Objectives: To analyze the clinical characteristics of 71 patients with coronavirus disease 2019 (COVID-19).
Methods: The general data, epidemiological data, laboratory tests, imaging examinations, and treatment of 71 patients with COVID-19 admitted to the Sixth People's Hospital of Zhengzhou from January 19, 2020 to March 3, 2020 were retrospectively analyzed.
Results: Of the 71 COVID-19 patients, the ages were 4-84 (41.29±15.21) years, 38 (53.5%) patients were male, 33 (46.5%) were female, and 52 (73.2%) were in 22 clusters. The main clinical manifestations were fever (78.9%), cough (64.8%), and sputum (38.0%). The fever was mainly low and moderate, with 49 patients (69.0%) at 37.3-39.0 ℃. Most of the leukocytes, neutrophils, and lymphocytes were normal, accounting for 47 (66.2%), 51 (71.8%), and 51 (71.8%) patients, respectively; a few of them were decreased, accounting for 21 (29.6%), 16 (22.5%), and 20 (28.2%) patients, respectively. There were 38 (53.5%) and 31 (43.7%) patients with the decreased CD4+ and CD8+ T cell counts, respectively. There were 41 (57.7%), 38 (53.5%), 32 (45.1%), 26(36.6%), 22 (31.0%), 20 (28.2%), 14 (19.7%), 14 (19.7%), and 9 (12.7%) patients with the increased levels of C-reactive protein, erythrocyte sedimentation rate, procalcitonin, fibrinogen,interleukin 6, lactate dehydrogenase,D-dimer,alanine aminotransferase, and aspartate aminotransferase, respectively. Of the 71 patients, the lung was involved in 60 (84.5%) patients, the double lung was involved in 47 (66.2%) patients, and the single lung was involved in 13 (18.3%) patients. The course of the disease was long, and the time from symptom onset to the second severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid negative transformation was (17.22±6.34) days.There were no significant differences in the incubation period (t=-0.453, P>0.05), the complicates (χ2=0.042, P>0.05), and the time from symptom onset to diagnosis (t=-1.330, P>0.05) in patients between the non-severe group and the severe group. The onset age, gender, SARS-CoV-2 nucleic acid negative time, lymphocyte count, D-dimer, C-reactive protein, total bilirubin, direct bilirubin, lactate dehydrogenase, calcium ion, CD4+ T cell count, CD8+ T cell count, calcitonin, procalcitonin, and troponin were significantly different between the severe group and the non-severe group (all P<0.05). Among the 71 patients, 4 (5.6%) patients were mild, 59 (83.1%) were normal, and 8 (11.3%) were severe or critical.
Conclusions: The aggregation phenomenon of COVID-19 is obvious. Fever and cough are the main clinical manifestations. White blood cells, neutrophils, and lymphocytes in the most patients in the early onset are normal. Most COVID-19 patients are light and ordinary type, with good prognosis.
目的: 分析71例2019冠状病毒病(coronavirus disease 2019，COVID-19)患者的临床特征。方法: 回顾性分析郑州市第六人民医院于2020年1月19日至3月3日收治的71例COVID-19患者的一般资料、流行病学资料、实验室检查指标、影像学表现及治疗情况，总结疾病的临床特征。结果: 71例患者年龄为4~84(41.29±15.21)岁，其中男38例(53.5%)，女33例(46.5%)。52例(73.2%)属于22起聚集性疫情发病。患者以发热[56例(78.9%)]、咳嗽[46例(64.8%)]、咳痰[27例(38.0%)]为主要临床表现。发热以低、中热为主，37.3~39.0 ℃共49例(69.0%)。白细胞、中性粒细胞及淋巴细胞数正常者分别有47例(66.2%)，51例(71.8%)及51例(71.8%)，下降者分别有21例(29.6%)，16例(22.5%)及20例(28.2%)；38例(53.5%)出现CD4+ T淋巴细胞计数下降，31例(43.7%)出现CD8+ T淋巴细胞计数下降；38例(53.5%)红细胞沉降率升高，41例(57.7%)C反应蛋白、32例(45.1%)降钙素原、26例(36.6%)纤维蛋白原、22例(31.0%)白介素-6、20例(28.2%)乳酸脱氢酶、14例(19.7%)D-二聚体、14例(19.7%)丙氨酸氨基转移酶、9例(12.7%)天门冬氨酸氨基转移酶水平升高。发病早期即可累及肺部，71例中累及肺部的有60例(84.5%)，其中累及双肺的47例(66.2%)，累及单肺13例(18.3%)。病程较长，从出现症状到第2次严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2，SARS-CoV-2)核酸转阴时间为(17.22±6.34) d。重症组患者与非重症组患者在潜伏期(t=-0.453，P>0.05)、基础疾病合并情况(χ2=0.042，P>0.05)、出现症状到确诊时间(t=-1.330，P>0.05)上差异无统计学意义，在发病年龄、性别、SARS-CoV-2核酸转阴时间、淋巴细胞计数、D-二聚体、C反应蛋白、总胆红素、直接胆红素、乳酸脱氢酶、钙离子、CD4+ T淋巴细胞计数、CD8+ T淋巴细胞计数、降钙素原、肌红蛋白及肌钙蛋白方面的差异有统计学意义(均P<0.05)。71例患者中轻症4例(5.6%)、普通型59例(83.1%)、重症和危重症8例(11.3%)。结论: COVID-19聚集性发病现象明显，应高度重视并预防；以发热、咳嗽为主要临床表现；在发病早期大部分患者白细胞、中性粒细胞、淋巴细胞数正常；大部分为轻症及普通型的患者，预后良好。.
Keywords: clinical characteristics; coronavirus disease 2019; cough; fever; pneumonia; severe acute respiratory syndrome coronavirus 2.