Analysis of 23 cases of imported coronavirus disease 2019

doi:10.3969/j.issn.2096-8493.2020.03.003

Abstract

Abstract:

Objective To investigate the clinical characteristics of the imported patients with coronavirus disease 2019 (COVID-19). Methods The clinical data, including the epidemiologic features, clinical symptoms, laboratory examinations, imaging manifestations and treatment outcomes of the 23 imported patients with COVID-19 admitted to the designated hospital in Fuzhou of Fujian from March 1st, 2020 to May 31th, 2020 were retrospectively analyzed. Results The median age of the patients was 44 years with the age range of 7 to 69 years and 47.8% (11/23) of the patients were female. The median incubation period was 7 days. 43.5% (10/23) of the patients had underlying diseases and the most common ones were diabetes (13.0%, 3/23) and hypertension (13.0%, 3/23). The most common symptoms were fever (69.6%, 16/23), cough (52.2%, 12/23) and expectoration (39.1%, 9/23). 8.7% (2/23) of the patients had smell and taste impairments. The 23 cases consisted of 18 moderate patients and 5 severe patients without mild and critically patients. Among the 23 cases, leukopenia and lymphopenia occurred in 5 cases (21.7%) and 12 cases (52.2%), respectively. Elevated CRP and IL-6 were found in 7 (30.4%) and 11 (47.8%), respectively. T lymphocyte subsets were detected in 21 cases. CD3⁺ T lymphocytes decreased in 33.3% (7/21) of the patients, CD4⁺ T lymphocytes decreased in 38.1% (8/21) and CD8⁺ T lymphocytes in 33.3% (7/21), respectively. The median times from onset to positive results of serum novel coronavirus IgM and IgG antibodies were 7 days and 13 days, respectively. All the cases had abnormalities on chest CT, including patchy consolidation (52.2%, 12/23), ground glass opacity (65.2%, 15/23), nodular shadow (43.5%, 10/23) and fibrous stripe shadow (43.5%, 10/23), and pleural effusion (4.3%, 1/23) was extremely rare. All the patients received antiviral treatment, among whom one received glucocorticoid (methylprednisolone) therapy and 3 cases were treated with convalescent plasma of COVID-19 patients. All patients were discharged without death. Follow-up chest CT showed that most of the patients (82.6%, 19/23) had mild residual lung lesions which gradually improved with sustained absorption. Conclusion Imported patients with COVID-19 are relatively young and have a longer incubation period. Some patients may develop abnormalities of smell and taste. There is a delay in the emergence of novel coronavirus specific antibodies. The condition of patients is relatively mild, and the patients recovered well after timely diagnosis and treatment.

Key words: COVID-19, Diagnosis, Tomography,X-ray computed, Treatment outcome, Data interpretation,statistical

HUANG Jin-bao, LAN Chang-qing, LYU Xiao, CHEN Lu-lu, WANG Xin-hang, CHEN Yu-rong, HUANG Ming-xiang. Analysis of 23 cases of imported coronavirus disease 2019[J]. Journal of Tuberculosis and Lung Disease , 2020, 1(3): 213-219. doi: 10.3969/j.issn.2096-8493.2020.03.003

Figures/Tables 19

临床资料

结果

年龄[岁,M(Q₁,Q₃)]
共存的基础疾病[例(率,%)]
主要临床症状
发热[例(率,%)]
发热时间[d,M(Q₁,Q₃)]
最高体温 [℃,M(Q₁,Q₃)]
咳嗽[例(率,%)]
咳痰[例(率,%)]
活动后气促[例(率,%)]
实验室检查
白细胞计数(×10⁹/L,

x ˉ

±s)
白细胞计数<3.5×10⁹/L[例(率,%)]
淋巴细胞计数(×10⁹/L,

x ˉ

±s)
淋巴细胞计数<1.1×10⁹/L [例(率,%)]
血小板计数(×10⁹/L,

x ˉ

±s)
CRP [mg/L,M(Q₁,Q₃)]
CRP>10mg/L [例(率,%)]
IL-6(最高值)[ng/L,M(Q₁,Q₃)]
发病后IL-6>7.0ng/L [例(率,%)]
ALT>52U/L [例(率,%)]
AST>36U/L [例(率,%)]
LDH>313U/L [例(率,%)]
CK>170U/L [例(率,%)]
PCT>0.05μg/L [例(率,%)]
CK-MB≥3.0μg/L [例(率,%)]
TYO>72μg/L [例(率,%)]

44(23,57)
10(43.5)

16(69.6)
6(2,8)
37.9(37.6,38.4)
12(52.2)
9(39.1)
3(13.0)

4.8±1.5
5(21.7)
1.3±0.6
12(52.2)
183±55
3.8(0.7,11.1)
7(30.4)
4.8(1.5,17.8)
11(47.8)
3(13.0)
3(13.0)
2(8.7)
2(8.7)
3(13.0)
1(4.3)
2(8.7)

T淋巴细胞亚群

结果

入院时
CD3⁺T淋巴细胞[×10⁶个/L,M(Q₁,Q₃)]
CD3⁺T淋巴细胞<955×10⁶个/L[例(率,%)]
CD4⁺T淋巴细胞(×10⁶个/L,

x ˉ

±s)
CD4⁺T淋巴细胞<550×10⁶个/L[例(率,%)]
CD8⁺T淋巴细胞[×10⁶个/L,M(Q₁,Q₃)]
CD8⁺T淋巴细胞<320×10⁶个/L[例(率,%)]
淋巴细胞总数[×10⁶个/L,M(Q₁,Q₃)]
淋巴细胞总数<1530×10⁶个/L[例(率,%)]
治疗后
CD3⁺T淋巴细胞[×10⁶个/L,M(Q₁,Q₃)]
CD4⁺T淋巴细胞(×10⁶个/L,

x ˉ

±s)
CD8⁺T淋巴细胞[×10⁶个/L,M(Q₁,Q₃)]
淋巴细胞总数[×10⁶个/L,M(Q₁,Q₃)]

1185(595,1397)
7(33.3)

572±268
8(38.1)

461(285,605)
7(33.3)

1572(853,1859)
10(47.6)

1211(945,1436)
687±210
466(340,620)
1751(1333,2020)

诊治经过及转归

统计结果

发病至入本院时间[d,M(Q₁,Q₃)]
发病至抗病毒治疗时间[d,M(Q₁,Q₃)]
发病至病毒转阴时间(d,

x ˉ

±s)
抗病毒至病毒转阴时间(d,

x ˉ

±s)
住院时间[d,M(Q₁,Q₃)]
联合中药治疗[例(率,%)]
吸氧[例(率,%)]
联合抗生素应用[例(率,%)]
甲泼尼龙[例(率,%)]
COVID-19患者恢复期血浆疗法[例(率,%)]
并发症
肺部感染[例(率,%)]
急性心功能不全[例(率,%)]
低血容量[例(率,%)]
治疗后CT表现转归
病灶残留[例(率,%)]
斑片状实变影[例(率,%)]
磨玻璃样影[例(率,%)]
纤维索条状影[例(率,%)]

3(2,5)
2(1,2)
20±9
18±8
19(15,29)
22(95.7)
8(21.7)
5(21.7)
1(21.7)
3(13.0)

4(17.4)
1(4.3)
1(4.3)

19(82.6)
11(47.8)
11(47.8)
0(43.5)

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