Analysis on epidemiological and clinical characteristics with fever in ever outpatient in a hospital in Anhui Province
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摘要:
目的 分析新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）疫情期间发热门诊患者的流行病学特征，为疾病的防治提供科学依据。 方法 选择2020年1月20日-2月18日在安徽医科大学第四附属医院发热门诊就诊的患者作为调查对象，调查内容包括一般人口学特征、主要临床症状和体征及实验室检查等，并对COVID-19疑似患者进行流行病学史调查。 结果 调查期间共有880例就诊患者，其中42例COVID-19疑似患者。就诊患者中以中青年为主，男女之比为1.61：1。COVID-19疑似患者与普通患者间年龄的差异有统计学意义（t=4.546，P < 0.001）；COVID-19疑似患者与普通患者多数在1~7 d内就诊，临床症状均以低热为主。有32例（76.2%）COVID-19疑似患者出现了淋巴细胞计数降低，39例（92.9%）COVID-19疑似患者出现了C反应蛋白升高。 结论 根据就诊患者的临床特征、实验室检查等结果做出综合预判，对COVID-19疑似患者进行严格的医疗隔离和观察，有助于疾病的控制和预防。 Abstract:Objective To analyze the epidemiological characteristics of patients with fever during the coronavirus disease 2019 situation, so as to provide scientific basis for the prevention and treatment of the disease. Methods Patients who visited the fever clinic of the fourth affiliated hospital of Anhui medical university from January 20, 2020 to February 18 were selected. The survey included general demographic characteristics, main clinical symptoms and signs, and laboratory tests. Patients diagnosed with suspected COVID-19 were investigated for their epidemiological history. Results A total of 880 patients included in this study during the survey period. In the 880 patients, 42 were clinically diagnosed as suspected COVID-19. The ratio of male to female patients was 1.61:1, mainly young and middle-aged. There was significant difference of age between patients with suspected COVID-19 and other patients (t=4.546, P < 0.001). Most patients in the suspected COVID-19 group and the common patients group visited the doctor within 1 to 7 days, and both groups mainly had low fever. Reduced lymphocyte count was found in 32 suspected COVID-19 patients (76.2%), and elevated cevels of c-reactive protein was found in 39 suspected COVID-19 patients (92.9%). Conclusions Prediction based on the clinical characteristics of suspected COVID-19 patients, laboratory tests and other results can facilitate strict medical isolation and observation of suspected patients and may contribute to disease control and prevention. -
Key words:
- Fever outpatient /
- Respiratory diseases /
- Infectious diseases /
- Epidemiology
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表 1 就诊患者性别、年龄分布
[n(%)] Table 1. Gender and age distribution of patients
[n(%)] 变量 n(例) 疑似患者 普通患者 χ2值 P值 性别 0.900 0.343 男 543(61.7) 23(53.8) 520(62.1) 女 337(38.3) 19(45.2) 318(37.9) 年龄(岁) 40.056 < 0.001 10~ 63(7.2) 0(0.0) 63(7.5) 20~ 391(44.4) 14(33.3) 377(45.0) 30~ 215(24.4) 8(19.0) 207(24.7) 40~ 90(10.2) 3(7.1) 87(10.4) 50~ 57(6.5) 7(16.7) 50(6.0) 60~ 29(3.3) 7(16.7) 22(2.6) 70~ 23(2.6) 1(2.4) 22(2.6) ≥80 12(1.4) 2(4.8) 10(1.2) 
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表 2 就诊患者的就诊时间和发热程度分析
[n(%)] Table 2. Analysis of visiting time and fever degree of patients
[n(%)] 变量 n(例) 疑似患者 普通患者 χ2值 P值 就诊时间(d) 19.085 < 0.001 < 1 381(43.3) 6(14.3) 375(44.7) 1~ 379(43.1) 30(71.4) 349(41.6) 7~ 65(7.4) 5(11.9) 60(7.2) ≥14 55(6.2) 1(2.4) 54(6.4) 发热程度(℃) 0.830 0.362 37.3~ 486(55.2) 30(71.4) 456(54.1) 38.1~ 144(16.4) 6(14.3) 138(16.5) >39.1 0(0.0) 0(0.0) 0(0.0)
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表 3 就诊患者的主要症状和体征分析
[n(%)] Table 3. Analysis of main symptoms and signs of patients
[n(%)] 变量 例数 疑似患者 普通患者 χ2值 P值 发热 4.385 0.036 有 629(71.6) 36(85.7) 594(70.8) 无 251(28.4) 6(14.3) 245(29.2) 咳嗽 4.674 0.031 有 285(32.4) 20(47.6) 265(31.6) 无 595(67.6) 22(52.4) 573(68.4) 咽痛 4.311 0.038 有 321(36.5) 9(21.4) 312(37.2) 无 559(63.5) 33(78.6) 526(62.8) 乏力 19.657 < 0.001 有 273(31.0) 26(61.9) 247(29.5) 无 607(69.0) 16(38.1) 591(70.5) 头痛 0.301 0.583 有 200(22.7) 11(26.2) 189(22.6) 无 680(77.3) 31(73.8) 649(77.4) 鼻塞 1.620 0.203 有 94(10.7) 2(4.8) 92(11.0) 无 786(89.3) 40(95.2) 746(89.0)
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表 4 就诊患者实验室检查结果和影像学检查结果分析
[n(%)] Table 4. Analysis of the examination results of laboratory and imaging of the patients
[n(%)] 变量 例数 疑似患者 普通患者 χ2值 P值 实验室检查 白细胞a 1.892 0.169 升高 332(37.7) 13(31.0) 319(38.1) 正常 483(54.9) 23(54.8) 460(54.9) 减少 65(7.4) 6(14.2) 59(7.0) 淋巴细胞b 223.721 < 0.001 升高 7(0.8) 0(0.0) 7(8.0) 正常 793(89.8) 10(23.8) 783(93.4) 减少 80(9.1) 32(76.2) 48(57.0) C反应蛋白c 25.257 < 0.001 升高 486(55.2) 39(92.9) 447(53.3) 正常 394(44.8) 3(7.1) 391(46.7) 肺炎影像学改变 467.80 < 0.001 有 56(6.4) 36(85.7) 20(2.4) 无 824(93.6) 6(14.3) 816(97.6) 注：a白细胞： < 4×109 /L为减少；4~10×109 /L为正常；>10×109 /L为升高；b淋巴细胞： < 0.8×109 /L为减少；0.8~4×109 /L为正常；>4×109 /L为升高；c C反应蛋白：0~10 mg/L为正常；>10 mg/L为升高。
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