中国上海市北部における2019年輸入新型コロナウイルス肺炎の疑い例と確定例の疫学的特徴と臨床的特徴を検討した。

The epidemiologic and clinical features of suspected and confirmed cases of imported 2019 novel coronavirus pneumonia in north Shanghai, China.

• Shuanshuan Xie
• Guoliang Zhang
• Hong Yu
• Jin Wang
• Sheng Wang
• Guangyu Tang
• Changfeng Guo
• Jiyu Li
• Songhua Wei
• Changhui Wang
• Huanlong Qin

抄録

背景:

武漢（中国）で最近発生した肺炎患者の集団は、コロナウイルス病2019（COVID-19）と名付けられた新規のβ-コロナウイルスによるもので、ヒトからヒトへの感染を介して伝播することが知られている。

Background: A recent cluster of pneumonia cases in Wuhan (China) is known to be caused by a novel beta-coronavirus named the corona virus disease 2019 (COVID-19) and can be spread through human-to-human transmission.

方法:

実験室でCOVID-19が確認された21例およびCOVID-19が疑われた84例のデータをRT-PCRで解析した．疫学的特徴、臨床的特徴、および臨床転帰を確認症例と疑われる症例の間で比較した。

Methods: Data of 21 patients with laboratory-confirmed COVID-19 and 84 patients with suspected COVID-19 were analyzed by RT-PCR. The epidemiologic and clinical features as well as clinical outcomes were compared between the confirmed and suspected cases.

結果:

2020年2月15日までに上海北部で105名の患者が本研究に登録されており、その中にはCOVID-19の確定症例21名、疑われる症例84名が含まれていた。これらの輸入COVID-19確定例の潜伏期間は17.6日（IQR 5～34日）、症状発症から診断までの時間の中央値は145.64時間（IQR 21～441時間）であった。確認された患者の50％以上が51歳（範囲、51～60歳）以上の高齢者であった。推定患者84人のうち50人（59.5％）は40歳未満であり、そのうち27人（32％）は30歳未満であった。確定患者の多くは男性（61.9％、13/21）で、基礎疾患は糖尿病（9.5％、2/21）、高血圧（19％、4/21）、COPD（23.8％、5/21）、CD（23.8％、5/21）などが50％未満であった。また、確認された21人のうち10人（47.6％）は一般従業員で、12人（57.2％）は最近武漢に来たことがあるか、武漢出身者と親しい関係にあった。疑われる患者84人のうち、28人（33.3％）は退職者で、69人（82.1％）は最近スーパーや食料品店に行ったことがあるか、海外や中国の他の都市に旅行したことがあった。両群の患者の共通の発症症状は発熱と咳であった。喀痰喀出の症状は、確定患者（9.5％、2/21）よりも、おそらく患者（40.5％、34/84）の方が顕著であった。輸入患者では50％以上（53.3％、56/105）に1葉と2葉の罹患があった。輸入患者105例中29例（27.6％）は退院しており、死亡した患者はおらず、その他の患者はすべて現在も入院中であった。

Results: Altogether 105 patients had been enrolled in this study by February 15, 2020 in north Shanghai, including 21 confirmed cases and 84 suspected cases of COVID-19. The incubation period of these confirmed patients with imported COVID-19 was 17.6 days (IQR 5-34 days) and the median time from symptom onset to diagnosis was 145.64 h (IQR 21-441 h). More than 50% of the confirmed patients were older than 51 (range, 51-60) years. Fifty (59.5%) of the 84 probably patients were younger than 40 years, including 27 (32%) patients younger than 30 years. Most confirmed patients were men (61.9%, 13/21), and less than 50% of them had underlying diseases, including diabetes (9.5%, 2/21), hypertension (19%, 4/21), COPD (23.8%, 5/21), and CD (23.8%, 5/21). In addition, 10 (47.6%) of the 21 confirmed patients were ordinary employees, and 12 (57.2%) of them had recently been to Wuhan or had close contacts with people from Wuhan. Of the 84 suspected patients, 28 (33.3%) were retired employees; 69 (82.1%) had recently been to supermarkets and groceries or had a history of traveling abroad or to other cities of China. The common onset symptoms of the patients in both groups were fever and cough. The symptom of Sputum production was more pronounced in probably patients (40.5%, 34/84) than that in confirmed patients (9.5%, 2/21). More than 50% imported patients (53.3%, 56/105) had one and two affected lobes. Twenty-nine (27.6%) of the 105 imported patients had been discharged, no patient had died, and all the other patients are still in hospital.

結論:

輸入COVID-19確定症例の全体的な潜伏期間は武漢のそれよりも長く，その多くは高齢の男性に感染していた．輸入COVID-19感染症の発症は潜伏性であり，臨床症状は微熱，倦怠感，軽度の咳，軽度の呼吸困難などの軽度であった．

Conclusions: The overall incubation period in this cohort of imported confirmed COVID-19 patients was longer than that in Wuhan, mostly infecting older men. The disease onset of imported COVID-19 infection was occult, and the clinical symptoms were usually mild, mostly presenting as low fever, fatigue, light cough, and mild dyspnea.

2020 Annals of Translational Medicine. All rights reserved.