新型冠状病毒肺炎患者合并鼻部症状临床分析及诊疗建议

Clinical analysis and medical advice of COVID-19 patients with nasal symptoms

摘要:

目的调查新型冠状病毒肺炎（COVID-19）患者鼻部相关症状及其临床特点。方法收集2020年2月10日—3月20日华中科技大学同济医院327例确诊COVID-19患者的病例资料，采集鼻塞、流涕、嗅觉改变等鼻部相关症状、全身伴随症状及基础疾病等情况，分析其临床特点。结果在327例纳入研究的COVID-19患者中，轻型、普通型、重型、危重型病例分别为33例（10.1%）、62例（19.0%）、146例（44.6%）、86例（26.3%）；54例（16.5%）COVID-19患者合并鼻部相关症状，按不同症状发生的总例数统计，其中鼻塞35例（10.7%）、鼻腔干燥29例（8.9%）和嗅觉下降21例（6.4%），鼻痒 17例（5.2％）、喷嚏16例（4.9％）、鼻出血14例（4.3％）和流清涕11例（3.4％）。在各不同病情分型患者间，鼻部症状的发生率没有统计学意义（P>0.05)。192例（58.7%）COVID19患者有高血压、糖尿病等基础疾病存在，经过积极的综合治疗244例（74.6%）痊愈出院。结论COVID-19患者除了发热、咳嗽、咳痰等症状之外，鼻塞、嗅觉下降等鼻腔局部症状并不少见。鼻部疾病的治疗不仅可以改善患者生活质量，同时可以提高患者的治疗效果。因此，临床医师不能忽视COVID-19患者鼻部疾病的处理

Abstract:

ObjectiveTo investigate the nasal symptoms and clinical characteristics of novel coronavirus pneumonia（COVID-19）patients.MethodsClinical data of 327 confirmed COVID-19 patients hospitalized at Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology were collected from February 10 to March 20, 2020. Nasal symptoms(nasal congestion, nasal discharging, olfactory disorderes and other nasal symptoms), systemic concomitant symptoms and basic diseases were collected, and their clinical characteristics were analyzed.ResultsOf the 327 patients included in the study. There were mild 33 cases(10.1%), normal 62 cases(19.0%), severe 146 cases (44.6%) and critical severe 86 cases(26.3%) respectively. The results showed that fiftyfour (16.5%) of COVID-19 patients were associated with nasal symptoms,the nasal symptoms mainly included the nasal obstruction 35 cases(10.7%), nasal dryness 29 cases (8.9%), and the decreased olfaction 21 cases(6.4%), nose pruritus 17 cases (5.2%), sneezing 16 cases (4.9%), epistaxis 14 cases (4.3%) and rhinorrhea 11 cases (3.4%). There was no significant difference in the incidence of nasal symptoms among patients with different disease groups (P>0.05). One hundred and ninetytwo cases(58.7%) of COVID19 patients had hypertension, diabetes and other basic diseases, and 244 cases(74.6%) of COVID-19 patients were cured and discharged after active comprehensive treatment.ConclusionsIn addition to symptoms of fever, cough and sputum, the local nasal symptoms such as nasal congestion and the decreased olfaction are not uncommon in COVID-19 patients. The treatment of nasal diseases can not only improve the quality of life and also improve the treatment effect in COVID-19 patients. Therefore, the clinicians cannot ignore the management of nasal diseases in COVID-19 patients.