(2020/4/17) Clinical features of covid-19 (+中文摘要轉譯)

新冠肺炎的典型臨床症狀為呼吸道症狀,例如:發燒、乾咳、呼吸急促,但是單靠這些典型的臨床症狀,不能有效診斷出非典型臨床症狀個案;例如:約2-40%的個案出現消化道症狀,像腹瀉,約53%的個案出現味覺或嗅覺失調,此外,零星案例出現喉嚨痛、流鼻水、胸悶或結膜充血等臨床症狀,在一些特定族群,像老人或孩童,新冠肺炎的臨床診斷更加複雜;目前研究報告指出,約12%的個案在出現臨床症狀之前就已具感染力;因此,制訂有效篩檢可疑感染者的策略,對防堵新冠肺炎疫情蔓延十分重要。(財團法人國家衛生研究院蔡慧如博士摘要整理)

The wide array of symptoms has implications for the testing strategy

In January 2020, coronavirus SARS-CoV-2 was identified as the cause of an outbreak of severe pneumonia, now known to be a complication of the coronavirus disease 2019 (covid-19).1 Since then, the spread of covid-19 has increased exponentially, with the World Health Organization declaring a pandemic on 11 March.2 By 15 April, more than 1 900 000 cases and 123 000 deaths had been reported worldwide.3

Severe acute respiratory illness with fever and respiratory symptoms, such as cough and shortness of breath, comprise the working case definition used to select people for viral testing. This strategy captures typical symptomatic presentation, but imperfectly identifies unusual manifestations, such as patients without respiratory symptoms or only very mild symptoms. One widely cited modelling study concluded that up to 86% of cases might have been missed in China,4 and reports of patients with unusual presenting symptoms are rising worldwide.

Author: Pauline Vetter, Diem Lan Vu,  Arnaud G L’Huillier, et al.

Link: https://www.bmj.com/content/369/bmj.m1470