医院工作人员COVID-19临床特征

Q4 Medicine
J. Yin, Ruiyun Li, Xiaojun Wu
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引用次数: 1

摘要

目的:了解医院工作人员感染COVID-19的临床特点,以减少医院传播,提高治愈率,降低死亡率。选择2020年1月31日至2月10日在武汉大学人民医院隔离病房就诊的95名新型冠状病毒肺炎工作人员为研究对象,回顾其临床症状、血液检查结果、呼吸道病毒鼻咽拭子RNA检测、新型冠状病毒RNA检测(痰、粪便)、胸部CT成像及临床结局。(1)新冠肺炎感染人员中位数年龄为35岁,女性多于男性(61例比34例),以医生、护士或医务技术人员为主(81例),其中慢性疾病患者12例(12.6%)进行了有创手术(气管插管、胃镜、鼻咽镜、血液透析等),其中9例(9.5%)进行了有创手术(气管插管、胃镜检查、鼻咽镜检查、血液透析等)。常见的84例(88 4%),5例(5 3%),和一个病例是在非常严重的类型(1 1%)的平均时间从出现症状到第一次住院5天(2)中最常见的症状是发烧67例(70 5%),咳嗽在60例(63 2%),疲劳在39例(41 1%),和(3)白细胞总数正常或减少90例(94 7%),中性粒细胞计数正常75例(78 9%),淋巴细胞计数下降29例(30.5%),超敏c反应蛋白升高21例(22.1%),血小板计数和肾功能(肌酐)无明显变化,总蛋白下降43例(45.3%),白蛋白下降36例(37.9%),转氨酶升高12例(12.6%),其中鼻咽拭子检测其他常见呼吸道病毒RNA 78例。(4) CT影像学显示90例患者肺部出现肺炎样改变,66例(69.5%)表现为双侧肺炎,其中70例(73.7%)表现为片状、斑片状、斑片状磨玻璃影或絮状影,部分表现为脊髓影,其中实变为主要表现3例(3.2%);1例(1.1%)合并胸腔积液和心包积液。医院工作人员的临床症状、血液检查和胸部CT影像学表现与普通患者相似,但其年龄、性别分布及预后与普通患者不同,医院工作人员感染可能通过与患者密切接触、气溶胶传播、飞沫传播、各种高危医疗操作、家庭聚会等途径传播©2021,武汉大学医学杂志编辑委员会版权所有
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical characteristics of COVID-19 among hospital staff
Objective: To investigate the clinical characteristics of hospital staff with COVID-19, so as to reduce hospital transmission, improve the cure rate and reduce the mortality Methods: A total of 95 staff with COVID-19 in the isolation ward of Renmin Hospital of Wuhan University were selected as the study subjects from January 31 to February 10, 2020 Their clinical symptoms, results of blood test, respiratory virus nasopharyngeal swab RNA detection, novel coronavirus RNA detection (sputum, stool), chest CT imaging, and clinical outcomes were reviewed Results: (1) Among the staff with COVID-19 infection, the median age was 35 years old The cases of female were more than male cases (61 cases versus 34 cases), and most cases (81 cases) were doctors, nurses, or medical technicians Twelve (12 6%) patients had chronic diseases Invasive operations (endotracheal intubation, gastroscopy, nasopharyngoscopy, hemodialysis, etc ) were performed in 9 cases(9 5%) According to the clinical classification, 5 cases were mild (5 3%), 84 cases were in common type (88 4%), 5 cases were severe (5 3%), and one case was in very severe type (1 1%) The median time from onset of symptoms to first hospital admission was 5 days (2) The most common symptoms at onset were fever in 67 cases (70 5%), cough in 60 cases (63 2%), fatigue in 39 cases (41 1%), and so on (3) The total leukocyte count was normal or decreased in 90 cases (94 7%), the neutrophil count was normal in 75 cases (78 9%), and lymphocyte count decreased in 29 cases (30 5%) Hypersensitive C-reactive protein increased in 21 cases (22 1%) There was no significant change in platelet count and renal function (creatinine) 43 (45 3%) patients had decreased total protein, 36 (37 9%) patients had decreased albumin, and 12 (12 6%) patients had elevated transaminase Among them, 78 patients were tested for RNA from nasopharyngeal swabs of other common respiratory viruses, and only 3 patients were positive (4) According to CT imaging, there were pneumonia-like changes in the lungs of 90 patients, and 66 patients (69 5%) showed bilateral pneumonia Among them, 70 cases (73 7%) showed flaky, patchy, patchy ground glass shadow or flocculent shadow, as well as some with cord shadow Among them, 3 cases (3 2%) showed consolidation as the main manifestation, and bronchial inflation sign was seen in some cases One patient (1 1%) was complicated with pleural effusion and pericardial effusion Conclusion: The clinical symptoms, blood test and chest CT imaging findings of COVID-19 of hospital staff are similar to those of ordinary patients, but the age and sex distribution and prognosis of hospital staff are different from those of ordinary patients Infection among hospital staff may be transmitted through close contact with patients, aerosol transmission, droplet transmission, various high-risk medical operations, family gathering, etc © 2021, Editorial Board of Medical Journal of Wuhan University All right reserved
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武汉大学学报(医学版)
武汉大学学报(医学版) Medicine-Medicine (all)
CiteScore
0.30
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7289
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