本研究報告新加坡前18名經PCR確診之武漢肺炎住院病患流行病學特徵及病程。這18名病患中，12名有上呼吸道症狀，15名鼻咽棉棒可檢出病毒超過7天以上。有6名病患使用氧氣治療，其中2名加護病房收治，無人死亡。8名患者中，4名糞便檢體PCR檢出病毒；12名患者中，1名患者血液檢體PCR檢出病毒；尿液檢體無檢出病毒。有5名氧氣治療者接受lopinavir-ritonavir治療；這5名病人中，有3名在3天內退燒且氧氣需要量減少，但另2名惡化至呼吸衰竭；有4名出現噁心、嘔吐、或下痢等症狀，有3名出現肝功能異常。
(財團法人國家衛生研究院 莊淑鈞博士摘要整理)
Abstract
IMPORTANCE:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, in December 2019 and has spread globally with sustained human-to-human transmission outside China.
OBJECTIVE:
To report the initial experience in Singapore with the epidemiologic investigation of this outbreak, clinical features, and management.
DESIGN, SETTING, AND PARTICIPANTS:
Descriptive case series of the first 18 patients diagnosed with polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection at 4 hospitals in Singapore from January 23 to February 3, 2020; final follow-up date was February 25, 2020.
EXPOSURES:
Confirmed SARS-CoV-2 infection.
MAIN OUTCOMES AND MEASURES:
Clinical, laboratory, and radiologic data were collected, including PCR cycle threshold values from nasopharyngeal swabs and viral shedding in blood, urine, and stool. Clinical course was summarized, including requirement for supplemental oxygen and intensive care and use of empirical treatment with lopinavir-ritonavir.
RESULTS:
Among the 18 hospitalized patients with PCR-confirmed SARS-CoV-2 infection (median age, 47 years; 9 [50%] women), clinical presentation was an upper respiratory tract infection in 12 (67%), and viral shedding from the nasopharynx was prolonged for 7 days or longer among 15 (83%). Six individuals (33%) required supplemental oxygen; of these, 2 required intensive care. There were no deaths. Virus was detectable in the stool (4/8 [50%]) and blood (1/12 [8%]) by PCR but not in urine. Five individuals requiring supplemental oxygen were treated with lopinavir-ritonavir. For 3 of the 5 patients, fever resolved and supplemental oxygen requirement was reduced within 3 days, whereas 2 deteriorated with progressive respiratory failure. Four of the 5 patients treated with lopinavir-ritonavir developed nausea, vomiting, and/or diarrhea, and 3 developed abnormal liver function test results.
CONCLUSIONS AND RELEVANCE:
Among the first 18 patients diagnosed with SARS-CoV-2 infection in Singapore, clinical presentation was frequently a mild respiratory tract infection. Some patients required supplemental oxygen and had variable clinical outcomes following treatment with an antiretroviral agent.
Author：Young BE,Ong SWX,Kalimuddin S, et al.
原文連結：https://www.ncbi.nlm.nih.gov/pubmed/32125362