四川省463例COVID-19确诊病例临床症状特征分析  

Epidemiological Analysis of Clinical Symptoms of 463 COVID-19 Cases in Sichuan Province

作　　者：黄婷[1] 周丽君[1] 程秀伟[1] 马雷 粟小燕 毛素玲[1] HUANG Ting;ZHOU Lijun;CHENG Xiuwei;MA Lei;SU Xiaoyan;MAO Sulin(Epidemic Investigation and disposal group,Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;Lu County Center for Disease Control and Prevention,Lu County 646100,Sichuan Province,China)

机构地区：[1]四川省疾病预防控制中心,成都610041 [2]泸县疾病预防控制中心,四川泸州646100

出　　处：《预防医学情报杂志》2021年第1期1-8,共8页Journal of Preventive Medicine Information

基　　金：四川省应对新型冠状病毒科技攻关应急项目“新型冠状病毒人间传播的适应性变异与致病规律研究”(项目编号:2020YFS0015)。

摘　　要：目的了解COVID-19病例临床症状,为早期识别病例和调整防控措施提供数据支持。方法从中国疾病预防控制信息系统的子模块"传染病管理信息系统"中获取数据,并结合现场流行病学调查情况对截至2020-02-27四川省报告的COVID-19确诊病例临床症状进行统计学描述和分析。结果四川省463例COVID-19确诊病例中,以发热(71.49%)、呼吸道和全身症状为主;有病例报告消化道症状,以恶心(8.42%)和腹泻(7.34%)较多。有发热症状的病例中仅62.32%体温高于38.0℃,其中56.49%伴咳嗽,16.38%伴咽痛;不发热但伴干咳和/或咳痰症状的病例构成比高于发热病例(P<0.001);四川省2月发病的病例,单一症状构成比较1月明显上升,且发热(χ^2=41.52,P<0.001)、乏力(χ^2=4.70,P=0.03)等症状构成比较1月有明显下降;咳嗽(χ^2=0.86,P=0.35)、咽痛(χ^2=0.51,P=0.48)和流涕(χ^2=0.03,P=0.87)症状构成比2月较1月有上升,但差异无统计学意义。结论采用体温筛查病例会有遗漏风险;不能通过流感样病例哨点监测有效发现COVID-19病例;应重视不发热但咳嗽和/或咳痰病例的发现与管理;随疾病传播,病例全身中毒症状逐步减轻,但数据有限,需持续观察。Objective To investigate the clinical symptoms of COVID-19 cases in Sichuan Province so as to provide scientific support for the development and adjustment of strategies for the case identification.Methods Data of COVID-2019 cases were collected from the Infectious Disease Management Information System in Chinese Information System for Disease Control and Prevention.The clinical symptoms of COVID-19 cases in Sichuan Province reported by Feb 27,2020 were analyzed.Results Fever(71.49%),respiratory and systemic symptoms were the main symptoms of 463 cases.Some cases reported digestive symptoms,including nausea(8.42%)and diarrhea(7.34%).Only62.32%of the fever cases had body temperature higher than 38.0℃.56.49%of fever cases with body temperature over 38.0℃had cough and 16.38%of them had sore throat.The proportion of cases without fever accompanied by dry cough and/or sputum symptom was higher than that of cases with fever accompanied by dry cough and/or sputum symptom(P<0.001).The proportion of cases with single symptom in February was significantly higher than that in January(P<0.001).Compared with January,the proportions of cases with fever(χ^2=41.52,P<0.001),fatigue(χ^2=4.70,P=0.03),were significantly decreased in February.But cough(χ^2=0.86,P=0.35),sore throat(χ^2=0.51,P=0.48)or runny nose(χ^2=0.03,P=0.87)were increased in February,but no significant difference was found.Conclusion There is a risk of missed diagnosis of cases by using body temperature screening.The effective detection of COVID-19 cases can not be achieved through sentinel surveillance of influenza-like cases.Attention should be paid to the detection and management of non-febrile but cough and/or sputum cases.With the spread of the COVID-19,the symptoms of the cases were gradually reduced,but the data were limited,and continuous observation was needed.

关 键 词：COVID-19 临床症状 流行病学 

分 类 号：R563.1[医药卫生—呼吸系统]