冰岛国立大学医院Runolfur Palsson团队研究了冰岛人群中Covid-19病例的临床特征。2020年12月2日，该研究发表在《英国医学杂志》上。

为了描述Covid-19的临床症状，研究组在冰岛进行了一项基于人群的队列研究。2020年3月17日至4月30日，研究组招募了1564名经RT-PCR确诊的SARS-CoV-2阳性患者。所有确诊病例都参加了远程医疗监测服务，并且从诊断到恢复对症状进行了系统监测。主要结局指标为随访期间发生19种预定义症状中的一种或多种。

在这些SARS-CoV-2阳性患者中，最常见的症状是肌痛（55％）、头痛（51％）和干咳（49％）。在诊断时，有83名（5.3％）患者没有症状，其中49名（59％）在随访期间无症状。诊断时，分别有216人（14％）和349人（22％）不符合疾控中心和世界卫生组织的病例定义。大多数（67％）SARS-CoV-2阳性患者在整个疾病过程中表现出轻度症状。

研究结果表明，在广泛使用RT-PCR检测的大环境中，大多数SARS-CoV-2阳性患者仅患有轻度症状。发烧和呼吸困难比此前报道的要少。在诊断时，很大一部分SARS-CoV-2阳性患者未达到指南建议的病例定义。

附：英文原文

Title: Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study

Author: Elias Eythorsson, Dadi Helgason, Ragnar Freyr Ingvarsson, Helgi K Bjornsson, Lovisa Bjork Olafsdottir, Valgerdur Bjarnadottir, Hrafnhildur Linnet Runolfsdottir, Solveig Bjarnadottir, Arnar Snaer Agustsson, Kristin Oskarsdottir, Hrafn Hliddal Thorvaldsson, Gudrun Kristjansdottir, Brynja Armannsdottir, Agnar Bjarnason, Birgir Johannsson, Olafur Gudlaugsson, Magnus Gottfredsson, Martin I Sigurdsson, Olafur S Indridason, Runolfur Palsson

Issue&Volume: 2020/12/02

Abstract:

Objective To characterise the symptoms of coronavirus disease 2019 (covid-19).

Design Population based cohort study.

Setting Iceland.

Participants All individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) between 17 March and 30 April 2020. Cases were identified by three testing strategies: targeted testing guided by clinical suspicion, open invitation population screening based on self referral, and random population screening. All identified cases were enrolled in a telehealth monitoring service, and symptoms were systematically monitored from diagnosis to recovery.

Main outcome measures Occurrence of one or more of 19 predefined symptoms during follow-up.

Results Among 1564 people positive for SARS-CoV-2, the most common presenting symptoms were myalgia (55%), headache (51%), and non-productive cough (49%). At the time of diagnosis, 83 (5.3%) individuals reported no symptoms, of whom 49 (59%) remained asymptomatic during follow-up. At diagnosis, 216 (14%) and 349 (22%) people did not meet the case definition of the Centers for Disease Control and Prevention and the World Health Organization, respectively. Most (67%) of the SARS-CoV-2-positive patients had mild symptoms throughout the course of their disease.

Conclusion In the setting of broad access to RT-PCR testing, most SARS-CoV-2-positive people were found to have mild symptoms. Fever and dyspnoea were less common than previously reported. A substantial proportion of SARS-CoV-2-positive people did not meet recommended case definitions at the time of diagnosis.

DOI: 10.1136/bmj.m4529

Source: https://www.bmj.com/content/371/bmj.m4529