Clinical features of 64 patients (outside Hubei) with COVID-19 in Wenzhou, China.
Clinical features of 64 patients (outside Hubei) with COVID-19 in Wenzhou, China.
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中国温州 64 例（湖北以外）COVID-19 患者的临床特征
DOI：
10.21037/jtd-20-1861
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发表时间：
2020-10
影响因子：
2.5
通讯作者：
Dai Y
中科院分区：
文献类型：
--
作者：
Qiu Z;Dai W;Syeda MZ;Ouyang L;Lin J;Sun L;Leng Z;Chen X;Xu X;Zhao Y;Ying B;Shen X;Ying S;Dai Y
J Thorac Dis 2020;12（10）：6127-6131|http://dx.doi.org/10.21037/jtd-20-1861 2019冠状病毒病（COVID-19）是由严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）引起的（1）。鉴于COVID-19在全球范围内迅速传播，其流行病学和临床特征需要进一步澄清。根据之前武汉的研究，分别包括41（2），99（3）和52（4）例实验室确诊的COVID-19患者，SARS-CoV-2在严重程度和高死亡率方面与严重急性呼吸综合征冠状病毒相似，然而，随后在北京对13例病例进行的研究表明，所有患者均为轻度感染（5）。这些研究的结果差异很大，相互矛盾，因此，我们收集了温州医科大学附属第二医院瓯江口分支和育英儿童医院收治的64例患者的数据，旨在描述温州市COVID-19患者的流行病学和临床特征，温州市虽然远离湖北省，但却是湖北以外中国最受影响的地区。在这项回顾性研究中，招募了2020年2月6日至2月11日在上述医院住院的64名实验室确诊的COVID-19患者。痰液、咽拭子标本经实时荧光定量RT-PCR检测确诊为SARS冠状病毒2型。根据世界卫生组织中期指南（6）定义的严重程度，将患者分为3组，分别为无并发症、轻度肺炎和重度肺炎。流行病学、人口统计学、临床、实验室和放射学数据从患者的医疗记录中提取。根据先前研究的方案，通过综合渗出性病变的范围和密度分级获得CT评分（7）。本研究已获得上述温州医科大学附属医院伦理委员会的批准（L-2020-13），同时沿着豁免知情同意。64例中男性38例（59.4%）。中位年龄为48.5岁（范围：10-77岁）。发热（71.9%）和咳嗽（64.1%）是最常见的症状，而恶心/呕吐（3.1%）、腹痛/腹泻（10.9%）和结膜充血（1.6%）较为罕见（表1）。在研究中发现了第5代病例（图1A）。患者1（2代）从未接触过野生动物或华南海鲜市场，在访问期间将SARSCoV-2传播给患者2（3代）。后者将病毒传染给了他的家人（患者3和4，第4代）。最后，当发型师（5号患者，第5代）反复与其中一名家庭成员联系并得到实验室确认的“致编辑的信”时，
J Thorac Dis 2020;12(10):6127-6131 | http://dx.doi.org/10.21037/jtd-20-1861 Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (1). Given its rapid spread worldwide, the epidemiological and clinical features of COVID-19 mandate further clarification. According to previous Wuhan-based studies, which respectively included 41 (2), 99 (3) and 52 (4) laboratory-confirmed COVID-19 patients, SARS-CoV-2 mimicked severe acute respiratory syndrome coronavirus in terms of severity and high mortality, however, a subsequent study conducted on 13-cases in Beijing demonstrated that all patients were mildly infected (5). Results of these studies varied greatly and were contradictory, therefore, we collected the data from 64 patients admitted to Oujiangkou Branch, the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, aiming to describe the epidemiological and clinical characteristics of COVID-19 patients in Wenzhou city which, although far away from Hubei Province, is the most-affected area in China outside Hubei. For this retrospective study, 64 laboratory-confirmed COVID-19 patients, admitted from Feb 6, to Feb 11, 2020 in above mentioned hospital were recruited. Confirmation of SARS-CoV-2 was done by real-time RT-PCR assay of sputum, throat-swab specimen. Patients were categorized into 3 groups, uncomplicated illness, mild-pneumonia and sever-pneumonia respectively, according to the severity defined by World Health Organization interim guidance (6). Epidemiological, demographic, clinical, laboratory and radiological data were extracted from medical records of patients. CT score was obtained by synthesizing the grading of range and density of the exudative lesion, following protocol from a previous study (7). Present study was approved by the Ethics Committee of above-mentioned Hospitals of Wenzhou Medical University (L-2020-13), along with a waiver of informed consent. Of all the 64 cases, 38 (59.4%) were male. Median age was 48.5 years (range, 10–77). Fever (71.9%) and cough (64.1%) were the most common symptoms, whereas nausea/vomiting (3.1%), abdominal pain/diarrhea (10.9%), and conjunctival congestion (1.6%) were rare (Table 1). A 5th-generation case was found in the study (Figure 1A). Patient 1 (Generation 2), who had never contacted with wildlife or Huanan Seafood Market, transmitted the SARSCoV-2 to Patient 2 (Generation 3) during his visit. The latter transmitted the virus to his family members (Patient 3 & 4, Generation 4). Finally, the virus reached to hairstylist (Patient 5, Generation 5) when he repeatedly contacted with one of the family members and got laboratory-confirmed Letter to the Editor