The clinical characteristics of pneumonia patients coinfected with 2019 novel coronavirus and influenza virus in Wuhan, China
The clinical characteristics of pneumonia patients coinfected with 2019 novel coronavirus and influenza virus in Wuhan, China
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DOI：
10.1002/jmv.25781
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发表时间：
2020-03-30
影响因子：
12.7
通讯作者：
Liu, Mei
中科院分区：
文献类型：
--
作者：
Ding, Qiang;Lu, Panpan;Liu, Mei
二零一九年新型冠状病毒（COVID-19）感染于二零一九年十二月在中国武汉爆发。自那时以来，新型冠状病毒肺炎疾病迅速蔓延，许多国家和地区受到影响，中国，韩国，意大利和伊朗爆发了重大疫情。流感病毒是冬季常见的病原体，可引起肺炎。临床发现，极少数患者同时被诊断为COVID-19和流感病毒。在115例确诊的COVID-19患者中，共有5例也被诊断为流感病毒感染，其中3例为甲型流感，2例为B型流感。在这项研究中，我们描述了感染COVID-19和流感病毒的患者的临床特征。发病时的常见症状包括发烧（5例[100%]患者），咳嗽（5例[100%]患者），呼吸短促（5例[100%]患者），鼻息肉（3例[60%]患者），咽痛（3例[60%]患者）、肌痛（2例[40%]患者）、疲乏（2例[40%]患者）、头痛（2例[40%]患者）和咳痰（2例[40%]患者）。实验室结果显示，与正常值相比，患者的淋巴细胞减少（4例[80%]患者），肝功能丙氨酸转氨酶和天冬氨酸转氨酶（2例[40%]患者和2例[40%]患者）以及C反应蛋白（4例[80%]患者）在入院时升高。他们分别住院14、30、17、12和19天（28.4 +/- 7.02）。患者的主要并发症为急性呼吸窘迫综合征（1例[20%]患者）、急性肝损伤（3例[60%]患者）和腹泻（2例[40%]患者）。所有患者均给予抗病毒治疗（包括奥司他韦）、吸氧和抗生素治疗。3例患者接受糖皮质激素治疗，其中2例接受口服糖皮质激素治疗。5例患者中有1例接受了暂时性止血药物治疗咯血。幸运的是，所有患者都不需要重症监护室，无死亡情况下出院。总之，同时感染COVID-19和流感病毒的患者似乎没有表现出更严重的病情，因为根据实验室检查结果、影像学研究和患者预后，他们表现出与仅感染COVID-19的患者相似的临床特征。但值得注意的是，对于那些合并感染的患者，可能更容易出现鼻塞和咽痛的症状。
The outbreak of 2019 novel coronavirus (COVID-19) infection emerged in Wuhan, China, in December 2019. Since then the novel coronavirus pneumonia disease has been spreading quickly and many countries and territories have been affected, with major outbreaks in China, South Korea, Italy, and Iran. Influenza virus has been known as a common pathogen in winter and it can cause pneumonia. It was found clinically that very few patients were diagnosed with both COVID-19 and influenza virus. A total of 5 of the 115 patients confirmed with COVID-19 were also diagnosed with influenza virus infection, with three cases being influenza A and two cases being influenza B. In this study, we describe the clinical characteristics of those patients who got infected with COVID-19 as well as influenza virus. Common symptoms at onset of illness included fever (five [100%] patients), cough (five [100%] patients), shortness of breath (five [100%] patients), nasal tampon (three [60%] patients), pharyngalgia (three [60%] patients), myalgia (two [40%] patients), fatigue (two [40%] patients), headache (two [40%] patients), and expectoration (two [40%] patients). The laboratory results showed that compared to the normal values, the patients' lymphocytes were reduced (four [80%] patients), and liver functions alanine aminotransferase and aspartate aminotransferase (two [40%] patients and two [40%] patients) and C-reactive protein (four [80%] patients) were increased when admitted to hospital. They stayed in the hospital for 14, 30, 17, 12, and 19 days (28.4 +/- 7.02), respectively. The main complications for the patients were acute respiratory distress syndrome (one [20%] patients), acute liver injury (three [60%] patients), and diarrhea (two [40%] patients). All patients were given antiviral therapy (including oseltamivir), oxygen inhalation, and antibiotics. Three patients were treated with glucocorticoids including two treated with oral glucocorticoids. One of the five patients had transient hemostatic medication for hemoptysis. Fortunately, all patients did not need intensive care unit and were discharged from the hospital without death. In conclusion, those patients with both COVID-19 and influenza virus infection did not appear to show a more severe condition because based on the laboratory findings, imaging studies, and patient prognosis, they showed similar clinical characteristics as those patients with COVID-19 infection only. However, it is worth noting that the symptoms of nasal tampon and pharyngalgia may be more prone to appear for those coinfection patients.