A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

The Sunspot Cycle Leads to Origin and Epidemic Mechanism of Novel Coronavirus COVID-19

Listed examples of virus transmission epidemics that can be strongly transmitted through the air caused by sunspot change cycle, analyzed the mechanism that promotes the generation of new viruses. From the schematic diagram of the changes in the combined force of the hydrodynamic effect of the sun sweeping the earth and the sweeping force, we obtain the places that are prone to light vortices are 30 degrees north latitude and 30 degrees south latitude on the east coast of the mainland creatively. The curved continental lines are perfect, the range of the light vortex generated is more obviously, and the effect is stronger. And the curved continental lines are perfect, the range of the light vortex generated is more obviously, and the effect is stronger. It is inferred that the light vortex produces the special amplified energy so that can make the virus mutate to produce a new highly infectious novel coronavirus. The earliest known place and time of the novel coronavirus origin are consistent with the reasoning of the new theory. Because the radius and frequency of the light vortex are different, the resulting virus strains are also different. Moreover, the fatality rate in the light vortex area is much higher than that in the non-light vortex area, indicating that the virus’s toxicity and lethality are higher in the light vortex area, so it can explain why Russia, India, and countries in the African equatorial region mortality are much lower than the United States, Italy, Spain and Brazil. Finally, preventive and recommended measures are proposed.

Discussion on Etiology and Pathogenesis of Corona Virus Disease 2019 from“Cold-dampness and Insidious Dryness”

Based on the characteristics of the epidemic situation and the authors’understanding of the related ancient books and documents,this paper explores the etiology and pathogenesis of Corona Virus Disease 2019(COVID-19)from 5 aspects:abnormal climate in"warm winter",unique geographical location,pathogenesis evolution of cold and dampness mixed with insidious dryness,transmission and change of"triple energizer"of toxic pathogens,and game between healthy Qi and toxic pathogens.Combined with the special treatment of traditional Chinese medicine(TCM),the purpose is to make a modest contribution to curbing the epidemic situation with TCM.

基于最新诊疗方案中抗新型冠状病毒药物的回顾分析与药学监护

2019年12月以来,湖北武汉爆发由新型冠状病毒引发的病毒性肺炎疫情并迅速蔓延,现已确认该新型病毒为SARS-CoV-2.由于目前针对该病毒尚无确切有效的抗病毒药物,给我国公共卫生事业带来了严峻的考验.随着疫情的发展,国家卫生健康委员会下发了最新的《新型冠状病毒肺炎诊疗的方案(试行第七版)》.该文从临床药学角度对最新诊疗方案中所涉及的抗病毒药物进行回顾分析,提出药学监护的重点,并对潜在有效的药物进行展望,以期为抗击新型冠状病毒疫情提供药物使用参考.

Updating the diagnostic criteria of COVID-19 “suspected case” and “confirmed case” is necessary

On 6 February 2020,our team had published a rapid advice guideline for diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infection,and this guideline provided our experience and make well reference for fighting against this pandemic worldwide.However,the coronavirus disease 2019(COVID-19)is a new disease,our awareness and knowledge are gradually increasing based on the ongoing research findings and clinical practice experience;hence,the strategies of diagnosis and treatment are also continually updated.In this letter,we answered one comment on our guideline and provided the newest diagnostic criteria of"suspected case"and"confirmed case"according to the latest Diagnosis and Treatment Guidelines for COVID-19(seventh version)that issued by the National Health Committee of the People’s Republic of China.

2019 novel coronavirus outbreak:a quiz or final exam?

The 2019 novel coronavirus(2019-nCoV)is an emerging pathogen and is threatening the global health.Strikingly,more than 28000 cases and 550 deaths have been reported within two months from disease emergence.Armed with experience from previous epidemics in the last two decades,clinicians,scientists,officials,and citizens in China are all contributing to the prevention of further 2019-nCoV transmission.Efficient preliminary work has enabled us to understand the basic characteristics of 2019-nCoV,but there are still many unanswered questions.It is too early now to judge our performance in this outbreak.Continuous and strengthened efforts should be made not only during the epidemic,but also afterwards in order to prepare for any incoming challenges.

