Clinical features and natural history of the first 2073 suspected COVID-19 cases in the Corona São Caetano primary care programme: a prospective cohort study.
Clinical features and natural history of the first 2073 suspected COVID-19 cases in the Corona São Caetano primary care programme: a prospective cohort study.
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DOI：
10.1136/bmjopen-2020-042745
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发表时间：
2021-01-12
期刊：
影响因子：
2.9
通讯作者：
Sabino EC
中科院分区：
文献类型：
--
作者：
Leal FE;Mendes-Correa MC;Buss LF;Costa SF;Bizario JCS;de Souza SRP;Thomaz O;Tozetto-Mendoza TR;Villas-Boas LS;de Oliveira-da Silva LC;Grespan RMZ;Capuani L;Buccheri R;Domingues H;Alexander N;Mayaud P;Sabino EC
尽管大多数病例不需要住院治疗，但基于社区的COVID-19临床数据有限。<s:1>南奥卡埃塔诺州新冠肺炎规划是一项初级保健倡议，为巴西南奥卡埃塔诺州所有感染COVID-19的居民提供护理。其目的是获取社区COVID-19病例的标准化临床数据。在对可能严重的病例进行分类后，在2020年4月13日至5月13日期间，连续出现在多媒体筛查平台的患者在家中接受了SARS-CoV-2逆转录酶（RT） PCR检测；阳性患者随访14 d，每2天进行一次电话随访。对rt - pcr阴性的患者进行额外的SARS-CoV-2血清学检测，以确定其感染状态。我们描述了这个前瞻性人群为基础的队列的临床、病毒学和自然历史特征。2073例疑似病例中，RT-PCR检测1583例（76.4%），其中阳性444例（28.0%,95% CI 25.9 ~ 30.3）；604/1136例（53%）rt - pcr阴性患者进行了血清学检查，其中52例（8.6%）检测出SARS-CoV-2血清阳性。新冠肺炎确诊患者最常见的症状是咳嗽、疲劳、肌痛和头痛；而自我报告的发热（OR 3.0, 95% CI 2.4至3.9）、嗅觉缺失（OR 3.3, 95% CI 2.6至4.4）和衰老（OR 2.9, 95% CI 2.3至3.8）与RT-PCR或血清学诊断的COVID-19阳性最密切相关。男性、老年患者、发热和关节痛患者以及更接近症状发作的患者的RT-PCR周期阈值较低。444例rt - pcr阳性病例的住院率和死亡率分别为6.7%和0.7%，住院组中年龄较大和肥胖的发生率更高。COVID-19的表现与其他轻度社区获得性呼吸系统疾病相似，但发热、嗅觉缺失和耳聋的存在有助于具体诊断。与其他以医院为基础的研究相比，大多数患者无需住院即可康复，死亡率低。
Despite most cases not requiring hospital care, there are limited community-based clinical data on COVID-19. The Corona São Caetano programme is a primary care initiative providing care to all residents with COVID-19 in São Caetano do Sul, Brazil. It was designed to capture standardised clinical data on community COVID-19 cases. After triage of potentially severe cases, consecutive patients presenting to a multimedia screening platform between 13 April and 13 May 2020 were tested at home with SARS-CoV-2 reverse transcriptase (RT) PCR; positive patients were followed up for 14 days with phone calls every 2 days. RT-PCR-negative patients were offered additional SARS-CoV-2 serology testing to establish their infection status. We describe the clinical, virological and natural history features of this prospective population-based cohort. Of 2073 suspected COVID-19 cases, 1583 (76.4%) were tested by RT-PCR, of whom 444 (28.0%, 95% CI 25.9 to 30.3) were positive; 604/1136 (53%) RT-PCR-negative patients underwent serology, of whom 52 (8.6%) tested SARS-CoV-2 seropositive. The most common symptoms of confirmed COVID-19 were cough, fatigue, myalgia and headache; whereas self-reported fever (OR 3.0, 95% CI 2.4 to 3.9), anosmia (OR 3.3, 95% CI 2.6 to 4.4) and ageusia (OR 2.9, 95% CI 2.3 to 3.8) were most strongly associated with a positive COVID-19 diagnosis by RT-PCR or serology. RT-PCR cycle thresholds were lower in men, older patients, those with fever and arthralgia and closer to symptom onset. The rates of hospitalisation and death among 444 RT-PCR-positive cases were 6.7% and 0.7%, respectively, with older age and obesity more frequent in the hospitalised group. COVID-19 presents in a similar way to other mild community-acquired respiratory diseases, but the presence of fever, anosmia and ageusia can assist the specific diagnosis. Most patients recovered without requiring hospitalisation with a low fatality rate compared with other hospital-based studies.
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影响因子：
34.3
作者：
Baqui, Pedro;Bica, Ioana;van der Schaar, Mihaela
通讯作者：
van der Schaar, Mihaela
影响因子：
82.9
作者：
He, Xi;Lau, Eric H. Y.;Leung, Gabriel M.
通讯作者：
Leung, Gabriel M.
DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
--
作者：
Richardson, Safiya;Hirsch, Jamie S.;,
通讯作者：
,
DOI：
10.1016/s1473-3099(20)30243-7
发表时间：
2020-06-01
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Verity, Robert;Okell, Lucy C;Ferguson, Neil M
通讯作者：
Ferguson, Neil M
影响因子：
3.7
作者：
Akmatov, Manas K.;Gatzemeier, Anja;Pessler, Frank
通讯作者：
Pessler, Frank