Clinical analysis of nine cases with critical corona virus disease 2019 in Hainan province/ 中华传染病杂志

中华传染病杂志 Pub Date : 2020-04-02 DOI:10.3760/CMA.J.CN311365-20200304-00208

Ming Liu, F. Lin, Jiao Wang, Chao-Lang Wei, Jia-Xin Tian, Juan Fu, S. Zhong, Xinping Chen, Li-su Han, Hui Li, Jing Cao, Suo-Xian Chen, Fu-rong Xiao, Yongxing Chen, Zhongyi Zhou, Xiaohong Xie, Tao Wu

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Abstract

Objective To explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19). Methods The clinical data of nine patients who were diagnosed with critical COVID-19 in Hainan General Hospital from January 21, 2020 to February 6, 2020 were retrospectively analyzed. RT-PCR testing for 2019 novel coronavirus (2019-nCoV) was performed with multi-sites synchronize specimens including pharyngeal swab, blood, excrement, and urine. The serum levels of leucocyte, C-reactive protein, procalcitonin and lactic acid between the improved group (five cases) and the deteriorated group (four cases) were compared. The t test was used for comparison of normally distributed continuous data between groups. Results There were eight males (88.9%) and 1 female enrolled. The patients aged 28-77 years old, with an age of (52.9±18.0) years. By March 4, 2020, all five cases in improved group were cured and discharged, three cases in deteriorated group died and 1case remained in critical condition. All multi-sites specimens of patients in improved group turned negative in 2-4 weeks of illness onset, while those of cases in deteriorated group showed sustained viral nucleic acid positive (up to 48th day of illness onset). The white blood cell counts ((13.52±8.24)×109/L vs (10.49±4.46) ×109/L), C-reactive protein ((139.71±87.46) mg/L vs (78.60±55.40) mg/L) and procalcitonin ((2.32±4.03) ng/mL vs (0.28±0.58) ng/mL) , lactic acid ((3.70±4.14) mmol/L vs (2.33±0.53) mmol/L) in deteriorated group were all significantly higher than those in improved group (t=2.908, 5.009, 4.391 and 2.942, respectively, all P<0.01). A rapid rise of serum IL-6 level up to 8 500 pg/mL was observed in one patient three days prior to death. Conclusion Among the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases. Key words: Coronavirus infection; Pneumonia; Coronavirus disease 2019; Critical type; Nucleic acid testing; Inflammatory cytokine

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2019年海南省新型冠状病毒感染症9例临床分析

目的探讨2019冠状病毒病（新冠肺炎）危重病例的临床特点。方法回顾性分析海南省总医院2020年1月21日至2月6日收治的9例危重症新冠肺炎患者的临床资料。对2019年新型冠状病毒（2019-nCoV）进行RT-PCR检测，使用包括咽拭子、血液、粪便和尿液在内的多点同步样本。比较改善组（5例）和恶化组（4例）的血清白细胞、C反应蛋白、降钙素原和乳酸水平。t检验用于组间正态分布连续数据的比较。结果男性8例（88.9%），女性1例。患者年龄28～77岁，年龄（52.9±18.0）岁。截至2020年3月4日，好转组5例全部治愈出院，恶化组3例死亡，1例病情危重。改善组患者的所有多部位标本在发病2-4周内均呈阴性，而恶化组患者的多部位标本显示持续的病毒核酸阳性（直到发病48天）。白细胞计数（13.52±8.24）×，恶化组乳酸（3.70±4.14）mmol/L vs（2.33±0.53）mmol/L均显著高于改善组（t=2.908、5.009、4.391和2.942，均P<0.01），1例患者死亡前3天血清IL-6水平迅速升高至8500 pg/mL。结论危重新冠肺炎患者中，死亡病例血清炎性细胞因子水平高于好转和出院病例。关键词：冠状病毒感染；肺炎；2019冠状病毒病；关键类型；核酸检测；炎症细胞因子

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中华传染病杂志

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期刊介绍： The Chinese Journal of Infectious Diseases was founded in February 1983. It is an academic journal on infectious diseases supervised by the China Association for Science and Technology, sponsored by the Chinese Medical Association, and hosted by the Shanghai Medical Association. The journal targets infectious disease physicians as its main readers, taking into account physicians of other interdisciplinary disciplines, and timely reports on leading scientific research results and clinical diagnosis and treatment experience in the field of infectious diseases, as well as basic theoretical research that has a guiding role in the clinical practice of infectious diseases and is closely integrated with the actual clinical practice of infectious diseases. Columns include reviews (including editor-in-chief reviews), expert lectures, consensus and guidelines (including interpretations), monographs, short monographs, academic debates, epidemic news, international dynamics, case reports, reviews, lectures, meeting minutes, etc.