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新型冠状病毒肺炎流行期间发热门诊就诊情况初步分析
薛晓成1△,姜海燕2△,陈晓平1,张燚1,佘会元3*
0
(1. 海军军医大学(第二军医大学)附属公利医院耳鼻咽喉科, 上海 200135;
2. 海军军医大学(第二军医大学)附属公利医院预防保健科, 上海 200135;
3. 海军军医大学(第二军医大学)附属公利医院感染科, 上海 200135
共同第一作者
*通信作者)
摘要:
目的 观察新型冠状病毒肺炎(COVID-19)流行期间发热门诊就诊情况及COVID-19的发病特点。方法 收集海军军医大学(第二军医大学)附属公利医院2020年1月15日至2020年2月29日发热门诊患者数据(包括COVID-19患者数据),进行流行病学描述性分析。结果 2020年1月15日至2020年2月29日在我院就诊的2193例患者中,以呼吸系统感染最多(97.08%),其次是消化系统感染、泌尿系统感染。疑似COVID-19患者81例,确诊COVID-19患者10例。疑似COVID-19患者中男38例(46.91%)、女43例(53.09%),确诊患者中男4例、女6例;疑似COVID-19患者发病年龄集中在20~69岁(83.95%),确诊的10例COVID-19患者年龄均≥50岁;疑似患者职业主要为公司职员(31例,38.27%)和退休人员(14例,17.28%),确诊的10例患者中8例为退休人员;疑似患者中15例(18.52%)居住地为湖北省,52例(64.20%)有流行病学史,确诊患者中7例居住地为湖北省,全部确诊患者均有流行病学史;疑似和确诊患者的发病周期主要集中在2020年1月21日至2020年2月10日。疑似患者临床表现主要为发热(66例,81.48%)和咳嗽(50例,61.73%),查血常规示白细胞正常65例(80.25%),淋巴细胞正常49例(60.49%)、降低24例(29.63%),13例(16.05%)患者胸部CT有COVID-19特征性表现;在10例确诊患者中,主要临床表现同样为发热(9例)和咳嗽(8例),血常规检查10例白细胞均正常,6例淋巴细胞正常、4例降低,7例患者胸部CT有COVID-19特征性表现。结论 COVID-19以中老年退休人员为主,流行病学时间特点显著,家庭聚集现象明显。
关键词:  新型冠状病毒肺炎  发热门诊  流行病学  临床特征
DOI:10.16781/j.0258-879x.2020.08.0828
投稿时间:2020-03-04修订日期:2020-04-07
基金项目:上海市医学重点专科项目(ZK2019C06),上海市浦东新区卫生系统重点学科群建设资助(PWZxq2017-04),上海市浦东新区卫生系统学科带头人项目(PWRd2018-05),上海市浦东新区卫生和计划生育委员会科研项目(PW2017F-5),上海市浦东新区公利医院拔尖人才项目(GLRb2018-02),上海市浦东新区公利医院青年英才项目(GLRq2017-05).
Visits of fever clinic during the epidemic of coronavirus disease 2019: a preliminary analysis
XUE Xiao-cheng1△,JIANG Hai-yan2△,CHEN Xiao-ping1,ZHANG Yi1,SHE Hui-yuan3*
(1. Department of Otolaryngology, Gongli Hospital, Naval Medical University(Second Military Medical University), Shanghai 200135, China;
2. Department of Prevention and Health Care, Gongli Hospital, Naval Medical University(Second Military Medical University), Shanghai 200135, China;
3. Department of Infectious Diseases, Gongli Hospital, Naval Medical University(Second Military Medical University), Shanghai 200135, China
Co-first authors.
* Corresponding author)
Abstract:
Objective To observe the visits of fever clinic during the epidemic of coronavirus disease 2019 (COVID-19) and the epidemic characteristics of COVID-19, so as to analyze the disease development trend. Methods The clinical data of fever outpatients (including covid-19 patients) in Gongli Hospital affiliated to Naval Medical University (Second Military Medical University) from Jan. 15, 2020 to Feb. 29, 2020 were collected for epidemiological descriptive analysis. Results Among the 2 193 patients visiting our hospital between Jan. 15, 2020 and Feb. 29, 2020, 97.08% had respiratory system infection, followed by digestive system infection and urinary system infection. Eighty-one suspected cases and 10 confirmed cases of COVID-19 were identified. Among the suspected cases, there were 38 males (46.91%) and 43 females (53.09%). Among the confirmed cases, four were males and six were females. The onset age of the suspected cases ranged from 20 to 69 years old (83.95%), and all the 10 confirmed patients were ≥ 50 years old. The suspected patients were mainly employees (31 cases, 38.27%) and retirees (14 cases, 17.28%). Among the 10 confirmed patients, eight cases were retirees. Of the suspected cases, 15 (18.52%) had lived in Hubei province and 52 (64.20%) had an epidemiological history. Of the confirmed cases, seven had lived in Hubei province and all had an epidemiological histories. The onset cycles of suspected and confirmed cases were mainly from Jan. 21, 2020 to Feb. 10, 2020. The main clinical symptoms of the suspected cases were fever (66 cases, 81.48%) and cough (50 cases, 61.73%). The blood routine showed normal white blood cell (65 cases, 80.25%), normal lymphocyte (49 cases, 60.49%) and decreased lymphocyte (24 cases, 29.63%). Chest CT showed COVID-19 characteristics in 13 cases (16.05%). Among the 10 confirmed patients, the main clinical manifestations were also fever (nine cases) and cough (eight cases). The blood routine showed normal white blood cells (10 cases), normal lymphocytes (six cases) and decreased lymphocytes (four cases). Chest CT showed COVID-19 characteristics in seven cases. Conclusion COVID-19 is more common in middle-aged and elderly retirees, with significant epidemiological and family clustering characteristics.
Key words:  coronavirus disease 2019  fever clinics  epidemiology  clinical characteristics