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6例确诊新型冠状病毒肺炎患者临床特征分析
余姣,薛建亚,黄飞虎,尹伟,黄倩云,梁雪松*,李成忠*
0
(海军军医大学(第二军医大学)长海医院感染科, 上海 200433
*通信作者)
摘要:
目的 分析新型冠状病毒肺炎(COVID-19)确诊患者的临床特征及流行病学特征,探讨该病早期识别与诊断的方法与经验。方法 归纳截至2020年2月12日海军军医大学(第二军医大学)长海医院感染科6例确诊COVID-19患者的流行病学特征、症状、体征、实验室检查及影像学检查结果,总结其特点与规律。结果 6例确诊COVID-19患者中男5例,女1例。青年患者2例,年龄分别为28、29岁;中老年患者4例,年龄分别为45、62、71、75岁。6例患者起病前均有明确的流行病学接触史,其中2例为家庭聚集性病例。临床表现均以发热和呼吸道症状为主,临床分型均为普通型。6例患者经上海市杨浦区疾病预防控制中心严重急性呼吸综合征冠状病毒2核酸检测均为阳性,实验室检查提示白细胞计数5例正常,1例略降低;淋巴细胞计数3例减少,3例正常。未见其他呼吸道病原体感染证据。6例患者CT检查结果均具有磨玻璃样或双侧斑片状影等典型病毒性肺炎特征。结论 COVID-19传染性很强,人群普遍易感,尽早识别感染者并隔离传染源是防止病毒传播的重要手段。流行病学史仍然是COVID-19诊断的重中之重,CT联合病毒PCR核酸检测是确诊COVID-19的有效方法。
关键词:  新型冠状病毒肺炎  临床特征  流行病学  X线计算机体层摄影术
DOI:10.16781/j.0258-879x.2020.04.0378
投稿时间:2020-02-16修订日期:2020-03-27
基金项目:
Clinical characteristics of 6 confirmed coronavirus disease 2019 patients
YU Jiao,XUE Jian-ya,HUANG Fei-hu,YIN Wei,HUANG Qian-yun,LIANG Xue-song*,LI Cheng-zhong*
(Department of Infectious Diseases, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding authors)
Abstract:
Objective To analyze the clinical and epidemiological characteristics of confirmed patients with coronavirus disease 2019 (COVID-19), and to explore the methods and experiences of early identification and diagnosis of COVID-19. Methods The epidemiological characteristics, symptoms, signs, laboratory and imaging findings of 6 confirmed COVID-19 patients diagnosed in Department of Infection Diseases, Changhai Hospital of Naval Medical University (Second Military Medical University) up to Feb. 12, 2020, were summarized. Results Among the 6 confirmed patients, 5 were males and one was female. There were two young patients, aged 28 and 29 years, and four elderly patients, aged 45, 62, 71 and 75 years, with anaverage age of 63.2 years. All the 6 patients had a clear epidemiological contact history before the onset of the disease, and 2 of them were family clustering cases. Clinical classification of all the 6 patients was ordinary type with fever and respiratory symptoms as the main manifestations. All patients were tested positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid by Centers for Disease Control and Prevention, Yangpu District, Shanghai. Laboratory tests showed the normal leukocyte count in 5 patients and a slightly decreased level in one patient. Decreased leukomonocyte count was found in 3 patients and the other 3 cases were within the normal range. There were no other respiratory pathogens except SARS-CoV-2. The CT scan showed the manifestations of typical viral pneumonia in all patients with ground-glass opacity or bilateral patchy shadow. Conclusion COVID-19 is highly infectious and all populations are susceptible to it. Early identification and isolation of the sources of infection are important to prevent the spread of the virus. The epidemiological history is very important for diagnosis, and CT scan combined with viral PCR nucleic acid test is an effective diagnostic method.
Key words:  coronavirus disease 2019  clinical characteristics  epidemiology  X-ray computed tomography