;  Sun Ruilin¹.

¹Department of Respiratory and Critical Care Medicine; ²Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou 510317, China

关键词:

COVID-19;  疑似病例;  影像学;  传染病防控

Keywords:

COVID-19;  Suspected case;  Radiography;  Prevention and control of infectious diseases

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2020.05.016

摘要:

目的 分析我院收治52例疑似新型冠状病毒肺炎(COVID-19)的流行病学及临床特点,探讨定点医院收治疑似病例的重要性。方法 回顾分析2020年1月31日至2020年2月15日广东省第二人民医院收治的52例疑似COVID-19病例的流行病学和临床表现、实验室检查和影像学检查特点,总结收治疑似病例的临床工作经验,以及疑似病例管理对传染病防控的重要作用。结果 52例患者中,男24例,女28例; 年龄范围为15～65岁,中位年龄为36.5岁。其中有疫区旅行史或居住史的占28.8%,有确诊病例接触史的占26.9%,有确诊区域发热或呼吸道症状患者接触史的占7.7%,无明确流行病学史的占34.6%。临床主要表现为发热39例(75.0%),咳嗽23例(44.2%)和乏力6例(11.5%)。血常规白细胞计数下降7例(13.5%),正常34例(65.4%),升高11例(21.2%); 淋巴细胞计数下降19例(36.5%),正常33例(63.5%)。CD3⁺ T淋巴细胞绝对值下降13例(28.9%); CD4⁺ T淋巴细胞绝对值下降15例(33.3%)。CD8⁺ T淋巴细胞绝对值下降12例(26.7%)。C反应蛋白(CRP)值升高30例(57.7%); 降钙素原(PCT)升高11例(21.1%)。44例行甲型流感、乙型流感、H7N9抗原检测,全阴性。22例行呼吸道13项常见病原体核酸检测,其中流感嗜血杆菌12例最多(54.5%)。影像学出现异常42例(80.8%),其中磨玻璃影29例(55.8%)、斑片影24例(46.2%),具有多重异常特征的16例(30.8%)。结论 疑似病例的收治对于疫情防控具有重要意义,其与确诊病例存在诸多相似之处,在收治的同时我们需要做好自身防护以及及时对其鉴别和诊治。

Abstract:

Objective To analyze the epidemiological and clinical characteristics of 52 suspected novel coronavirus pneumonia(COVID-19)patients admitted to our hospital, and to explore the importance of treating suspected cases in designated hospitals. Methods A retrospective analysis of the epidemiological and clinical manifestations, laboratory tests, and radiological features of 52 suspected COVID-19 cases admitted to Guangdong Second Provincial General Hospital from January 31, 2020 to February 15, 2020, and summarized the treatment clinical work experience of suspected cases, and the important role of suspected case management in the prevention and control of infectious diseases. Results Among the 52 patients, there were 24 males and 28 females; the age range was 15 to 65 years, and the median age was 36.5 years. Among them, 28.8% had a history of travel or residence in the epidemic area, 26.9% had contact history of confirmed cases, 7.7% had contact history of patients with fever or respiratory symptoms in the confirmed area, and 34.6% had no clear epidemiological history. Clinical manifestations: 39 cases of fever(75.0%), 23 cases of cough(44.2%)and 6 cases of fatigue(11.5%). Blood routine white blood cells count decreased in 7 cases(13.5%), normal in 34 cases(65.4%), increased in 11 cases(21.2%); lymphocytes count decreased in 19 cases(36.5%), and normal in 33 cases(63.5%). The absolute value of CD3⁺ T lymphocytes decreased in 13 cases(28.9%); the absolute value of CD4⁺ T lymphocytes decreased in 15 cases(33.3%); the absolute value of CD8⁺ T lymphocytes decreased in 12 cases(26.7%). C-reactive protein(CRP)value increased in 30 cases(57.7%); procalcitonin(PCT)increased in 11 cases(21.1%). Forty-four cases were tested for influenza A, influenza B, and H7N9 antigens, all of which were negative. Twenty-two cases were tested for the nucleic acid of 13 common pathogens in the respiratory tract, among which 12 cases were Haemophilus influenzae(54.5%). Radiography showed 42 abnormalities(80.8%), including 29 ground-glass shadows(55.8%), 24 patchy shadows(46.2%), and 16 cases(30.8%)with multiple abnormal features. Conclusion The admission of suspected cases is of great significance for the prevention and control of the epidemic, and there are many similarities between them and confirmed cases. During the admission and treatment, we need to do a good job in our own protection and timely identification and diagnosis.

参考文献/References:

1 任成山, 林 辉, 杨仕明, 等. 冠状病毒及新型冠状病毒肺炎防控策略[J/CD]. 中华肺部疾病杂志(电子版), 2020, 13(1): 1-5.
2 张玉坤, 江 兵, 杨时光,等. 糖皮质激素在普通型新冠肺炎治疗中的探索[J/CD]. 中华肺部疾病杂志(电子版), 2020, 13(4): 497-500.
3 中国疾病预防控制中心. 截至3月1日24时COVID-19疫情最新情况. 2020-03-01.(http://www.chinacdc.cn/jkzt/crb/zl/szkb_11803/jszl_11809/202003/t20200302_213970.html).
4 魏秋华, 任 哲. 2019新型冠状病毒感染的肺炎疫源地消毒措施[J]. 中国消毒学杂志, 2020, 37(1): 59-62.
5 新型冠状病毒感染的肺炎诊疗方案(试行第六版).国卫办医函〔2020〕145号.http://www.nhc.gov.cn/xcs/zhengcwj/202002/8334a8326dd94d329df351d7da8aefc2.shtml
6 Yang Y, Lu QB, Liu MJ, et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China[J]. MedRxiv preprint. Doi: https://doi.org/10.1101/2020.02.10.20021675.
7 Carly E, Travis E. Clinical Characteristics of Coronavirus Disease 2019 in China[J]. N Engl J Med, 58(4): 711-712.
8 Pan Y, Guan H, Zhou S, et al. Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia(2019-nCoV): a study of 63 patients in Wuhan, China[J]. Eur Radiol, 2020. DOI: 10.1007/s00330-020-06731-x.
9 王成彬. 核酸检测用于确诊COVID-19阳性率低的原因分析[J]. 中华医学杂志, 2020, 100(13): 991-996.
10 刘 蒙, 徐洪吕, 袁 敏, 等. 安徽省新型冠状病毒肺炎流行与疫情时空变化分析[J]. 中华预防医学杂志, 2020, 54(6): 630-633.
11 纪建松, 韦铁民. 新冠肺炎CT早期征象与鉴别诊断[M]. 北京: 科学出版社, 2020.
12 吕亚兰, 刘 聪, 周文正, 等. COVID-19与SARS和MERS的流行病学特征及其防控措施[J]. 医药导报, 2020, 39(3): 334-337.
13 周毅武, 何彦琪, 蒋 臻, 等. 新冠肺炎流行期发热门诊管理模式探讨[J/OL]. 中华急诊医学杂志, 2020, 29, DOI: 10.3760/cma.j.issn.1671-0282.2020020.006
14 Wu JY, Liu LL, Wang GL, et al. One Health in China[J]. Infect Ecol Epidemiol, 2016, 6: 33843.
15 曾 玫, 翟晓文, 王建设. 新型冠状病毒感染:儿科医务工作者的审视和应对[J]. 中华传染病杂志, 2020, 38: E003-E003.

备注/Memo

备注/Memo:

通信作者: 孙瑞琳, Email: sunruilin213@163.com

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更新日期/Last Update: 2020-10-20