内科

目的分析柳州市24例确诊新型冠状病毒肺炎（COVID-19）患者的流行病学及临床特征，为有效防控疫情提供参考。方法回顾性分析柳州三家定点医院收治的24例COVID-19患者的流行病学特点、临床症状、实验室检查情况、影像学资料、治疗及转归。结果24例确诊患者中，男14例，女10例，平均年龄（38.92±17.15）岁；其中23例（95.8%）患者有武汉旅居史或与确诊病例接触史，有14例（58.3%）为聚集性发病，有9例（37.5%）合并基础疾病或其他疾病，中位潜伏期为5 d。患者最常见的初始症状为发热（62.9%）、咳嗽（45.8%）及乏力（37.5%），7例（29.2%）患者白细胞降低，5例（20.8%）患者淋巴细胞计数降低，6例（25.0%）患者C反应蛋白升高，5例（20.8%）患者血沉升高，15例（62.5%）患者CD4+T淋巴细胞计数下降，10例（41.7%）患者CD8+T淋巴细胞计数下降；19例（79.2%）患者胸部CT出现单侧或双侧肺磨玻璃样密度影、斑片状高密度影。所有患者给予抗病毒治疗，15例（62.5%）患者给予抗生素治疗，14例（58.3%）患者给予免疫支持治疗，2例（8.3%）患者使用糖皮质激素治疗。治疗后24例患者核酸检测均阴转，阴转中位时间为15 d(5～47 d)，全部治愈出院。结论COVID-19传染性强，人群普遍易感，患者以发热、咳嗽、乏力为主要临床表现，多数患者胸部CT出现阴影、出现CD4+T计数下降，普通型患者多见，积极治疗后一般较快痊愈。

ObjectiveTo analyze the epidemiology and clinical characteristics in 24 patients with COVID-19 in Liuzhou, so as to provide references for effective epidemic prevention and control. MethodsThe epidemiological characteristics, clinical symptoms, laboratory examination status, imaging data, treatment and outcome of 24 COVID-19 patients admitted to three appointed hospitals in Liuzhou were analyzed retrospectively. ResultsAmong the 24 confirmed patients, 14 were males and 10 were females, with an average age of (38.92±17.15). Of them, 23 patients (95.8%) had a history of travel or residence in Wuhan, or a contact history of confirmed cases, 14 patients (58.3%) were cluster onset, and 9 patients (37.5%) had underlying diseases or other diseases, with median incubation period in 5 days. The most common initial symptoms of patients were fever (62.9%), cough (45.8%), and fatigue (37.5%). Seven patients (29.2%) had a decrease in white blood cells, 5 patients (20.8%) had a decrease in lymphocyte count, and 6 patients (25.0%) had an elevation in C-reactive protein, 5 patients (20.8%) had an elevation in erythrocyte sedimentation rate, 15 patients (62.5%) had a decrease in lymphocyte count of CD4+ T cell, and 10 patients (41.7%) had a decrease in lymphocyte count of CD8+ T cell. Nineteen patients (79.2%) showed unilateral or bilateral ground-glass opacity and patchy shadow on chest CT. All patients were given antiviral therapy, 15 patients (62.5%) were administered antibiotics, 14 patients (58.3%) were administered immuno-supportive therapy, and 2 patients (8.3%) were given glucocorticoid therapy. The nucleic acid tests of 24 patients were negative after treatment, the median time of negative conversion was 15 days (5-47 days), and all of them were cured and discharged. ConclusionCOVID-19 is highly infectious, and the population is generally susceptible. The main clinical manifestations of patients are fever, cough, and fatigue. Most patients have shadows on chest CT and a decrease in CD4+ T cell count. The ordinary type is more common in patients, and patients usually recover quickly after active treatment.