【主要发现】
1）中位年龄 47.0 岁，女性占 41.90%；
2）仅有 1.18% 的患者与野生动物有过直接接触，而 31.30% 的患者曾到过武汉，71.80% 的患者与来自武汉的人有过接触；
3）最常见的症状是发烧（87.9%）和咳嗽（67.7%），腹泻少见；
4）潜伏期中位数为 3.0 天（范围 0-24 天）；
5）55 例（5.00%）患者入住重症监护病房，15 例（1.36%）死亡；
6）82.1% 的病患发现淋巴细胞减少；
7）患者入院时，胸部计算机断层扫描的典型放射学表现是毛玻璃样阴影（50.00%）；
胸部 CT 最常见的放射学表现为毛玻璃样阴影（50%）与双侧斑片状阴影（46%）。但，未见 CT 放射学异常的部分轻症患者（23.87%）与部分重症患者（5.20%）可根据症状+RT-PCR 阳性进行确诊。总体上，仅靠 CT 确诊的准确率为 76.4%；CT+RT+PCR+症状确诊准确率为 97.36%。
8）在多变量竞争风险模型中，重症肺炎与入住重症监护病房（ICU）、机械插管通气或是死亡的关系不大（亚分布危险比 9.80；95% 置信区间为 4.06 到 23.67）。
【作者认为】
1）新型冠状病毒通过人际传播迅速流行；
2）在一些感染患者中却存在正常的放射学表现；
3）检测结果的异常程度（包括氧饱和度、呼吸频率、血液白细胞/淋巴细胞计数和胸部 X 光片/ CT 表现）预计着较严重的临床结果。
分析数据来自 31 个省级行政区的 552 家医院，截至 1 月 29 日，共计 1099 例患者。
Clinical characteristics of 2019 novel coronavirus infection in China
Wei-jie Guan, Zheng-yi Ni, Yu Hu, Wen-hua Liang, Chun-quan Ou, Jian-xing He, Lei Liu, Hong Shan, Chun-liang Lei, David SC Hui, Bin Du, Lan-juan Li, Guang Zeng, Kowk-Yung Yuen, Ru-chong Chen, Chun-li Tang, Tao Wang, Ping-yan Chen, Jie Xiang, Shi-yue Li, Jin-lin Wang, Zi-jing Liang, Yi-xiang Peng, Li Wei, Yong Liu, Ya-hua Hu, Peng Peng, Jian-ming Wang, Ji-yang Liu, Zhong Chen, Gang Li, Zhi-jian Zheng, Shao-qin Qiu, Jie Luo, Chang-jiang Ye, Shao-yong Zhu, Nan-shan Zhong
doi: https://doi.org/10.1101/2020.02.06.20020974
This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.
Abstract
Background: Since December 2019, acute respiratory disease (ARD) due to 2019 novel coronavirus (2019-nCoV) emerged in Wuhan city and rapidly spread throughout China. We sought to delineate the clinical characteristics of these cases. Methods: We extracted the data on 1,099 patients with laboratory-confirmed 2019-nCoV ARD from 552 hospitals in 31 provinces/provincial municipalities through January 29th, 2020. Results: The median age was 47.0 years, and 41.90% were females. Only 1.18% of patients had a direct contact with wildlife, whereas 31.30% had been to Wuhan and 71.80% had contacted with people from Wuhan. Fever (87.9%) and cough (67.7%) were the most common symptoms. Diarrhea is uncommon. The median incubation period was 3.0 days (range, 0 to 24.0 days). On admission, ground-glass opacity was the typical radiological finding on chest computed tomography (50.00%). Significantly more severe cases were diagnosed by symptoms plus reverse-transcriptase polymerase-chain-reaction without abnormal radiological findings than non-severe cases (23.87% vs. 5.20%, P<0.001). Lymphopenia was observed in 82.1% of patients. 55 patients (5.00%) were admitted to intensive care unit and 15 (1.36%) succumbed. Severe pneumonia was independently associated with either the admission to intensive care unit, mechanical ventilation, or death in multivariate competing-risk model (sub-distribution hazards ratio, 9.80; 95% confidence interval, 4.06 to 23.67). Conclusions: The 2019-nCoV epidemic spreads rapidly by human-to-human transmission. Normal radiologic findings are present among some patients with 2019-nCoV infection. The disease severity (including oxygen saturation, respiratory rate, blood leukocyte/lymphocyte count and chest X-ray/CT manifestations) predict poor clinical outcomes.
Competing Interest Statement
The authors have declared no competing interest.
Clinical Trial
NA
Funding Statement
Supported by Ministry of Science and Technology, National Health Commission, National Natural Science Foundation, Department of Science and Technology of Guangdong Province.
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