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首页> 美国卫生研究院文献>Medicina >Acute Clinical Syndromes and Suspicion of SARS-CoV-2 Infection: The Experience of a Single Romanian Center in the Early Pandemic Period
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Acute Clinical Syndromes and Suspicion of SARS-CoV-2 Infection: The Experience of a Single Romanian Center in the Early Pandemic Period

机译：SARS-COV-2感染急性临床综合征及怀疑：初期大流行时期单一罗马尼亚中心的经验

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Background and Objectives: During the coronavirus disease 2019 (COVID-19) pandemic, patients with chronic diseases suffering exacerbations have required acute medical care. The purpose of our study was to determine useful criteria for the differentiation of patients with acute clinical syndromes and suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Materials and Methods: This was an observational retrospective study, conducted in an internal medicine clinic from April to May 2020. We collected clinical, biological, and computed tomography (CT) data on patients with exacerbations of chronic diseases and clinical suspicion of SARS-CoV-2 infection. Patients with an already-positive real-time reverse-transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2 on presentation at the emergency department were excluded from our study. Results: Of 253 suspected cases, 20 were laboratory-confirmed as having SARS-CoV-2 infection by RT-PCR, whereas COVID-19 diagnosis was ruled out in the remaining 233. Venous thromboembolism (VTE) correlated significantly with COVID-19 diagnosis in suspected patients, while laboratory markers were not significantly different between the two groups. Of the suspected patients, significantly higher percentages of dry cough, fever, myalgias, sore throat, loss of smell and appetite, and ground-glass opacities (GGOs) on CT were found in SARS-CoV-2-positive individuals. Conclusions: The study demonstrated that, until receiving the result of an RT-PCR test for SARS-CoV-2 (usually 12–24 h), association with VTE as a comorbidity, fever, dry cough, and myalgia as clinical features, and GGO on CT are the main markers for the identification of COVID-19 patients among those suspected with acute clinical syndromes. Our results also provide evidence for doctors not to rely solely on biological markers in the case of suspected SARS-CoV-2 infection in patients with exacerbations of chronic diseases. These data are useful for faster decision-making with regard to suspected COVID-19 patients before receiving RT-PCR test results, thus avoiding keeping patients in crowded emergency departments.
机译：背景和目标：在冠状病毒疾病2019（Covid-19）大流行中，患有恶化的慢性疾病的患者需要急性医疗。我们的研究目的是确定急性临床综合征患者分化的有用标准，并怀疑严重急性呼吸综合征冠状病毒2（SARS-COV-2）感染。材料和方法：这是一项观察到的回顾性研究，从4月到2020年5月在内科诊所进行。我们收集了临床，生物学和计算机断层扫描（CT）数据，慢性疾病加剧患者和SARS-COV的临床怀疑-2感染。在急诊部门介绍的SARS-COV-2上具有已阳性实时逆转录聚合酶链反应（RT-PCR）试验的患者被排除在我们的研究中。结果：253例疑似病例，20例疗效证实具有RT-PCR的SARS-COV-2感染，而Covid-19在其余233中排除了静脉血栓栓塞（VTE）与Covid-19诊断有显着相关性在疑似患者中，两组之间的实验室标记没有显着差异。在疑似患者中，在SARS-COV-2阳性中发现，在SARS-COV-2阳性个体中发现了干咳，发热，肌伽肌的喉咙痛，嗅觉和食欲的丧失和碎片不透射率（GGO）。结论：该研究表明，直到接受SARS-COV-2（通常为12-24小时）的RT-PCR试验结果，与VTE为合并症，发热，干咳和肌痛作为临床特征， CT上的GGO是用于鉴定急性临床综合征的人的Covid-19患者的主要标志物。我们的业绩还为医生提供了证据，以便在患有慢性疾病的患者的疑似SARS-COV-2感染的情况下依赖于生物学标志物。这些数据对于在接受RT-PCR测试结果之前对疑似Covid-19患者的决策更快的决策，从而避免将患者保持在拥挤的急诊部门。

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