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2019冠状病毒病中国患者的临床特征
Clinical Characteristics of Coronavirus Disease 2019 in China


Wei-jie Guan ... 呼吸系统疾病 • 2020.04.30
NEJM 动画解读

COVID-19的临床特征
相关阅读
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中国新型冠状病毒感染患者的临床特征释疑

 

关伟杰,梁文华,何建行,钟南山*

呼吸疾病国家重点实验室,呼吸疾病国家临床研究中心,广州呼吸健康研究院,广州医科大学附属第一医院,广州医科大学

*通讯作者

 

研究的亮点有哪些

本研究1首次收集全国范围的新冠患者,通过分析大样本量数据:

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摘要


背景

2019冠状病毒病(COVID-19)于2019年12月在中国武汉市出现并在中国大陆迅速传播,此后我们一直需要收集患者的临床特征数据。

 

方法

我们提取了截至2020年1月29日中国大陆30个省、自治区和直辖市552家医院1,099例经实验室确诊的COVID-19患者的数据。主要复合终点是送入重症监护病房(ICU)、采用机械通气或死亡。

 

结果

患者中位年龄为47岁;女性占41.9%。67例患者(6.1%)发生了主要复合终点,包括送入ICU的5.0%、接受有创机械通气的2.3%和死亡的1.4%。仅1.9%的患者有与野生动物的直接接触史。在非武汉居民中,72.3%有与武汉居民的接触史,其中31.3%曾去过武汉。最常见症状为发热(入院时43.8%有发热,住院期间88.7%有发热)和咳嗽(67.8%)。腹泻不常见(3.8%)。中位潜伏期为4天(四分位距,2~7)。入院时,磨玻璃影是胸部计算机断层扫描(CT)中最常见的影像学表现(56.4%)。877例非重症患者中的157例(17.9%)和173例重症患者中的5例(2.9%)无影像学或CT异常。入院时,83.2%的患者有淋巴细胞减少。

 

结论

在此次疫情的前2个月期间,COVID-19在中国大陆迅速传播,并引起了不同程度的疾病。患者就诊时常无发热,许多无影像学异常表现(由中国国家卫生健康委员会等资助)。





作者信息

Wei-jie Guan, Ph.D., Zheng-yi Ni, M.D., Yu Hu, M.D., Wen-hua Liang, Ph.D., Chun-quan Ou, Ph.D., Jian-xing He, M.D., Lei Liu, M.D., Hong Shan, M.D., Chun-liang Lei, M.D., David S.C. Hui, M.D., Bin Du, M.D., Lan-juan Li, M.D., Guang Zeng, M.Sc., Kwok-Yung Yuen, Ph.D., Ru-chong Chen, M.D., Chun-li Tang, M.D., Tao Wang, M.D., Ping-yan Chen, M.D., Jie Xiang, M.D., Shi-yue Li, M.D., Jin-lin Wang, M.D., Zi-jing Liang, M.D., Yi-xiang Peng, M.D., Li Wei, M.D., Yong Liu, M.D., Ya-hua Hu, M.D., Peng Peng, M.D., Jian-ming Wang, M.D., Ji-yang Liu, M.D., Zhong Chen, M.D., Gang Li, M.D., Zhi-jian Zheng, M.D., Shao-qin Qiu, M.D., Jie Luo, M.D., Chang-jiang Ye, M.D., Shao-yong Zhu, M.D., and Nan-shan Zhong, M.D. for the China Medical Treatment Expert Group for Covid-19*
From the State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University (W.G., W.L., J.H., R.C., C.T., T.W., S.L., Jin-lin Wang, N.Z., J.H., W.L.), the Departments of Thoracic Oncology (W.L.), Thoracic Surgery and Oncology (J.H.), and Emergency Medicine (Z.L.), First Affiliated Hospital of Guangzhou Medical University, and Guangzhou Eighth People’s Hospital, Guangzhou Medical University (C.L.), and the State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University (C.O., P.C.), Guangzhou, Wuhan Jinyintan Hospital (Z.N., J.X.), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (Yu Hu), the Central Hospital of Wuhan (Y.P.), Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine (L.W.), Wuhan Pulmonary Hospital (P.P.), Tianyou Hospital Affiliated to Wuhan University of Science and Technology (Jian-ming Wang), and the People’s Hospital of Huangpi District (S.Z.), Wuhan, Shenzhen Third People’s Hospital and the Second Affiliated Hospital of Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases (L. Liu), and the Department of Clinical Microbiology and Infection Control, University of Hong Kong–Shenzhen Hospital (K.-Y.Y.), Shenzhen, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai (H.S.), the Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin (D.S.C.H.), and the Department of Microbiology and the Carol Yu Center for Infection, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pok Fu Lam (K.-Y.Y.), Hong Kong, Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences (B.D.), and the Chinese Center for Disease Control and Prevention (G.Z.), Beijing, the State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou (L. Li), Chengdu Public Health Clinical Medical Center, Chengdu (Y.L.), Huangshi Central Hospital of Edong Healthcare Group, Affiliated Hospital of Hubei Polytechnic University, Huangshi (Ya-hua Hu), the First Hospital of Changsha, Changsha (J. Liu), the Third People’s Hospital of Hainan Province, Sanya (Z.C.), Huanggang Central Hospital, Huanggang (G.L.), Wenling First People’s Hospital, Wenling (Z.Z.), the Third People’s Hospital of Yichang, Yichang (S.Q.), Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan (J. Luo), and Xiantao First People’s Hospital, Xiantao (C.Y.) — all in China. Address reprint requests to Dr. Zhong at the State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Rd., Guangzhou, Guangdong, China, or at nanshan@vip.163.com. A list of investigators in the China Medical Treatment Expert Group for Covid-19 study is provided in the Supplementary Appendix, available at NEJM.org.

