Clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study
Clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study
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2019年冠状病毒病出院患者的临床特征和结果：一项前瞻性队列研究
DOI：
10.1093/qjmed/hcaa178
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发表时间：
2020-09-01
影响因子：
13.3
通讯作者：
Xu, S.
中科院分区：
文献类型：
--
作者：
Wang, X.;Xu, H.;Xu, S.
背景资料：2019冠状病毒病2019冠状病毒病（COVID-19）是一种全球性流行病，但出院患者的随访数据几乎没有描述。目的：调查COVID-19患者出院后的临床结局、隔离地点分布和接触者的感染状况。设计：前瞻性队列研究。方法：通过回顾性审查病历，收集并分析了中国武汉市131名2020年2月3日至2020年2月21日出院的COVID-19患者的人口统计学、基线特征。通过每周对患者进行长达4周的随访，获得与临床结局、隔离地点和密切接触史相关的住院后数据。五十三40.05%的患者出院时有咳嗽29.01%、乏力7.63%、咳痰6.11%、胸闷6.11%、呼吸困难3.82%、胸痛3.05%、心悸1.53%。这些症状在出院后4周内持续下降。11例（8.4%）患者出现一过性发热。出院患者中，78例（59.5%）进行了胸部CT检查，2例（1.53%）显示恶化。共有94例（71.8%）患者接受了SARS-CoV-2复检，8例（6.10%）报告阳性。7例（2.29%）患者因发热或SARS-CoV-2复检阳性而再次入院。出院后分别有121例（92.37%）和4例（3.05%）患者在家中或社区点进行自我隔离，与研究终点时未感染COVID-19的共167人密切接触。结论：大多数COVID-19患者出院后处于恢复期。在极少数情况下，由于怀疑COVID-19复发而需要再次入院。虽然没有发现接触性感染，但有必要进行适当的自我隔离和定期复查，特别是那些症状复发的人。
Background: Coronavirus disease 2019 (COVID-19) is a global pandemic but the follow-up data of discharged patients was barely described.Aim: To investigate clinical outcomes, distribution of quarantine locations and the infection status of the contacts of COVID-19 patients after discharge.Design: A prospective cohort study.Methods: Demographics, baseline characteristics of 131 COVID-19 patients discharged from 3 February 2020 to 21 February 2020 in Wuhan, China were collected and analyzed by reviewing the medical records retrospectively. Post-hospitalization data related to clinical outcomes, quarantine locations and close contact history were obtained by following up the patients every week up to 4 weeks.Results: Fifty-three (40.05%) patients on discharge had cough (29.01%), fatigue (7.63%), expectoration (6.11%), chest tightness (6.11%), dyspnea (3.82%), chest pain (3.05%) and palpitation (1.53%). These symptoms constantly declined in 4 weeks postdischarge. Transient fever recurred in 11 (8.4%) patients. Among the discharged patients, 78 (59.5%) underwent chest CT and 2 (1.53%) showed deterioration. A total of 94 (71.8%) patients received SARS-CoV-2 retest and 8 (6.10%) reported positive. Seven (2.29%) patients were readmitted because of fever or positive SARS-CoV-2 retest. After discharge, 121 (92.37%) and 4 (3.05%) patients were self-quarantined at home or community spots, respectively, after a close contact with 167 persons in total who were free of COVID-19 at the endpoint of study.Conclusion: The majority of COVID-19 patients after discharge were in the course of recovery. Readmission was required in rare cases due to suspected recurrence of COVID-19. Although no contacted infection observed, appropriate self-quarantine and regular re-examination are necessary, particularly for those who have recurred symptoms.