At present, there is a lack of effective antiviral drugs for pathogens, mainly in isolation and symptomatic supportive treatment.
According to the “Pneumonitis Diagnosis and Treatment Program for New Coronavirus Infection (Trial Version 4)” issued by the ·National Health and Health Commission: For severe and critical cases, based on symptomatic treatment, actively prevent complications, treat basic diseases, and prevent secondary Infection, timely organ function support. Take the following measures:
·Respiratory Support: Non-invasive mechanical ventilation for 2 hours, no improvement in the condition, or the patient cannot tolerate non-invasive ventilation, increased airway secretions, severe cough, or hemodynamic instability, and should promptly transition to invasive mechanical ventilation. Invasive mechanical ventilation uses a small tidal volume “pulmonary protective ventilation strategy” to reduce ventilator-related lung injury. If necessary, take prone ventilation, lung retension or extracorporeal membrane oxygenation (ECMO), etc .;
·Circulation Support: based on adequate fluid resuscitation, improve microcirculation, use vasoactive drugs, and monitor hemodynamics if necessary;
·Other Treatment Measures: According to the patient’s dyspnea and chest imaging progress, glucocorticoids can be used for a short period of time (3 to 5 days) as appropriate. The recommended dose is not to exceed 1 to 2 mg / kg · d of methylprednisolone. Xuebijing can be administered intravenously 100mL / day, twice a day for treatment. Intestinal microecological regulators can be used to maintain intestinal microecological balance and prevent secondary bacterial infections. If possible, consider recovery plasma therapy;
·Patients often have anxiety and fear, and psychological counseling should be strengthened.
Acute Phase Treatment
Patients with hypoxia and dyspnea should be given oxygen therapy (such as nasal catheter oxygen, mask oxygen) and non-invasive or invasive ventilator support if necessary.
General Treatment
·Rest in bed, strengthen supportive treatment to ensure sufficient heat; pay attention to water and electrolyte balance to maintain internal environment stability; closely monitor vital signs, oxygen saturation, etc.
·Monitor blood routine, urine routine, C-reactive protein (CRP), biochemical indicators (liver enzyme, myocardial enzyme, renal function, etc.), coagulation function according to the condition, and perform arterial blood gas analysis if necessary, and review chest imaging.
·According to the change of oxygen saturation, timely provide effective oxygen therapy measures, including nasal catheter, mask to give oxygen, nasal high-flow oxygen therapy if necessary, non-invasive or invasive mechanical ventilation.
Mdical Treatement
·Antiviral therapy: There are currently no effective antiviral drugs. Try alpha-interferon inhalation (5 million U each time for adults, add 2 ml of sterile water for injection twice daily), 2 capsules of lopinavir / ritonavir, twice daily;
·Antimicrobial treatment: Avoid blind or inappropriate use of antimicrobials, especially in combination with broad-spectrum antimicrobials. Strengthen bacteriological surveillance and apply antibacterial drugs in time when there is evidence of secondary bacterial infections;
·Others: According to the patient’s dyspnea and chest imaging progress, glucocorticoids should be used within a short period (3 to 5 days) as appropriate. The recommended dose is not to exceed 1 to 2 mg / kg · d of methylprednisolone.
Chinese Treatment
TCM treatment of the disease is currently lacking evidence-based medical evidence. On January 23, 2020, the National Health and Medical Commission issued the “Diagnosis and Treatment Scheme for New Coronavirus Infected Pneumonia (Trial Version)”, which covers 4 traditional Chinese medicine prescriptions and can be used as a treatment for pneumonia caused by new Coronavirus Important addition. It is recommended to go to a regular medical institution for treatment under the guidance of a physician.
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