LIANG Lianshao 1 , LIN Yanrong 1 , LI Zhifeng 1 , XIE Zhouhua , 1
01 August 2020
SARS-CoV-2, pneumonia, clinical features, differential diagnosis
Objective To analyze the characteristics of suspected and confirmed cases of coronavirus disease 2019 (COVID-19), and we provide relevant clinical evidence for epidemic prevention and control.
Methods Retrospective review of 50 inpatients of COVID-19 diagnosed in Nanning Fourth People's Hospital during January 24th 2020 to February 11th 2020, according to the SARS-CoV-2 nucleic acid test (real-time reverse transcription polymerase chain reaction). The general situation , epidemiology and clinical manifestations of the infections were collected and analyzed.
Results Of the 50 patients, 22 were male and 28 were female; The average age were (36 土 16) years old, these cases distributed across all age group; Most of them were imported cases and 86% were Wuhan related persons. At last, 13 cases were diagnosed as SARS-CoV-2 infected, 7 cases could be diagnosed by two or more throat swab nucleic acid tests, 1 case co-infected with influenza A(H1N1), 37 cases with non SARS-CoV-2 infected, including 26 cases of bacterial pneumonia, 6 cases with simple influenza A(H1N1), 5 cases with B-influenza virus infection; the most common symptoms were fever (32/50) and cough (24/50), and the general symptoms were fatigue (12/50) , gastrointestinal symptoms were rare. 94% of the patients had normal / decreased leukocyte count, 30% of the patients had decreased lymphocyte count, no impairment of heart, liver and kidney function, 86% of the patients showed pneumonia on chest CT, mainly ground glass shadow (60%) and patchy shadow (56%), pleural effusion was rare.
Conclusions Epidemiological history is one of the most important condition in screening suspected cases of COVID-19. The attention should be paid to the identification and mixed infection with influenza viruses. Early detection and isolation of suspected cases of COVID-19 will have an important impact on the prevention and control of outbreak.
摘要:目的 收集疑似和确诊的新型冠状病毒肺炎(COVID-19)患者病历资料,分析患者相关病例特点,为疫情防 控提供相关临床依据。 方法 本研究回顾性收集2020年1月24日一2月11日在南宁市第四人民医院就诊,符合新型 冠状病毒肺炎疑似病例诊断标准的患者50例的临床资料,根据咽拭子进行SARS-CoV-2实时逆转录聚合酶链反应检 测结果,确诊或除外SARS-CoV-2感染,分析其一般情况、流行病学、临床表现等方面特征。 结果 本研究疑似患者共 50例,男22例,女28例,平均年龄(36±16)岁,各年龄段人群均有分布;大部分为输人性病例,86%患者为武汉相关人 员。最终有13例确诊为SARS-CoV-2感染者,7例经2次及其以上咽拭子核酸检测方可确诊,1例合并甲型HIN1。37 例为非SARS-CoV-2感染患者,其中26例细菌性肺炎,6例为单纯性甲型HIN1,5例乙型流感病毒感染;最常见的症状 是发热(32/50)和咳嗽(24/50),周身症状以乏力多见(12/50),消化道症状少见。94%的患者白细胞计数正常/降低,30% 的淋巴细胞计数减少,无心肝肾功能损害表现,86%患者胸部CT提示肺炎表现,以毛磨玻璃影(60%)和斑片状影 (56%)为主,胸腔积液少见。 结论 流行病学史是筛查新型冠状病毒肺炎疑似病例的重要条件之一,诊断需注意警惕 同流感病毒的鉴别及混合叠加感染;疑似病例的早期发现及隔离诊治对疫情防控有重要影响。
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