➥本文為回溯性分析自今年1月16日至1月29日於中國武漢協和醫院經RT-PCR診斷感染SARS-CoV-2的病患臨床特徵。


共計分析69個病例，年齡中位數為42歲，其中30至49歲最多(51%)；男性佔46%。常見臨床症狀包括：發燒(87%)，其中大多數為38.1~39°C (58%)、咳嗽 (55%)、倦怠(42%)。絕大部分的病患都有接受抗病毒藥物及抗生素治療，85%病患使用干擾素，僅12~15%病患使用抗黴菌藥物或類固醇。追蹤至2月4日，有2位轉院、18位出院(26.9%)、5位死亡，死亡率為7.5%。依入院期間最低的血氧飽和度SpO2將病患分為兩組：SpO2 ≥90%有55人，SpO2 <90%有14人。


死亡的5人均落在SpO2 <90%的組別中。此外，SpO2 <90%組的病患發生最低血氧飽和度的時間約在症狀出現後的8.5天、年齡較高(平均70.5歲)、比較多人合併有潛在疾病(包括：高血壓、心血管疾病及糖尿病)以及淋巴球數目減少的情形、血中IL-6、IL-10、LDH (lactate dehydrogenase)及CRP (C reactive protein)也都比較高。出院的原則是：症狀緩解、電腦斷層上有明顯改善、退燒，以及連續兩次（間隔至少一天）檢驗喉頭拭子的RT-PCR呈陰性。


值得注意的是，使用抗病毒藥物Arbidol (umifenovir)可以改善出院率，並且有助降低死亡率。Arbidol在中國是治療流感的藥物選擇之一，其藥理機轉在於抑制病毒與宿主細胞融合以阻斷病毒進入細胞。在這次住院病患中使用的劑量是0.4g/次，每日三次，約治療9日。但是因為使用的病人數太少，因此其治療效果仍需要更大規模的臨床研究來證實。(中文摘要轉譯：「財團法人國家衛生研究院」齊嘉鈺醫師整理)


📋Clinical Features of 69 Cases With Coronavirus Disease 2019 in Wuhan, China (2020/03/16)+中文摘要轉譯

➥Author：Zhongliang Wang, Bohan Yang, Qianwen Li, et al.
➥Link： Oxford Academic (Oxford University Press) - Clinical Infections Diseases
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa272/5807944


#2019COVID19Academic
衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇

「Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China(2020/02/07)+中文摘要轉譯」


➥中文摘要轉譯：
截至2/4日，北京報告13例，大多為年輕健康人。症狀輕微且無人死亡。與過去報導一致，健康人感染後預後較佳。
註：初期流行病學易有偏誤，不可推估大流行時狀況。(財團法人國家衛生研究院-郭書辰醫師整理)


➥In December 2019, cases of pneumonia appeared in Wuhan, China. The etiology of these infections was a novel coronavirus (2019-nCoV),1,2 possibly connected to zoonotic or environmental exposure from the seafood market in Wuhan. Human-to-human transmission has accounted for most of the infections, including among health care workers.3,4 The virus has spread to different parts of China and at least 26 other countries.1 A high number of men have been infected, and the reported mortality rate has been approximately 2%, which is lower than that reported from other coronavirus epidemics including severe acute respiratory syndrome (SARS; mortality rate, >40% in patients aged >60 years)5 and Middle East respiratory syndrome (MERS; mortality rate, 30%).6 However, little is known about the clinical manifestations of 2019-nCoV in healthy populations or cases outside Wuhan. We report early clinical features of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing.


「Methods」
Data were obtained from 3 hospitals in Beijing, China (Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University [8 patients], Beijing Anzhen Hospital, Capital Medical University [4 patients], and College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital [1 patient]). Patients were hospitalized from January 16, 2020, to January 29, 2020, with final follow-up for this report on February 4, 2020. Patients with possible 2019-nCoV were admitted and quarantined, and throat swab samples were collected and sent to the Chinese Center for Disease Control and Prevention for detection of 2019-nCoV using a quantitative polymerase chain reaction assay.3 Chest radiography or computed tomography was performed. Data were obtained as part of standard care. Patients were transferred to a specialized hospital after diagnosis. This study was approved by the ethics commissions of the 3 hospitals, with a waiver of informed consent.


「Results」
The median age of the patients was 34 years (25th-75th percentile, 34-48 years); 2 patients were children (aged 2 years and 15 years), and 10 (77%) were male. Twelve patients either visited Wuhan, including a family (parents and son), or had family members (grandparents of the 2-year-old child) who visited Wuhan after the onset of the 2019-nCoV epidemic (mean stay, 2.5 days). One patient did not have any known contact with Wuhan.


