Clinical Characteristics of Coronavirus Disease 2019 in China
Clinical Characteristics of Coronavirus Disease 2019 in China
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DOI：
10.1056/nejmoa2002032
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发表时间：
2020-04-30
影响因子：
158.5
通讯作者：
Zhong, N.
中科院分区：
文献类型：
--
作者：
Guan, W.;Ni, Z.;Zhong, N.
在这项研究中，研究人员描述了2019年冠状病毒病的临床特征，在当前疫情爆发的前2个月，在中国大陆选择了1099名实验室确诊疾病的患者。背景自2019年12月以来，当2019年冠状病毒病（新冠肺炎）在武汉市出现并迅速蔓延到中国各地，需要有关受影响患者临床特征的数据。方法我们提取了1099例实验室确诊的新冠肺炎患者的数据，截至2020年1月29日，来自中国大陆30个省、自治区、直辖市的552家医院。主要复合终点是入住重症监护室（ICU）、使用机械通气或死亡。结果患者的中位年龄为47岁; 41.9%的患者为女性。主要复合终点发生在67例患者（6.1%）中，包括5.0%入住ICU，2.3%接受有创机械通气，1.4%死亡。只有1.9%的患者有直接接触野生动物的历史。在非武汉居民中，72.3%的人与武汉居民有过接触，其中31.3%的人去过武汉。最常见的症状是发热（入院时占43.8%，住院期间占88.7%）和咳嗽（67.8%）。腹泻不常见（3.8%）。中位潜伏期为4天（四分位距，2 - 7）。入院时，胸部计算机断层扫描（CT）最常见的影像学发现是毛玻璃样阴影（56.4%）。877例非重症患者中157例（17.9%）和173例重症患者中5例（2.9%）未发现放射学或CT异常。83.2%的患者入院时存在淋巴细胞减少症。结论在本次疫情爆发的前2个月，新冠肺炎在中国迅速蔓延，并造成不同程度的疾病。患者通常没有发烧，许多没有异常的放射学发现。（由中国国家卫生健康委员会等资助。
In this study, researchers describe the clinical characteristics of coronavirus disease 2019 in a selected cohort of 1099 patients with laboratory-confirmed disease throughout mainland China during the first 2 months of the current outbreak.Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients.Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death.Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission.Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)