Epidemiological and clinical characteristics of 46 newly-admitted coronavirus disease 2019 cases in Beijing/ 中华传染病杂志

Ke Wen, Wen-gang Li, Dawei Zhang, Aimin Zhang, Tao Zhang, Peng Zhao, E. Qin
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引用次数: 12

Abstract

Objective To investigate and analyze the epidemiological and clinical characteristics of some cases of coronavirus disease 2019 (COVID-19) in Beijing. Methods A retrospective study was conducted to analyze the data of 46 patients with COVID-19 in Beijing from 20th January 2020 to 8th February 2020 at the Fifth Medical Center of the PLA General Hospital. Features of clinical symptoms, laboratory inspections and imaging inspections were analyzed. Statistical analysis used Fisher exact test. If P<0.05, post-hoc test was used for pairwise comparison, and the statistics were corrected by Bonferroni test. Results Among the 46 patients included in this study, 27 were male and 19 were female. The age range was between 3 - 79 years old, and the mean age was (41.8 ± 16.3) years old. The average incubation period was (4.85 ± 3.00) days. A total of 26 cases (56.5%) were clustered patients, and 12 (26.1%), 23 (50.0%) and 11 patients (23.9%)were assigned to the mild group, common group, and sever group, respectively. Fever (39.8%), cough (27.6%), and fatigue (25.3%) was the main clinical symptom for these patients. The decrease in white blood cell counts occurred in 12 patients, four had the decrease in T lymphocyte counts, 17 had the decrease in CD4 + T lymphocyte counts, seven had the decrease in CD8 + T lymphocyte counts, 21 had the increase level of C-reactive protein (45.7%), and IL-6 level increased in 32 cases (69.6%), erythrocyte sedimentation rate increased in 20 cases(50.0%), serum ferritin level increased in 26 cases (56.5%), and blood lactate level increased in nine cases. There was a statistically significant difference in the number of cases in which the absolute value of T lymphocytes and of CD8 + T lymphocytes decreased among the mild, common and severe groups (all P<0.05). Comparing the number of cases in the three groups with elevated C-reactive protein, interleukin-6, erythrocyte sedimentation rate, serum ferritin and blood lactate levels, the differences were statistically significant (all P<0.05). The number of cases with elevated C-reactive protein levels was higher in severe group than that in mild and common group. The number of cases with elevated interleukin-6, erythrocyte sedimentation rate, and serum ferritin levels were higher in severe group than in mild group. The number of cases with elevated blood lactic acid levels was higher in severe group than in mild group. The differences between the above groups were statistically significant (both adjusted P<0.017). Analysis of chest X-rays showed that 34 patients (73.9%) had inflammation in the lungs. Conclusions The epidemiological characteristics of cases with COVID-19 in Beijing are mainly imported cases and clustered cases. The clinical manifestations are mainly fever , fatigue and cough. C-reactive protein, interleukin-6, red blood cell sedimentation rate, serum ferritin and blood lactate levels are higher in severe patients. Key words: COVID-19; Epidemiology; Clinical characteristics
北京市2019年新冠肺炎46例流行病学及临床特点中华传染病杂志
目的调查分析北京市部分2019冠状病毒病(新冠肺炎)病例的流行病学和临床特点。方法对解放军总医院第五医学中心2020年1月20日至2月8日收治的46例新冠肺炎患者的临床资料进行回顾性分析。分析了临床症状、实验室检查和影像学检查的特点。统计分析采用Fisher精确检验。如果P<0.05,则使用事后检验进行配对比较,并通过Bonferroni检验校正统计数据。结果46例患者中,男性27例,女性19例。年龄在3-79岁之间,平均年龄为(41.8±16.3)岁。平均潜伏期为(4.85±3.00)天。共有26例(56.5%)为聚集性患者,12例(26.1%)、23例(50.0%)和11例(23.9%)分别分为轻度组、普通组和重度组。发热(39.8%)、咳嗽(27.6%)和疲劳(25.3%)是这些患者的主要临床症状。白细胞计数下降发生在12例患者中,4例T淋巴细胞计数下降,17例CD4+T淋巴细胞计数降低,7例CD8+T淋巴细胞数下降,21例C反应蛋白水平升高(45.7%),IL-6水平升高32例(69.6%),红细胞沉降率升高20例(50.0%),血清铁蛋白水平升高26例(56.5%),血乳酸水平升高9例。轻度组、普通组和重度组T淋巴细胞和CD8+T淋巴细胞绝对值下降的病例数差异有统计学意义(均P<0.05)。比较三组C反应蛋白、白细胞介素-6、血沉、血清铁蛋白和血乳酸水平升高的病例数,差异有统计学意义(均P<0.05)。重症组C反应蛋白水平升高的病例数高于轻症和普通组。重症组白细胞介素-6、红细胞沉降率和血清铁蛋白水平升高的病例数高于轻症组。重症组血乳酸水平升高的病例数高于轻症组。上述两组之间的差异具有统计学意义(均经调整P<0.017)。胸部X光片分析显示,34名患者(73.9%)患有肺部炎症。结论北京市新冠肺炎病例的流行病学特征主要为输入性病例和聚集性病例。临床表现以发热、乏力、咳嗽为主。重症患者的C反应蛋白、白细胞介素-6、红细胞沉降率、血清铁蛋白和血乳酸水平较高。关键词:新冠肺炎;流行病学;临床特征
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