新加坡国家传染病中心Barnaby Edward Young联合Yee-Sin Leo研究组近日取得新进展。他们分析了新加坡SARS-CoV-2感染患者的流行病学特征和临床病程。这一研究成果发表在《美国医学会杂志》上。
Title: Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore
Author: Barnaby Edward Young, Sean Wei Xiang Ong, Shirin Kalimuddin, Jenny G. Low, Seow Yen Tan, Jiashen Loh, Oon-Tek Ng, Kalisvar Marimuthu, Li Wei Ang, Tze Minn Mak, Sok Kiang Lau, Danielle E. Anderson, Kian Sing Chan, Thean Yen Tan, Tong Yong Ng, Lin Cui, Zubaidah Said, Lalitha Kurupatham, Mark I-Cheng Chen, Monica Chan, Shawn Vasoo, Lin-Fa Wang, Boon Huan Tan, Raymond Tzer Pin Lin, Vernon Jian Ming Lee, Yee-Sin Leo, David Chien Lye
Abstract: AbstractImportance 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.