這篇論文分析1/1至2/5武漢人民醫院、中南醫院、同濟醫院,及中央醫院34名手術患者;這些患者在手術後確診為武漢肺炎患者,手術時應仍在潛伏期。這些患者年齡中位數55歲,其中20名女性。常見症狀包括發燒(91.2%)、疲倦(73.5%)、及乾咳(52.9%);其中15名患者後來轉至加護病房,7名患者轉至加護病房後死亡,死亡率20.5%。相較於沒有轉至加護病房的患者,轉至加護病房的患者年齡較大、有其他慢性病、手術複雜度較高、及較嚴重的實驗室數值異常。死亡者中常見之併發症有呼吸窘迫、休克、心律失調、及急性心肌損傷。34名患者中,從住院開始算天數,至手術之中位數為2.5天,至症狀出現之中位數為5天,至出現呼吸困難之中位數為9.5天(15名患者),至出現呼吸窘迫之中位數為11天(11名患者),至死亡之中位數為16天(7名患者)。

(財團法人國家衛生研究院 莊淑鈞博士摘要整理)

Background: The outbreak of 2019 novel coronavirus disease (COVID-19) in Wuhan, China, has spread rapidly worldwide. In the early stage, we encountered a small but meaningful number of patients who were unintentionally scheduled for elective surgeries during the incubation period of COVID-19. We intended to describe their clinical characteristics and outcomes.

Methods: We retrospectively analyzed the clinical data of 34 patients underwent elective surgeries during the incubation period of COVID-19 at Renmin Hospital, Zhongnan Hospital, Tongji Hospital and Central Hospital in Wuhan, from January 1 to February 5, 2020.

Findings: Of the 34 operative patients, the median age was 55 years (IQR, 43–63), and 20 (58·8%) patients were women. All patients developed COVID-19 pneumonia shortly after surgery with abnormal findings on chest computed tomographic scans. Common symptoms included fever (31 [91·2%]), fatigue (25 [73·5%]) and dry cough (18 [52·9%]). 15 (44·1%) patients required admission to intensive care unit (ICU) during disease progression, and 7 patients (20·5%) died after admission to ICU. Compared with non-ICU patients, ICU patients were older, were more likely to have underlying comorbidities, underwent more difficult surgeries, as well as more severe laboratory abnormalities (eg, hyperleukocytemia, lymphopenia). The most common complications in non-survivors included ARDS, shock, arrhythmia and acute cardiac injury.

Interpretation: In this retrospective cohort study of 34 operative patients with confirmed COVID-19, 15 (44·1%) patients needed ICU care, and the mortality rate was 20·5%.

Author:Shaoqing Lei , Fang Jiang , Wating Su, et al.
原文連結:https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30075-4/fulltext

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