2. The Epidemiology of COVID-19
3. Pathogenic Characteristics of Coronavirus
4. Clinical Characteristics of COVID-19
4.1. Clinical Manifestations
4.2. Laboratory Examination
4.3. Chest Imaging
5. Diagnosis of COVID-19
5.1. Suspected Cases
5.2. Confirmed Cases
5.3. Clinical Typing of the Confirmed Cases
6. Treatment of COVID-19
6.1. Treatment Area Decision According to the Disease Severity
6.2. General Treatment
- Bed rest, strengthen supportive treatment, ensure sufficient energy; pay attention to water-electrolytes balance and maintain the stability of the internal environment; closely monitor vital signs and finger oxygen saturation, and so on.
- Monitor the blood routine, urine routine, C-reactive protein (CRP) and health indications (liver enzyme, myocardial enzyme, renal function, etc.), coagulation function, arterial blood gas analysis if necessary, and recheck chest imaging.
- According to the change of oxygen saturation, give effective oxygen therapy in time, including oxygen given by nasal catheter or mask. If necessary, apply high flow oxygen therapy via the nose, noninvasive or invasive mechanical ventilation, and so on.
- Antiviral treatment: no effective antiviral drug at present. Treat with IFN-α aerosol inhalation (five million U per time for adults, two times per day), and/or Lopinavir/Ritonavir oral administration (two tablets per time, two times per day).
- Antibiotic treatment: avoid blind and improper use of antibiotics, especially the combination use of broad-spectrum antibiotics. Strengthen bacteriological monitoring. Antibiotics should be used in time in secondary bacterial infection.
6.3. Treatment of Severe and Critical Cases
- Treatment principle: based on symptomatic treatment, actively prevent and treat complications, treat basic diseases, prevent secondary infection, and timely apply organ function support.
- Respiratory support: apply noninvasive mechanical ventilation for two hours, if the condition is not improved, or the patient is intolerable to noninvasive ventilation, accompanied with increased airway secretions, severe coughing, or unstable hemodynamics, the patient should be transferred to invasive mechanical ventilation in time. The “lung-protective ventilation strategy” with low tidal volume should be adopted in invasive mechanical ventilation to reduce ventilator-associated lung injury. If necessary, ventilation in the prone position, recruitment maneuver, or extracorporeal membrane oxygenation (ECMO) can be used.
- Circulation support: improve microcirculation based on full fluid resuscitation, use vasoactive drugs, and apply hemodynamic monitoring if necessary.
- Others: according to the degree of dyspnea and the progress of chest imaging, use glucocorticoids appropriately for a short time (3–5 days) with the recommended dose no more than what is equivalent to methylprednisolone 1–2 mg/kg·day.
7. Prevention and Control
Conflicts of Interest
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|Coronavirus Infection Outbreak||Total Confirm Cases||Median Age (Years Old)||Number of Deaths||Case-Fatality Rate (%)||Countries Reported Cases||References|
|Female (%)||Male (%)|
(November 2019–18 February 2020)
|32 *||67 *|
(November 2002–July 2003)
(April 2012–November 2019)
|Organization at all Levels||Health Administration Department||Center for Diseases Control||Medical Institutions|
|Objectives||To timely find and report the COVID-19 cases, understand the disease characteristics and possible sources of infection, standardize the management of close contacts, and prevent the spread of the epidemic.|
|Responsibilities||Overall guidance of epidemic control, organizing a technical expert group for prevention and control; formulation and improvement of relevant work and technical schemes, and implementation of funds and materials for disease prevention and control; tracking and management of close contacts.||Organization, coordination, supervision, and evaluation of the monitoring work; collection, analysis, report, and feedback of the monitoring data; epidemiological investigation; strengthening laboratory testing ability, bio-safety protection awareness, and technical training; carrying out health education and publicity and risk communication to the public.||Case detection and report, isolation, diagnosis, and treatment; clinical management and prevention and control of nosocomial infections; sample collection and detection, and training of medical staff in the institution.|
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