关键词: 新型冠状病毒肺炎, 淋巴细胞, C反应蛋白, 乳酸脱氢酶, 临床特征

Abstract: Objective To investigate the clinical characteristics of corona virus disease 2019(COVID-19)patients in Wuhan City, and the correlation between inflammatory factors and severity. Methods According to the COVID-19 diagnosis and treatment plan(trial version fifth), the clinical data, including clinical symptoms, blood tests and chest CT, of 51 patients were retrospectively analyzed. The patients were divided into 3 groups: 32 cases of general type, 9 cases of severe type and 10 cases of critical type. Results (1) The main symptoms were fever(42 cases, 82.35%), cough, expectoration(39 cases, 76.47%), chest distress, shortness of breath(24 cases, 47.06%), diarrhea and headache(few cases); the accompanying symptoms included fatigue, muscle ache, headache, nausea, vomiting and diarrhea. The number of days before hospitalization was 1-21, with a median of 7; the number of days of hospitalization was 3-30, with a median of 12. (2) The results of peripheral blood generally showed that, CRP was increased(80.39%), lymphocyte count was decreased(68.63%), lactate dehydrogenase(LDH)was increased(52.94%), and the leukocyte count, neutrophil count, alanine transaminase(ALT), aspartate aminotransferase(AST), γ-glutamyl transpeptidase(γ-GT), total bilirubin(TBIL), direct bilirubin(DBIL), blood urea nitrogen(BUN)and creatinine(Cr)were normal. (3) The characteristics of chest CT showed that the foci were multiple in double lung and field lung, with mainly ground-glass opacity and patchy shadow, showing interstitial pneumonia change. During the course of the disease, the focus could increase, expand and increase in density, and did not form cavity. There was no pleural effusion change, and the focus was not easy to cause blockage of trachea and bronchi. (4) The lymphocyte count in general type was higher than those in severe type and critical type(H=3.656, P=0.001; H=5.572, P<0.001); the lymphocyte count showed no statistical difference between severe type and critical type(H=1.391, P=0.493). The CRP levels among the three groups were statistically different as a whole(F=5.220,P=0.009); The CRP level in critical type was higher than those in general type and severe type(both P<0.05), while that between general type and severe type exhibited no statistical difference(P>0.05). The LDH level in critical type was higher than that in general type(H=-2.961, P=0.009); Compared with the severe type, the LDH levels in general type and critical type exhibited no statistical difference(H=-1.051, P=0.879; H=-1.484, P=0.414). For leukocyte count, neutrophil count, ALT, AST, γ-GT, TBIL, DBIL, BUM, Cr expression levels, there existed no statistical difference after pairwise comparisons(P>0.05). Conclusion (1) Most of the COVID-19 patients are not severe at the initial stage of onset; the main symptoms are fever and cough, accompanied by gastrointestinal system or other systemic symptoms. (2) The levels of lymphocyte count, CRP and LDH are abnormal in severe patients, which may help to judge the severity of the disease.

Key words: Corona virus disease 2019, Lymphocyte, C-reactive protein, Lactate dehydrogenase, Clinical characteristics