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Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study.

中国湖北省非武汉地区 2019 例冠状病毒病患者的临床特征: 一项回顾性研究。

  • 影响因子:2.79
  • DOI:10.1186/s12879-020-05010-w
  • 作者列表:"Zhao XY","Xu XX","Yin HS","Hu QM","Xiong T","Tang YY","Yang AY","Yu BP","Huang ZP
  • 发表时间:2020-04-29
Abstract

BACKGROUND:Since December 2019, the 2019 coronavirus disease (COVID-19) has expanded to cause a worldwide outbreak that more than 600,000 people infected and tens of thousands died. To date, the clinical characteristics of COVID-19 patients in the non-Wuhan areas of Hubei Province in China have not been described. METHODS:We retrospectively analyzed the clinical characteristics and treatment progress of 91 patients diagnosed with COVID-19 in Jingzhou Central Hospital. RESULTS:Of the 91 patients diagnosed with COVID-19, 30 cases (33.0%) were severe and two patients (2.2%) died. The severe disease group tended to be older (50.5 vs. 42.0 years; p = 0.049) and have more chronic disease (40% vs. 14.8%; p = 0.009) relative to mild disease group. Only 73.6% of the patients were quantitative polymerase chain reaction (qPCR)-positive on their first tests, while typical chest computed tomography images were obtained for each patient. The most common complaints were cough (n = 75; 82.4%), fever (n = 59; 64.8%), fatigue (n = 35; 38.5%), and diarrhea (n = 14; 15.4%). Non-respiratory injury was identified by elevated levels of aspartate aminotransferase (n = 18; 19.8%), creatinine (n = 5; 5.5%), and creatine kinase (n = 14; 15.4%) in laboratory tests. Twenty-eight cases (30.8%) suffered non-respiratory injury, including 50% of the critically ill patients and 21.3% of the mild patients. CONCLUSIONS:Overall, the mortality rate of patients in Jingzhou was lower than that of Wuhan. Importantly, we found liver, kidney, digestive tract, and heart injuries in COVID-19 cases besides respiratory problems. Combining chest computed tomography images with the qPCR analysis of throat swab samples can improve the accuracy of COVID-19 diagnosis.

摘要

背景: 自 2019 年 12 月以来,2019 冠状病毒病 (600,000 coronavirus disease,新型冠状病毒肺炎) 已在全球范围内爆发,超过人感染,数万人死亡。迄今为止,中国湖北省非武汉地区新型冠状病毒肺炎患者的临床特征尚未得到描述。 方法: 回顾性分析荆州市中心医院 91 例确诊为新型冠状病毒肺炎患者的临床特点及治疗进展。 结果: 91 例新型冠状病毒肺炎患者中,重症 30 例 (33.0%),死亡 2 例 (2.2%)。重症组倾向于年龄较大 (50.5 vs. 42.0 年; P = 0.049) 且有较多慢性疾病 (40% vs. 14.8%; P = 0.009) 相对于轻症组。只有 73.6% 的患者首次检测定量聚合酶链反应 (qPCR) 阳性,而每个患者都获得了典型的胸部计算机断层扫描图像。最常见的主诉是咳嗽 (n = 75; 82.4%) 、发热 (n = 59; 64.8% 乏力n = 35; 38.5%) 、和腹泻 (n = 14; 15.4%)。非呼吸损伤通过天冬氨酸氨基转移酶 (n = 19.8%) 、肌酐 (n = 5; 5.5%) 和肌酸激酶 (n = 14) 水平升高来确定; 15.4%) 在实验室测试中。非呼吸系统损伤 28 例 (30.8%),其中危重病 50%,轻症 21.3%。 结论: 荆州市患者死亡率总体低于武汉市。重要的是,除了呼吸问题,我们还发现了新型冠状病毒肺炎的肝脏、肾脏、消化道和心脏损伤。将胸部ct图像与咽拭子样本的qPCR分析相结合,可以提高新型冠状病毒肺炎诊断的准确性。

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影响因子:4.36
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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.

翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

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.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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