Twelve patients reported fever (mean, 1.6 days) before hospitalization. Symptoms included cough (46.3%), upper airway congestion (61.5%), myalgia (23.1%), and headache (23.1%) (Table). No patient required respiratory support before being transferred to the specialty hospital after a mean of 2 days. The youngest patient (aged 2 years) had intermittent fever for 1 week and persistent cough for 13 days before 2019-nCoV diagnosis. Levels of inflammatory markers such as C-reactive protein were elevated, and numbers of lymphocytes were marginally elevated (Table).


Four patients had chest radiographs and 9 had computed tomography. Five images did not demonstrate any consolidation or scarring. One chest radiograph demonstrated scattered opacities in the left lower lung; in 6 patients, ground glass opacity was observed in the right or both lungs (Figure). As of February 4, 2020, all the patients recovered, but 12 were still being quarantined in the hospital.


➥Author: De Chang, Minggui Lin, Lai Wei, et al.

➥Link: (JAMA) https://jamanetwork.com/journals/jama/fullarticle/2761043


衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
#2019COVID19Academic

「Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China(2020/02/07)+中文摘要轉譯」


➥中文摘要轉譯：
截至2/4日，北京報告13例，大多為年輕健康人。症狀輕微且無人死亡。與過去報導一致，健康人感染後預後較佳。
註：初期流行病學易有偏誤，不可推估大流行時狀況。(財團法人國家衛生研究院-郭書辰醫師整理)


➥In December 2019, cases of pneumonia appeared in Wuhan, China. The etiology of these infections was a novel coronavirus (2019-nCoV),1,2 possibly connected to zoonotic or environmental exposure from the seafood market in Wuhan. Human-to-human transmission has accounted for most of the infections, including among health care workers.3,4 The virus has spread to different parts of China and at least 26 other countries.1 A high number of men have been infected, and the reported mortality rate has been approximately 2%, which is lower than that reported from other coronavirus epidemics including severe acute respiratory syndrome (SARS; mortality rate, >40% in patients aged >60 years)5 and Middle East respiratory syndrome (MERS; mortality rate, 30%).6 However, little is known about the clinical manifestations of 2019-nCoV in healthy populations or cases outside Wuhan. We report early clinical features of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing.


「Methods」
Data were obtained from 3 hospitals in Beijing, China (Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University [8 patients], Beijing Anzhen Hospital, Capital Medical University [4 patients], and College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital [1 patient]). Patients were hospitalized from January 16, 2020, to January 29, 2020, with final follow-up for this report on February 4, 2020. Patients with possible 2019-nCoV were admitted and quarantined, and throat swab samples were collected and sent to the Chinese Center for Disease Control and Prevention for detection of 2019-nCoV using a quantitative polymerase chain reaction assay.3 Chest radiography or computed tomography was performed. Data were obtained as part of standard care. Patients were transferred to a specialized hospital after diagnosis. This study was approved by the ethics commissions of the 3 hospitals, with a waiver of informed consent.


「Results」
The median age of the patients was 34 years (25th-75th percentile, 34-48 years); 2 patients were children (aged 2 years and 15 years), and 10 (77%) were male. Twelve patients either visited Wuhan, including a family (parents and son), or had family members (grandparents of the 2-year-old child) who visited Wuhan after the onset of the 2019-nCoV epidemic (mean stay, 2.5 days). One patient did not have any known contact with Wuhan.


Twelve patients reported fever (mean, 1.6 days) before hospitalization. Symptoms included cough (46.3%), upper airway congestion (61.5%), myalgia (23.1%), and headache (23.1%) (Table). No patient required respiratory support before being transferred to the specialty hospital after a mean of 2 days. The youngest patient (aged 2 years) had intermittent fever for 1 week and persistent cough for 13 days before 2019-nCoV diagnosis. Levels of inflammatory markers such as C-reactive protein were elevated, and numbers of lymphocytes were marginally elevated (Table).


Four patients had chest radiographs and 9 had computed tomography. Five images did not demonstrate any consolidation or scarring. One chest radiograph demonstrated scattered opacities in the left lower lung; in 6 patients, ground glass opacity was observed in the right or both lungs (Figure). As of February 4, 2020, all the patients recovered, but 12 were still being quarantined in the hospital.


➥Author: De Chang, Minggui Lin, Lai Wei, et al.

➥Link: (JAMA) https://jamanetwork.com/journals/jama/fullarticle/2761043


衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
#2019COVID19Academic