新型冠状病毒无症状感染者的临床特征分析  

Analysis of clinical characteristics of asymptomatic carriers with 2019 novel coronavirus

作　　者：苏文豪 张吉翔[1] 熊秋棠 李娇[1] 季梦遥[1] 马静静[1] 郭远美 董卫国[1] Su Wenhao;Zhang Jixiang;Xiong Qiutang;Li Jiao;Ji Mengyao;Ma Jingjing;Guo Yuanmei;Dong Weiguo(Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院消化内科,430060

出　　处：《中华传染病杂志》2020年第12期772-776,共5页Chinese Journal of Infectious Diseases

摘　　要：目的分析新型冠状病毒无症状感染者的临床特征,为疫情防控中无症状感染者的诊治提供临床指导。方法收集2020年1月11日至2月6日武汉大学人民医院收治的663例新型冠状病毒肺炎(COVID-19)确诊患者的临床资料,根据诊断标准分为无症状感染者21例(无症状组)和有症状的COVID-19患者642例(有症状组),回顾性分析比较两组患者的一般情况、临床分型、死亡情况、影像学和实验室检查结果。统计学分析采用曼-惠特尼U检验、χ^2检验或Fisher确切概率法。结果663例患者的2019新型冠状病毒核酸检测均为阳性。无症状组的年龄为35.0(31.5,58.0)岁,低于有症状组的58.5(45.0,69.0)岁,差异有统计学意义(U=4234.500,P=0.002)。两组间年龄<30岁患者比例[19.0%(4/21)比6.1%(39/642)]差异有统计学意义(Fisher确切概率法,P=0.041)。21例无症状组患者中,女15例(71.4%);642例有症状组患者中,女327例(50.9%);两组间性别分布差异无统计学意义(χ^2=3.420,P=0.064)。轻型-普通型、重型、危重型患者在无症状组中分别占47.6%(10/21)、47.6%(10/21)和4.8%(1/21),在有症状组中分别占38.0%(244/642)、47.5%(305/642)和14.5%(93/642),两组差异无统计学意义(χ^2=1.847,P=0.397)。截至2月9日,无症状组死亡1例(4.8%),为轻型-普通型患者,有恶性肿瘤病史;有症状组死亡24例(3.7%),2例为轻型-普通型,22例为危重型;两组间病死率差异无统计学意义(Fisher确切概率法,P=0.560)。594例患者行胸部CT检查,其中591例(99.5%)患者表现为单侧或双侧肺炎,3例(0.5%)患者未见肺炎表现。结论新型冠状病毒无症状感染者的年龄低于有症状的COVID-19患者,且年龄<30岁患者较多。有无临床症状与COVID-19患者的临床分型和死亡情况并无明显关联。Objective To investigate the clinical characteristics of asymptomatic carriers with 2019 novel coronavirus(2019-nCoV),and to provide clinical guidance for the management of asymptomatic infection with 2019-nCoV.Methods The clinical data of 663 patients with confirmed coronavirus disease 2019(COVID-19)admitted to Renmin Hospital of Wuhan University from January 11 to February 6,2020 were collected.Patients were divided into asymptomatic group(21 cases)and symptomatic group(642 cases)according to the diagnostic criteria.General conditions,clinical classification,death,chest computed tomograph(CT)and laboratory results of patients were retrospectively collected.Mann-Whitney U test,chi-square test and Fisher exact test were used for statistical analysis.Results All 663 patients were positive for 2019-nCoV nucleic acid tests.The age of patients in the asymptomatic group were significantly younger than those in symptomatic group(35.0(31.5,58.0)years old vs 58.5(45.0,69.0)years old,U=4234.500,P=0.002).The proportion of patients<30 years old in the two groups was significantly different(19.0%(4/21)vs 6.1%(39/642),Fisher exact test,P=0.047).There were 15 women(71.4%)in the asymptomatic group and 327 women(50.9%)in the symptomatic group,while the difference of gender distributions was not statistically significant(χ2=3.420,P=0.064).In addition,among patients with asymptomatic infection,the proportions of mild/ordinary,severe and critical patients were 10 cases(47.6%),10 cases(47.6%),and one case(4.8%),respectively,which were not significantly different from those in symptomatic group(244 cases(38.0%),305 cases(47.5%)and 93 cases(14.5%),respectively,χ2=1.847,P=0.397).As of February 9,one(4.8%)mild/ordinary patient in the asymptomatic group died who had malignant tumor.Twenty-four(3.7%)patients in the symptomatic group died including two mild/ordinary and 22 critical patients.There was no significant difference in mortality between the two groups(Fisher exact test,P=0.560).CT examination was performed on 594 patients,and 5

关 键 词：冠状病毒感染 2019新型冠状病毒 无症状感染 临床特征 

分 类 号：R512.99[医药卫生—内科学]