- 作者列表："Wang J","Zhu X","Xu Z","Yang G","Mao G","Jia Y","Xie Z","Wang J","Ao W
BACKGROUND:The novel coronavirus pneumonia (coronavirus disease 2019, COVID-19) has spread around the world. We aimed to recapitulate the clinical and CT imaging features of COVID-19 and their differences in three age groups. METHODS:The clinical and CT data of patients with COVID-19 (n = 307) that had been divided into three groups (Group 1: < 40 years old; Group 2: 40 ≤ age < 60 years old; Group 3: ≥ 60 years old) according to age were analyzed retrospectively. RESULTS:Of all patients, 114 (37.1%) had histories of epidemiological exposure, 48 (15.6%) were severe/critical cases, 31 had hypertension (10.1%), 15 had diabetes mellitus (4.9%), 3 had chronic obstructive pulmonary disease (COPD, 1%). Among the three groups, severe/critical type, hypertension and diabetes occurred more commonly in the elderly group compared with Group 1&2 (P < 0.05, respectively). Cough and chest tightness/pain were more commonly appeared in Group 2&3 compared with Group 1 (P < 0.05, respectively). Compared with Group 1 and 2, there were more abnormal laboratory examination indexes (including CRP increase, abnormal percentage of lymphocytes, neutrophils and monocytes) in Group 3 (P < 0.05, respectively). CT images revealed that more lobes were affected and more subpleural lesions were involved in the elderly group, besides, crazy paving sign, bronchodilatation and pleural thickening were more commonly seen in the elderly group, with significant difference between Group 1&2, Group 2&3 (P < 0.05, respectively). CONCLUSIONS:COVID-19 presented representative clinical manifestations, laboratory examinations and CT findings, but three age groups possessed their own specific characteristics. Grasping the clinical and CT features stratified by age will be helpful for early definite diagnosis of COVID-19.
背景: 新冠肺炎 (冠状病毒病 2019，新型冠状病毒肺炎) 已在全球蔓延。我们的目的是总结新型冠状病毒肺炎的临床和CT影像特征及其在三个年龄组中的差异。 方法: 将 307 例新型冠状病毒肺炎患者分为 3 组 (组 1: <40 岁; 组 2: 40 岁 ≤ 年龄 <60 岁; 第 3 组: ≥ 60 岁) 按年龄进行回顾性分析。 结果: 所有患者中，114 (37.1%) 有流行病学暴露史，48 (15.6%) 为重症/危重病例，31 例有高血压 (10.1%)，糖尿病 15 例 (4.9%)，慢性阻塞性肺疾病 3 例 (1%)。三组中，老年组中重度/危重病型、高血压和糖尿病发生率高于第一组和第二组 (p <0.05)。与组 1 相比，组 2 和组 3 更常见咳嗽和胸闷/疼痛 (分别为p <0.05)。与 1 组和 2 组比较，3 组实验室检查指标异常 (包括CRP升高、淋巴细胞、中性粒细胞和单核细胞百分比异常) 更多 (p <0.05)。CT显示老年组累及肺叶较多，累及胸膜下病变较多，老年组以疯铺征、支气管扩张、胸膜增厚多见。组 1 和组 2 、组 2 和组 3 之间差异显著 (p <0.05)。 结论: 新型冠状病毒肺炎具有代表性的临床表现、实验室检查和CT表现，但 3 个年龄组有各自的特点。掌握按年龄分层的临床及CT特征，将有助于新型冠状病毒肺炎的早期明确诊断。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.