朱雯, 周海, 帅小青, 程磊, 翁超. 2022年上海市某区定点医院151例新型冠状病毒肺炎病例临床特征分析[J]. 上海预防医学, 2022, 34(12): 1180-1187. DOI: 10.19428/j.cnki.sjpm.2022.22263
引用本文: 朱雯, 周海, 帅小青, 程磊, 翁超. 2022年上海市某区定点医院151例新型冠状病毒肺炎病例临床特征分析[J]. 上海预防医学, 2022, 34(12): 1180-1187. DOI: 10.19428/j.cnki.sjpm.2022.22263
ZHU Wen, ZHOU Hai, SHUAI Xiaoqing, CHENG Lei, WENG Chao. Clinical characteristics of 151 COVID-19 cases in a designated hospital in a district of Shanghai, 2022[J]. Shanghai Journal of Preventive Medicine, 2022, 34(12): 1180-1187. DOI: 10.19428/j.cnki.sjpm.2022.22263
Citation: ZHU Wen, ZHOU Hai, SHUAI Xiaoqing, CHENG Lei, WENG Chao. Clinical characteristics of 151 COVID-19 cases in a designated hospital in a district of Shanghai, 2022[J]. Shanghai Journal of Preventive Medicine, 2022, 34(12): 1180-1187. DOI: 10.19428/j.cnki.sjpm.2022.22263

2022年上海市某区定点医院151例新型冠状病毒肺炎病例临床特征分析

Clinical characteristics of 151 COVID-19 cases in a designated hospital in a district of Shanghai, 2022

  • 摘要:
    目的 分析2022年上海市151例本土新型冠状病毒肺炎(简称“新冠肺炎”)患者的临床特征。
    方法 回顾2022年4月13日至5月10日上海市某区级定点医院收治的151例新冠肺炎患者临床资料,分析其临床特征、实验室检查、肺部影像学特征以及治疗转归情况。
    结果 151例患者年龄3~97岁,中位年龄72岁,以社区、家庭聚集性病例为主;临床分型以轻型(95例,62.9%)和普通型(47例,31.1%)为主;重型/危重型患者(9例,6.0%)大多数为高龄、合并多种基础疾病;未接种新冠疫苗比例高达66.9%,重型/危重型患者未接种者比例更高。最常见的首发症状是咳痰(71例,47.0%)、发热(51例,33.8%)和干咳(30例,19.9%);轻型、普通型患者白细胞、中性粒细胞计数大多为正常或下降,重型/危重型上升显著(P<0.001);重型/危重型患者D⁃二聚体、肌酐、肌红蛋白、肌钙蛋白升高以及淋巴细胞下降均较其他类型常见(P<0.05);重型/危重型和普通型患者使用抗生素、抗病毒药物、胸腺法新和肝素的比例显著高于轻型(P<0.05)。治愈出院患者(138例,91.4%)中,治疗后核酸转阴中位天数为12 d,轻型患者转阴天数显著短于普通型与重型/危重型(P<0.01);4例(2.6%)死亡病例均>80岁、未接种疫苗、合并多种基础疾病,最终死于原发疾病。
    结论 该区定点医院收治的新冠肺炎患者以聚集性病例为主,未接种新冠疫苗比例高,大多数患者为轻型,但高龄、合并基础疾病多、未接种疫苗均是发展为重型的高危因素。尽早病情评估,制订综合性治疗方案或是改善预后的关键。

     

    Abstract:
    Objective To analyze the clinical characteristics of 151 local COVID-19 patients in Shanghai, 2022.
    Methods The clinical data of 151 COVID-19 patients admitted to a district-level designated hospital in Shanghai from April 13 to May 10, 2022 were reviewed, and their clinical manifestations, laboratory tests, lung imaging, treatment and outcomes were analyzed.
    Results The 151 patients ranged from 3 to 97 years old, with a median age of 72 years. Most of them were clustered cases in the communities and families. The main clinical types were mild (95 cases, 62.9%) and general (47 cases, 31.1%). Most of the 9 severe/critical patients (6.0%) were elderly and complicated with multiple comorbidities. The proportion of people who had not been vaccinated was as high as 66.9%, and the proportion of those among severe/critically ill patients who had not been vaccinated was even higher. The most common first symptoms were expectoration in 71 cases (47.0%), fever in 51 cases (33.8%) and dry cough in 30 cases (19.9%). The counts of white blood cells and neutrophils in mild or general group were mostly normal or decreased, and in the severe/critical group increased significantly (P<0.001). Increase of troponin, D-dimer, creatinine, and myoglobin; and decrease of lymphocytes in severe/critical group were more common than the other clinical types (P<0.05). The proportions of use of antibiotics, antiviral drugs, thymalfasin and heparin in severe/critical and general patients were significantly higher than those in mild patients (P<0.05). Among the cured and discharged patients (138 cases, 91.4%), the median number of days for COVID-19 viral nucleic acid to turn negative after treatment was 12 days. The negative conversion days of mild patients were significantly shorter than those of general patients and severe/critical patients (P<0.01). Four (2.6%) death patients were all over 80 years old, unvaccinated, combined with multiple comorbidities, and eventually died of those serious comorbidities.
    Conclusion COVID-19 patients at the district-level designated hospital are mainly clustered cases, and the proportion of patients who do not receive COVID-19 vaccine is high. Most of the hospitalized patients are mild, but advanced age, multiple underlying diseases, and lack of vaccination are high-risk factors for developing severe disease. Early assessment and comprehensive treatment are the key to improve prognosis.

     

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