Original title: Zhong Nanshan has an important discovery! Ignoring this or causing missed diagnosis of the case →
Recently (February 29), the research paper of Academician Zhong Nanshan’s team was officially published in the form of an original article in the most influential comprehensive medical journal in the medical field, the New England Journal of Medicine “on. The data source of this paper was collected by the National Health and Medical Commission, led by Academician Zhong Nanshan, from a total of 552 hospitals in 30 provinces, autonomous regions and municipalities across the country from December 11, 2019 to January 29, 2020. Clinical information of 1099 laboratory-confirmed patients with novel coronavirus infection (hereinafter referred to as neocorona infection).
(5th), Academician Zhong Nanshan gave an exclusive interpretation of the main highlights and clinical significance of the paper, providing new insights for clinical treatment Ideas.
What are the main highlights of the study and their clinical significance?
1) For the first time in this study, we collected clinical information of a large number of patients (more than 1,000) of new crowns nationwide. Many patients sought treatment outside Hubei Province. Most of the patients were non-severe cases (84.3%), and 15.7% were severe. Cases and patient populations are relatively representative;
2) The fatality rate calculated in this study (1.4%) is closer to the official data reported by the National Health Commission (about 2.3%);
3) Only 1.9% was found Of patients have a history of direct exposure to wildlife, 31.3% of residents living outside Wuhan have visited Wuhan in the past 2 weeks, and 72.3% of patients have contacted Wuhan personnel in the past 2 weeks;
4) pointed out 56.2% of new crown patients did not develop fever at the time of admission, but as the disease progressed, 88.7% of patients developed fever in succession, so it is easy to miss the diagnosis of suspected cases by relying only on fever as a diagnostic criterion;
5) Point out digestive symptoms (including nausea, vomiting) , Diarrhea) are relatively rare, pointing out the evidence of the transmission of neocoronavirus through the digestive tract (the virus is isolated in the feces, the damaged mucosa of the gastrointestinal tract, and the bleeding site), suggesting that all sectors need to pay attention to prevent drainage The new crown spread of the virus caused by pollution;
6) pointed out that part of the nucleic acid testing positive does exist, clinical symptoms but no new crown radiographic abnormalities of the infected patients on admission, and non-serious proportion of these patients patients (17.9%) far It was higher than that in patients with severe new crown infection (2.9%);
7) It was pointed out that lymphocyte reduction can be seen in 83.2% of patients with new crown infection. Finding the key mechanism of virus destruction of lymphocytes will inspire clinicians to improve the success of treatment by regulating the immune function of patients rate.
How do foreign colleagues evaluate the paper?
The New England Journal of Medicine attaches great importance to the new crown epidemic. Professors Anthony Fauci, Clifford Lane, and Robert Redfield of the National Institutes of Health have written an article entitled Covid-19 —Navigating the Uncharted. The findings of this study suggest that the new crown epidemic may eventually be possible. More similar to seasonal influenza (case fatality rate close to 0.1%) or influenza pandemics (similar to pandemics of 1957 and 1968), and high case fatality rates of SARS or MERS (9% to 10%, 36%, respectively) )In sharp contrast.
Academician Zhong Nanshan also stressed that clinical treatment must always be in the first place to fight the new crown epidemic Clinical and basic scientific research escorted clinical practice.