RESUMEN
Objective: To analyze the general situation and clinical characteristics of coronavirus disease 2019 (COVID-2019)in Yongzhou city and provide reference for COVID-2019 control. Methods: 44 patients with COVID-2019 admitted in Yongzhou central hospital were included in the study. According to the clinical classification, the patients were divided into two groups: mild and moderate group (MM group, 32 cases), severe and critical group (SC group, 12 cases). The general situation, epidemiology, clinical symptoms, medical history and complications, laboratory examination, imaging characteristics and treatment plan of the two groups were compared and analyzed, and the clinical characteristics, treatment process and prognosis were summarized. Results: There was no significant difference between mild and moderate group and severe and critical group in age, gender, definite incubation period or definite infection transmission generations (P=0.072, 0.543, 0.108, 0.067). Compared with MM group, SC group needs longer hospitalization time(16.5±6.0 vs 12.4±4.5, P=0.019). There was no significant difference between the two groups in clinical symptoms of fever, cough, fatigue, pharyngeal pain, nasal obstruction, runny nose, diarrhea, history of hypertension or diabetes (each P> 0.05), Compared with MM group, SC group had higher proportion of hypokalemia and AST increase (58.3％ vs 15.6％, P=0.014;41.7％ vs 9.4％, P=0.042). There was no significant difference in hypoproteinemia, elevated ALT, respiratory failure or heart failure (each P > 0.05). Compared with MM group, SC group had higher WBC count, higher neutrophil count, lower lymphocyte count and more multileaf lesions in the laboratory and CT results (91.7％ vs 37.5％, P=0.010;91.7％ vs 46.9％, P=0.019;91.7％ vs 18.8％, P=0.000;100.00％ vs 59.4％, P=0.024). There was no significant difference between the two groups in decrease of leukocyte count, neutrophil count, eosinophil count, increase of C-reactive protein, ESR, LDH, ground glass or subpleural or extrapulmonary zone were the main pathological changes of CT (each P > 0.05). Compared with MM group, SC group were different in the use rate of antibiotics, glucocorticoids, immunoglobulin and noninvasive ventilator in the treatment plan (91.7％ vs 53.1％, P=0.044;100.00％ vs 59.4％, P=0.024;83.3％ vs 28.1％, P=0.001;41.7％ vs 0, P=0.001). 44 cases (100％) were cured without death. Conclusion: Compared with MM group, SC group is more likely to have increased leukocyte count, increased neutrophil count, decreased lymphocyte count and CT lesions with multileaf focus, more likely to have hypokalemia and increased AST, more likely to use antibiotics, glucocorticoids, immunoglobulins and non-invasive ventilator.
RESUMEN
Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs. The transmission of such pathogens to humans may lead to self-sustaining chains of transmission. These pathogens represent the highest risk for future pandemics. For their prevention, the transmission over the species barrier - although rare - should, by all means, be avoided. In the current COVID-19 pandemic, surprisingly though, most of the current research concentrates on the control by drugs and vaccines, while comparatively little scientific inquiry focuses on future prevention. Already in 2012, the World Bank recommended to engage in a systemic One Health approach for zoonoses control, considering integrated surveillance-response and control of human and animal diseases for primarily economic reasons. First examples, like integrated West Nile virus surveillance in mosquitos, wild birds, horses and humans in Italy show evidence of financial savings from a closer cooperation of human and animal health sectors. Provided a zoonotic origin can be ascertained for the COVID-19 pandemic, integrated wildlife, domestic animal and humans disease surveillance-response may contribute to prevent future outbreaks. In conclusion, the earlier a zoonotic pathogen can be detected in the environment, in wildlife or in domestic animals; and the better human, animal and environmental surveillance communicate with each other to prevent an outbreak, the lower are the cumulative costs.