摘要
目的了解重庆地区2019冠状病毒病(coronavirus disease 2019,COVID-19)患者临床特征、治疗及转归。方法回顾性收集重庆市公共卫生医疗救治中心收治的COVID-19患者临床资料,总结其临床特征,对比轻重症患者临床特征、治疗方案及转归等差异。结果共收集COVID-19患者82例,男43例,女39例,平均年龄(49.7±15.7)岁(12~77岁),中老年患者占比74.4%,29例(35.4%)合并慢性基础疾病。轻症、重症患者分别占64.6%(53例)、35.4%(29例)。常见症状有咳嗽、发热、气促、肌痛乏力,发生率分别为76.8%、56.1%、41.5%、32.9%,少数伴头痛、腹泻。轻、重症比较,重症患者发热(86.2%)、咳嗽(96.6%)发生率更高,CD4^+T细胞(中位数196/μL)更低,合并细菌感染概率(72.4%)、肝功能异常率(65.5%)及凝血功能异常率(82.8%)更高(P均<0.05)。76例(92.7%)肺部有病灶,以磨玻璃样改变为主。主要予洛匹拉韦/利托那韦+α干扰素抗病毒治疗,部分联合抗细菌、激素、中药等综合治疗。观察期内无一例死亡,所有患者病毒核酸检测转阴,好转出院。结论重庆地区COVID-19患者以咳嗽、发热、气促症状为主,40%以上患者无发热,应避免漏诊。重症患者易合并细菌感染及肝功能等异常,但采取综合治疗预后良好。
Objective To review the clinical characteristics,treatment,and outcome of coronavirus disease 2019(COVID-19)in Chongqing.Methods The clinical data of COVID-19 patients were retrospectively summarized and analyzed.The clinical characteristics,treatment,and outcome were compared between mild and severe patients.Results A total of 82 COVID-19 patients were analyzed,including 43 males and 39 females,with an average age of(49.7±15.7)(12-77)years old.Most(74.4%)were elderly patients.Underlying disease was found in 29(35.4%)cases.Overall,53(64.6%)cases were mild and 29(35.4%)were severe.Main clinical symptoms were cough(76.8%),fever(56.1%),shortness of breath(41.5%),myalgia and asthenia(32.9%).A few patients also had headache and diarrhea.Fever(86.2%)and cough(96.6%)were more prevalent in severe patients.Median CD4^+T cells count 196/μL was lower in severe cases than in mild cases.The incidence of bacterial infection(72.4%),abnormal liver function test(65.5%)and abnormal coagulation assay(82.8%)was higher in severe patients(P<0.05).Ground glass lesion was found on CT image of lungs.The patients were primarily treated with lopinavir/ritonavir combined withα-interferon,or combined with antibacterial agents,corticosteroids,traditional Chinese medicines,and other integrated supportive treatment.No patient died during in-hospital treatment and viral nucleic acid test was negative in all cases.Conclusions The main symptoms of COVID-19 patients in Chongqing are cough,fever,and shortness of breath.The diagnosis of COVID-19 may be missed in some cases because some patient may have no fever.Severe patients are usually complicated with bacterial infection and abnormal liver function,which warrants comprehensive supportive treatment.
作者
曾琴
陈耀凯
李明俊
曾妍茗
鲁雁秋
刘倩
何小庆
刘敏
ZENG Qin;CHEN Yaokai;LI Mingjun;ZENG Yanming;LU Yanqiu;LIU Qian;HE Xiaoqing;LIU Min(Infection DivisionⅡ,Chongqing Public Health Medical Center,Chongqing 400036,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2020年第5期515-520,共6页
Chinese Journal of Infection and Chemotherapy
基金
重庆市新型冠状病毒性肺炎防治专项研究项目(cstc2020jscx-fyzx0074)。
关键词
2019冠状病毒病
临床特征
重症
治疗
核酸
coronavirus disease 2019
clinical characteristic
severe
treatment
nucleic acid