 

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NEJM 动画解读

COVID-19的临床特征

相关阅读
• DNA疫苗在猴体内产生对抗SARS-CoV-2感染的防护作用 • COVID-19的不同临床病程应归因于病毒还是宿主因素 • 推进RNA疫苗研发工作 • COVID-19与肾移植 • COVID-19大流行期间治疗的紧迫性——让我们随学随用 • 羟氯喹治疗COVID-19住院患者的观察性研究 • SARS-CoV-2的PCR检测法:对检测法进行检测 • 进入SARS-CoV-2抗体检测的时代:问题比答案还多 • 不为人知的代价——COVID-19全球大流行对其他疾病患者的影响 • 托珠单抗有可能减轻COVID-19患者的“细胞因子风暴” • COVID-19的潜在并发症吉兰-巴雷综合征 • 如何快速发现抗病毒药 • 妊娠中期SARS-CoV-2感染 • 如何采集鼻咽拭子样本 • 洛匹那韦-利托那韦治疗COVID-19的试验 • ST段抬高和COVID-19的关系:纽约病例系列 • 反复出现的人类冠状病毒在美国密歇根州的长期传播 • COVID-19的肝脏表现 • 洗手液成分对SARS-CoV-2的抗病毒效果 • 无形之手——全球大流行期间的医疗服务 • COVID-19患者的产科诊疗建议 • 恢复期血浆治疗重症COVID-19患者 • COVID-19患者胰腺损伤的血清学证据 • COVID-19大流行期间的ACE抑制剂和ARB用药 • COVID-19的胃肠道症状 • 症状出现前的SARS-CoV-2传播 • 法匹拉韦是否是对COVID-19可能有效的抗病毒药 • 2019年从中国肺炎患者分离出的新型冠状病毒 • 一个专业养老院内的症状前SARS-CoV-2感染及传播 • 无症状传播是目前COVID-19控制策略的阿喀琉斯之踵 • 中国武汉孕产妇COVID-19患者的临床特征 • COVID-19大流行时期的药物评估 • 液滴与气溶胶在传播SARS-CoV-2中的作用 • 通过激光散射观察讲话产生的口腔液滴 • 入院分娩女性的SARS-CoV-2普遍筛查 • 瑞德西韦同情用药治疗重症COVID-19患者 • 以疾病大流行的速度开发针对COVID-19的疫苗 • 新冠状病毒和老教训——为大流行做好医疗系统的准备 • COVID-19——寻找有效的治疗方法 • 洛匹那韦-利托那韦治疗重症COVID-19成人住院患者的试验 • 新冠疫情的种种是非,是不是昔日重来 • 新冠肺炎可能成为百年不遇的大流行病 • 恢复期血浆在治疗COVID-19方面有潜在效用 • 死亡的中度至危重COVID-19患者的临床特征 • 合并凝血异常和抗磷脂抗体的COVID-19病例 • 儿童感染SARS-CoV-2的情况 • 10周让疾病曲线归零 • 武汉COVID-19患者的心脏损伤 • COVID-19对中国医疗人员心理健康的影响 • 美国三个心脏领域学会联合声明:COVID-19患者应继续服用ACE抑制剂和ARB • ACE2是SARS-CoV-2进入细胞所需的受体 • 从中国武汉旅行归来者的SARS-CoV-2感染 • 隔离对心理的影响:一篇定性“快速综述” • 2020年1月初在中国武汉儿童中检出的COVID-19 • 逃出潘多拉魔盒——又一种新型冠状病毒 • 为疫情期间开展随机临床试验建立框架 • 从中国武汉旅行归来者的SARS-CoV-2感染证据 • Covid-19疫情应对——在茫茫未知中前行 • 新型冠状病毒感染肺炎在中国武汉的初期传播动力学 • 阐明COVID-19流行病学需要开展的研究
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