中国2019年新型冠状病毒感染的临床特征 钟南山院士

Clinical characteristics of 2019 novel coronavirus infection in China

中国2019年新型冠状病毒感染的临床特征

Nan-shan Zhong钟南山院士等

【Abstract】

Background:

Since December 2019, acute respiratory disease (ARD) due to 2019 novel coronavirus (2019-nCoV) emerged in Wuhan city and rapidly spread throughout China. We sought to delineate the clinical characteristics of these cases.

Methods:

We extracted the data on 1,099 patients with laboratory-confirmed 2019-nCoV ARD from 552 hospitals in 31 provinces/provincial municipalities through January 29th, 2020.

Results:

The median age was 47.0 years, and 41.90% were females. Only 1.18% of patients had a direct contact with wildlife, whereas 31.30% had been to Wuhan and 71.80% had contacted with people from Wuhan. Fever (87.9%) and cough (67.7%) were the most common symptoms. Diarrhea is uncommon. The median incubation period was 3.0 days (range, 0 to 24.0 days).

On admission, ground-glass opacity was the typical radiological finding on chest computed tomography (50.00%). Significantly more severe cases were diagnosed by symptoms plus reverse-transcriptase polymerase-chain-reaction without abnormal radiological findings than non-severe cases (23.87% vs. 5.20%, P<0.001). Lymphopenia was observed in 82.1% of patients. 55 patients (5.00%) were admitted to intensive care unit and 15 (1.36%) succumbed. Severe pneumonia was independently associated with either the admission to intensive care unit, mechanical ventilation, or death in multivariate competing-risk model (sub-distribution hazards ratio, 9.80; 95% confidence interval, 4.06 to 23.67).

Conclusions:

The 2019-nCoV epidemic spreads rapidly by human-to-human transmission. Normal radiologic findings are present among some patients with 2019-nCoV infection. The disease severity (including oxygen saturation, respiratory rate, blood leukocyte/lymphocyte count and chest X-ray/CT manifestations) predict poor clinical outcomes.

Key words:

2019 novel coronavirus; acute respiratory disease; transmission; mortality; risk factor

【摘要】

研究背景：

自2019年12月以来，由于2019年新型冠状病毒（2019-nCoV）引起的急性呼吸道疾病（ARD）在武汉市出现并迅速在全国传播。 我们试图描述这些病例的临床特征。
研究方法：

截止2020年1月29日，我们从31个省、自治区和直辖市的552家医院中提取了1,099名经实验室确认的2019-nCoV 急性呼吸道疾病患者的数据。
研究结果：

中位年龄为47.0岁，41.90％为女性。仅1.18％的患者直接接触过野生动植物，然而31.30％的患者去过武汉，71.80％的患者接触过来自武汉的人。发热（87.9％）和咳嗽（67.7％）是最常见的症状。腹泻很少见。中位潜伏期为3.0天（范围为0至24.0天）。入院时，毛玻璃样不透明是胸部CT的典型影像学表现（50.00％）。通过症状加逆转录酶聚合酶链反应（RT-PCR）诊断而无异常放射学表现的严重病例比非严重病例更为严重（23.87％vs.5.20％，P<0.001）。在82.1％的患者中观察到了淋巴细胞减少。55名患者（5.00％）入住重症监护病房（ICU），15名患者（1.36％）死亡。在多变量竞争风险模型中，重症肺炎与入住重症监护病房，机械通气或死亡独立相关（亚分布危险比为9.80； 95％可信区间（CI）为4.06至23.67）。

研究结论：

2019新型冠状病毒通过人传人传播方式迅速流行性传播。在一些2019-nCoV感染的患者中，存在影像学表现正常。该疾病的严重程度（包括血氧饱和度，呼吸频率，白血球/淋巴细胞计数和胸部X线/ CT表现）预示了不良的临床结果。
关键词：

2019新型冠状病毒；急性呼吸系统疾病；传播；死亡率；危险因素