上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (05): 559-565.doi: 10.3969/j.issn.1674-8115.2020.05.001

• 新型冠状病毒防控专栏 • 上一篇    下一篇

上海市新型冠状病毒肺炎患者的临床特征及其相关因素分析

仇成豪1，卢洪洲 2，宋 冰3，凌 云2，刘鑫喆1，朱婷婷1   

  1. 1. 上海市（复旦大学附属）公共卫生临床中心口腔科，上海 201500；2. 上海市（复旦大学附属）公共卫生临床中心感染科，上海 201500；3. 北得克萨斯大学健康科学中心生物医学研究生院遗传学系，沃斯堡 TX76107
  • 出版日期:2020-05-28 发布日期:2020-05-28
  • 通讯作者: 卢洪洲，电子信箱：luhongzhou@fudan.edu.cn。
  • 作者简介:仇成豪（1972—），男，主治医师，学士；电子信箱：qch_zsny@163.com。
  • 基金资助:
    上海市传染病重大项目（shslczdzk01102）。

Analysis of clinical features and related factors of coronavirus disease 2019 in Shanghai

QIU Cheng-hao1, LU Hong-zhou2, SONG Bing3, LING Yun2, LIU Xin-zhe1, ZHU Ting-ting1   

  1. 1. Department of Stomatology, Shanghai Public Health Clinical Center, Shanghai 201500, China; 2. Department of Infection, Shanghai Public Health Clinical Center, Shanghai 201500, China; 3. Department of Genetics, Graduate School of Biomedical Science, University of North Texas Health Science Center, Fort Worth TX76107, USA
  • Online:2020-05-28 Published:2020-05-28
  • Supported by:
    Shanghai Major Projects on Infectious Diseases (shslczdzk01102).

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摘要： 目的·探讨上海市本地新型冠状病毒SARS-CoV-2（severe acute respiratory syndrome coronavirus 2）感染人群发病的一般临床特征及其相关影响因素。方法·选取2020年1月—3月在上海市（复旦大学附属）公共卫生临床中心收治住院并确诊为新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）的320例患者为研究对象。收集患者临床资料，分析其临床特征；利用R语言的统计学运算公式，分别对患者的住院天数、超敏C反应蛋白浓度升高天数（超敏天数）、肺部CT好转天数（CT天数）、咽拭子核酸检测转阴天数与其主要临床表现及实验室数据进行相关性分析，寻找影响上述4个变量的关联因素。结果·在320例患者中，轻型患者占6.25%、普通型占83.44%、重型占6.88%、危重型占3.44%，其中91.25%有湖北接触史，79.06%有发热症状，46.56%有咳嗽，21.56%有咳痰，15.31%有疲劳感。Spearman相关性分析结果显示，乳酸脱氢酶浓度、白细胞介素-2（interleukin-2，IL-2）浓度、IL-6浓度分别与上述4个变量呈正相关（均P<0.05），白蛋白浓度与超敏天数呈负相关（P=0.018），CD4+细胞计数与CT天数、核酸转阴天数呈负相关（均P<0.05）。逐步多元线性回归分析结果显示，降钙素原（procalcitonin，PCT）浓度与住院天数、CT天数、超敏天数呈负相关（均P<0.05），分型与住院天数、超敏天数、CT天数、核酸转阴天数呈正相关（均P<0.05）。结论·上海市本地患者以普通型多见，发热、咳嗽、疲劳为常见症状，多伴有肺部CT异常。该类患者的治疗效果及预后与疾病分型、PCT及IL-6浓度、CD4+细胞等水平相关。

关键词: 新型冠状病毒肺炎, 超敏C反应蛋白, 肺部CT, 核酸转阴天数, 住院天数

Abstract:

Objective · To explore the common clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected local patients in Shanghai and their related influencing factors. Methods · A total of 320 patients admitted to Shanghai Public Health Clinical Center from January to March 2020 and diagnosed as having coronavirus disease 2019 (COVID-19) were selected. Clinical data of the patients were collected to analyze their characteristics. Using the statistical operation formula of R language, the correlation analysis of hospitalization days, days of increased hypersensitive C-reactive protein concentration (allergic days), days of lung CT improvement (CT days), and days required for nucleic acid turning negative with the main clinical manifestations and laboratory data was carried out. The correlation factors affecting the above four variables were analyzed. Results · Among the 320 patients, the proportions of mild type, moderate type, serious type and critical type were 6.25%, 83.44%, 6.88% and 3.44%, respectively; 91.25% of them had a history of exposure to Hubei. The proportions of fever, cough, sputum and fatigue were 79.06%, 46.56%, 21.56% and 15.31%, respectively. Spearman correlation analysis showed that the concentrations of lactate dehydrogenase, interleukin-2 (IL-2) and IL-6 were positively correlated with the above four variables, respectively (all P<0.05), albumin concentration was negatively correlated with allergic days (P=0.018), and CD4+ cell count was negatively correlated with CT days and days required for nucleic acid turning negative (both P<0.05). Stepwise multiple linear regression analysis showed that procalcitonin (PCT) concentration was negatively correlated with hospitalization days, CT days and allergic days (both P<0.05), and disease type was positively correlated with hospitalization days, allergic days, CT days and days required for nucleic acid turning negative (all P<0.05). Conclusion · Moderate type is common in the local patients in Shanghai; fever, cough and fatigue are common symptoms, and most of the patients are accompanied by lung CT abnormalities. The therapeutic effect and prognosis of these patients are closely related to disease type, concentrations of PCT and IL-6, as well as CD4+ cell count.

Key words: coronavirus disease 2019 (COVID-19), hypersensitive C-reactive protein (hs-CRP), lung CT, day required for nucleic acid turning negative, hospitalization day

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