其他表现
其他非特异性轻症可包括厌食、意识模糊、头晕、咽痛、鼻溢和痰液产生。部分患者可能出现胸痛或咯血。胃肠道症状(例如腹泻、恶心、呕吐和腹痛)罕有报道,但这有可能遭到低估。[4]Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/31986264?tool=bestpractice.com
[5]Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-13.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30211-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/32007143?tool=bestpractice.com
[6]Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020 Feb 7;323(11):1061-9.
https://jamanetwork.com/journals/jama/fullarticle/2761044
http://www.ncbi.nlm.nih.gov/pubmed/32031570?tool=bestpractice.com
[7]Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-20.
https://www.nejm.org/doi/full/10.1056/NEJMoa2002032
http://www.ncbi.nlm.nih.gov/pubmed/32109013?tool=bestpractice.com
[8]Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected by SARS-CoV-2 in Wuhan, China. Allergy. 2020 Feb 19 [Epub ahead of print].
https://onlinelibrary.wiley.com/doi/epdf/10.1111/all.14238
http://www.ncbi.nlm.nih.gov/pubmed/32077115?tool=bestpractice.com
有传闻证据表明,轻症患者在无其他症状时,可能会出现嗅觉缺失/嗅觉减退或味觉缺失/味觉障碍。[9]ENT UK. Loss of sense of smell as marker of COVID-19 infection. 2020 [internet publication].
https://www.entuk.org/loss-sense-smell-marker-covid-19-infection
部分患者可能症状极轻或无症状,尤其是儿童。[10]Chen ZM, Fu JF, Shu Q, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. World J Pediatr. 2020 Feb 5 [Epub ahead of print].
https://link.springer.com/article/10.1007%2Fs12519-020-00345-5
http://www.ncbi.nlm.nih.gov/pubmed/32026148?tool=bestpractice.com
[11]Shen KL, Yang YH. Diagnosis and treatment of 2019 novel coronavirus infection in children: a pressing issue. World J Pediatr. 2020 Feb 5 [Epub ahead of print].
https://link.springer.com/article/10.1007/s12519-020-00344-6
http://www.ncbi.nlm.nih.gov/pubmed/32026147?tool=bestpractice.com
[12]Wang XF, Yuan J, Zheng YJ, et al. Clinical and epidemiological characteristics of 34 children with 2019 novel coronavirus infection in Shenzhen [in Chinese]. Zhonghua Er Ke Za Zhi. 2020 Feb 17;58(0):E008.
http://www.ncbi.nlm.nih.gov/pubmed/32062875?tool=bestpractice.com
[13]Lu X, Zhang L, Du H, et al. SARS-CoV-2 infection in children. N Engl J Med. 2020 Apr 23;382(17):1663-5.
https://www.nejm.org/doi/full/10.1056/NEJMc2005073
http://www.ncbi.nlm.nih.gov/pubmed/32187458?tool=bestpractice.com
大约 80% 患者表现为轻症,14% 患者表现为重症,5% 患者表现为危重症。[14]Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China [in Chinese]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Feb 17;41(2):145-51.
http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51
http://www.ncbi.nlm.nih.gov/pubmed/32064853?tool=bestpractice.com
重症患者可能会出现病毒性肺炎征象和症状,或出现包括急性呼吸窘迫综合征、急性心肌损伤、心律失常、急性肾损伤、继发感染、脓毒症或休克在内的并发症。[4]Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/31986264?tool=bestpractice.com
[5]Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-13.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30211-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/32007143?tool=bestpractice.com
[6]Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020 Feb 7;323(11):1061-9.
https://jamanetwork.com/journals/jama/fullarticle/2761044
http://www.ncbi.nlm.nih.gov/pubmed/32031570?tool=bestpractice.com
可能出现非典型表现,尤其是老年患者或免疫功能低下患者。