Abstract：Objective:To enhance the understanding of novel coronavirus pneumonia (COVID-19), to prevent misdiagnosis and to provide reference for the early diagnosis and treatment. Methods: All the COVID-19 patients who were isolated and treated in the department of infectious diseases of hai 'an hospital affiliated to nantong university and the infectious diseases department of the third people's hospital of nantong from January 21, 2020 to March 3, 2020 were selected, and their clinical characteristics including epidemiology, signs and symptoms, laboratory and imaging examinations were retrospectively analyzed. Results: A total of 5 confirmed COVID-19 patients were included in the study, including 4 males and 1 female. The age ranged from 32 to 59 years old, with an average of (43.6±5.7) years old. The time from onset to diagnosis was 5 ~ 10d, with an average of (7.8±1.5) d. Three patients had a history of residence or sojourn in wuhan, one had a history of close contact with a locally confirmed patient, and one female medical worker had a history of suspicious contact with a locally confirmed patient.There were 3 cases of normal type, 1 case of heavy type and 1 case of critical type. There were 5 cases of fever, 5 cases of cough, 4 cases of sputum, 5 cases of fatigue, 3 cases of muscle soreness, 3 cases of headache, 4 cases of shortness of breath, 4 cases of chest tightness, 1 case of mild abdominal pain and diarrhea. There were 2 cases of LYMPH decline, 1 case of accelerated ESR, 5 cases of abnormal myocardial enzyme spectrum, 3 cases of abnormal liver function, 3 cases of decreased PO2 and 2 cases of decreased SO2. Hs-crp increased in 2 cases and il-6 increased in 2 cases. Five patients tested positive for nucleic acid. MSCT showed 4 cases of bilateral pulmonary change and 1 case of right pulmonary change, most of which were segmental or subsegmental ground-glass like localized inflammatory infiltration. After receiving high flow oxygen therapy, assisted breathing, integrated traditional Chinese and western medicine and supportive treatment, they were cured and discharged from the hospital. The length of stay ranged from 16 to 34d, with an average of (17.8±3.7) d. No significant sequelae were found after 1 month of follow-up. Conclusion: The COVID-19 in hai 'an area was dominated by common cases with fever as the first symptom. In critical and severe cases, the course of disease is short, and the degree of inflammation and organ damage is significant. All cases were cured and discharged. Clinicians should improve the disease prevention and treatment level of COVID-19 in this region by combining the epidemiological history and clinical characteristics, nucleic acid detection and chest MSCT examination.
[1] Li Qun,Guan Xuhua,Wu Peng,et al.Early transmission dynamics in wuhan, China, of novel coronavirus-infected pneumonia[J].The New England Journal of Medicine,2020,382(13):1199~1207. [2] 侯阳,郭启勇.从SARS、MERS到COVID-19-以史为鉴-浅谈影像学在冠状病毒肺炎中的应用价值[J].中国临床医学影像杂志,2020,31(2):77~82. [3] Chan JF,Yuan SF,Yuan K,et al.A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster[J].The Lancet, 2020,395(10223):514~523. [4] 刘昌孝,伊秀林,王玉丽,等.认识新冠病毒(SARS-CoV-2),探讨抗病毒药物研发策略[J].药物评价研究,2020,43(3):361~370. [5] 国家卫生健康委办公厅.新型冠状病毒肺炎诊疗方案(试行第七版)[J].传染病信息,2020,33(1):1~6. [6] 管汉雄,熊颖,申楠茜,等.新型冠状病毒(COVID-19)临床影像学特征[J].放射学实践,2020,35(2):125~130. [7] 曹琪琪,秦乐,周慧娟,等.新型冠状病毒(2019-nCoV)肺炎的CT征象分析[J].诊断学理论与实践,2020,19(1):16~19. [8] 董国菊,王冰,李浩.中西医结合治疗新型冠状病毒肺炎重症患者的思考[J].中国中西医结合杂志,2020,40(3):269~271. [9] 严丽,李永胜.新型冠状病毒肺炎重症患者的识别和处理策略[J].新医学,2020,51(3):161~167. [10] 祁飞,夏加伟,张乐,等.COVID-19患者急性期T淋巴细胞亚群及血常规的变化[J].昆明医科大学学报,2020,41(4):56~59. [11] 周红,李小丽,李斌.重视2019冠状病毒病(COVID-19)诱导的脓毒症免疫抑制[J].第三军医大学学报,2020,42(3):2172. [12] 王蓉,谢伶俐,杜鹏,等.新型冠状病毒肺炎96例临床分析[J].中国呼吸与危重监护杂志,2020,19(2):144~147. [13] 靳英辉,蔡林,程真顺,等.新型冠状病毒(2019-nCoV)感染的肺炎诊疗快速建议指南(标准版)[J].解放军医学杂志,2020,42(1):1~20.
2020, Vol. 26 
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