The disease is an acute infection, which usually worsens gradually during the first week. If you have any of the following conditions, please seek medical treatment in time:
·Recent fever, fatigue, and cough of unknown cause;
·Wuhan residence or travel history within two weeks before the onset of illness;
·A history of close contact with confirmed patients two weeks before the onset of illness;
·Aggregative onset (2 and over).
During the consultation, the doctor may ask the following questions to get a preliminary understanding of the medical history, and patients can prepare corresponding answers in advance:
·When do you experience fever and cough?
·Where did you go before and who did you contact?
·Does anyone have similar symptoms?
·Are you having difficulty breathing?
·What are the underlying diseases?
Diagnostic Criteria
According to the “Pneumonitis Diagnosis and Treatment Program for New Coronavirus Infection (Trial Implementation)” issued by the National Health Commission:
|| Suspected cases (formerly observed cases)
Combining the following comprehensive analysis of epidemiological history and clinical manifestations, there is any one of the epidemiological history and any two of the clinical manifestations.
Epidemiological History
Travel history or residence history in Infected area within two weeks before the onset of illness;
Or patients who had fever from Infected area with respiratory symptoms within 14 days before the onset of illness;
There is an epidemiological association in patients with clustered onset or new coronavirus infection.
Clinical Manifestation
Heat;
Have the above-mentioned pneumonia imaging characteristics;
The total number of white blood cells is normal or decreased in early onset, or the lymphocyte count is decreased.
||Confirmed Case
Suspected cases with one of the following pathogenic evidence:
·Real-time fluorescent RT-PCR of respiratory or blood samples for detection of novel coronavirus nucleic acids.
·Respiratory or blood specimens are genetically sequenced and highly homologous to known new coronaviruses.
Normal Type
With fever, respiratory tract and other symptoms, imaging shows pneumonia.
Heavy
Meet any of the following:
·Respiratory distress, breathing frequency ≥ 30 times / minute;
·In the resting state, it means oxygen saturation ≤ 93%;
·Arterial blood oxygen partial pressure (PaO₂) / oxygen concentration (FiO₂) ≤ 300 mmHg (1 mmHg = 0.133kPa).
Critical
One of the following:
·Respiratory failure occurs and requires mechanical ventilation;
·Appear shock
·Combining other organ failures requires ICU monitoring.
Visiting department
Fever diagnosis and infection department.
Related Inspection
|Physical Examination
Mainly check the lungs, auscultation of breathing sounds, etc.
|Laboratory Inspection
·Blood routine: The total number of white blood cells in the early stage is normal or decreased, and the lymphocyte count is reduced.
·Liver and kidney function: Transaminase, creatine kinase, etc. may be elevated.
·C-reactive protein (CRP) is elevated and procalcitonin can be normal.
·Coagulation function: D-dimer can be increased.
|Film Degree Exam
Multiple small patchy shadows and interstitial changes appeared early, and the extrapulmonary bands were obvious. Furthermore, it develops multiple ground glass infiltration and infiltrates in both lungs. In severe cases, pulmonary consolidation and pleural effusion are rare.
|Special Inspection
For pathogen detection, samples of throat swabs, sputum, or lower respiratory tract secretions were collected and subjected to real-time fluorescent RT-PCR. The results were positive for the new coronavirus nucleic acid test. Or sequencing of pathogen genes suggests a high degree of homology with the new coronavirus.
Differential Diagnosis
The disease needs to be distinguished from influenza virus, SARS coronavirus, MERS coronavirus and other known viral pneumonias, as well as from Mycoplasma pneumoniae, Chlamydia pneumonia and bacterial pneumonia. In addition, it should be distinguished from non-infectious diseases such as vasculitis, dermatomyositis, and organizing pneumonia.
Doctors will make detailed inspections from multiple aspects to determine. The main characteristics of this pneumonia are atypical onset, less high fever, most around 38 ° C, and some of them may not have fever, mainly dry cough. Compared with influenza, severe disease progresses slightly slowly The incubation period is generally 3 to 7 days, and the final diagnosis depends on the results of pathogenic testing.
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