Clinical characteristics of 28 patients with novel coronavirus pneumonia / 中华传染病杂志

ABSTRACT

Objective:To analyze the clinical characteristics and experiences in diagnosis and treatment of the patients with novel coronavirus pneumonia (NCP).Methods:Clinical data of 28 patients with NCP in the Fourth People′s Hospital of Nanning from January 22 to February 5 in 2020 were collected. The clinical manifestations, epidemiological history, laboratory tests, imaging examinations and treatments of patients were analyzed retrospectively.Results:The 28 patients with NCP included one mild case, 25 ordinary cases and two severe cases. They were all positive for 2019 novel coronavirus (2019-nCoV) nucleic acid in throat swabs. There were four groups of family clusters. The clinical symptoms were mainly fever and cough, which progressed rapidly in a short period of time. Since the onset of illness, the peak values of axillary temperature of the 28 patients were 36.6 ℃ to 39.5 ℃, while five patients had no fever throughout the course of the disease with the peak temperature ≤37.0 ℃. The illness onset ranged from 1 to 12 days after exposure, and the time from the symptom onset to the positive results of the nucleic acid tests was 0 to 13 days. There were two patients presented with decreased white blood cell counts, five patients with elevated C reactive protein, six patients with abnormal alanine aminotransferase, three patients with abnormal aspartate aminotransferase, 10 patients with elevated creatine kinase, three patients with elevated creatine kinase isoenzyme, four patients with elevated lactate dehydrogenase, and all with normal procalcitonin levels. The chest computed tomography examinations showed that the common features of patients with NCP were ground glass shadows (21 cases), blurred edges (18 cases), speckles and patchy shadows (17 cases), thickening and disorder of some lung textures (seven cases), and visible band shadows (seven cases). Pulmonary lesions often progressed rapidly. A included 11-year-old child was treated with alpha-interferon alone. A total of 27 patients were treated with alpha-interferon inhalation and lopinavir/ritonavir, while four occured withdrawal due to adverse reactions. Up to February 12, nine patients had been cured and discharged who were all ordinary cases, without death cases.Conclusions:The NCP patients mostly present with fever and cough. Pulmonary lesions often progress rapidly. Respiratory pathogen testing should be conducted as early as possible and repeatedly. Disisolation should be cautious for suspected people who are negative for 2019-nCoV nucleic acid in pharynx swabs.