IDM editorial statement on the 2019-nCoV

In December of 2019,27 patients with viral pneumonia including 7 severe cases were reported inWuhan,the capital city of Hubei province and one of the largest cities of China.By the morning of January 23,2020,the infected cases have increased to 571 including 17 deaths,and spread to 25 of 31 mainland provinces and municipals and Hong Kong,Macao and Taiwan as well as to 7 other countries,including South Korea,Japan,Thailand,Singapore,Philippines,Mexico and the United States of America.

Analysis of diagnosis and treatment of traditional Chinese medicine for COVID-19 nucleic acid

Since the outbreak of coronavirus disease 2019(COVID-19),the author has been involved in the treatment of COVID-19 in the first line.It is found that some patients had a long viral nucleic acid negative time,and even the course of the disease lasted more than 40 days.After a thorough investigation of the root causes,it is found the four possible causes were:"Blood stasis syndrome"is difficult to remove;"Damp heat"sticky greasy;Stubborn basic diseases;weak constitution.All the patients treated with traditional Chinese medicine have turned negative,and now the typical cases were analyzed and summarized in order to provide reference for the traditional Chinese medicine treatment and scientific research of the patients with COVID-19 who were difficult to turn negative.

Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province

Background:The 2019 novel coronavirus(2019-nCoV)causing an outbreak of pneumonia in Wuhan,Hubei province of China was isolated in January 2020.This study aims to investigate its epidemiologic history,and analyze the clinical characteristics,treatment regimens,and prognosis of patients infected with 2019-nCoV during this outbreak.Methods:Clinical data from 1372019-nCoV-infected patients admitted to the respiratory departments of nine tertiary hospitals in Hubei province from December 30,2019 to January 24,2020 were retrospectively collected,including general status,clinical manifestations,laboratory test results,imaging characteristics,and treatment regimens.Results:None of the 137 patients(61 males,76 females,aged 20-83 years,median age 57 years)had a definite history of exposure to Huanan Seafood Wholesale Market.Major initial symptoms included fever(112/137,81.8%),coughing(66/137,48.2%),and muscle pain or fatigue(44/137,32.1%),with other,less typical initial symptoms observed at low frequency,including heart palpitations,diarrhea,and headache.Nearly 80%of the patients had normal or decreased white blood cell counts,and 72.3%(99/137)had lymphocytopenia.Lung involvement was present in all cases,with most chest computed tomography scans showing lesions in multiple lung lobes,some of which were dense;ground-glass opacity co-existed with consolidation shadows or cord-like shadows.Given the lack of effective drugs,treatment focused on symptomatic and respiratory support.Immunoglobulin G was delivered to some critically ill patients according to their conditions.Systemic corticosteroid treatment did not show significant benefits.Notably,early respiratory support facilitated disease recovery and improved prognosis.The risk of death was primarily associated with age,underlying chronic diseases,and median interval from the appearance of initial symptoms to dyspnea.Conclusions:The majority of patients with 2019-nCoV pneumonia present with fever as the first symptom,and most of them still showed typical manifestations of viral pneumonia on chest imaging.Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis.

Clinical features of severe pediatric patients with coronavirus disease 2019 in Wuhan: a single center's observational study

Background An outbreak of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was first detected in Wuhan,Hubei,China.People of all ages are susceptible to SARS-CoV-2 infection.No information on severe pediatric patients with COVID-19 has been reported.We aimed to describe the clinical features of severe pediatric patients with COVID-19.Methods We included eight severe or critically ill patients with COVID-19 who were treated at the Intensive Care Unit (ICU),Wuhan Children's Hospital from January 24 to February 24.We collected information including demographic data,symptoms,imaging data,laboratory findings,treatments and clinical outcomes of the patients with severe COVID-19.Results The onset age of the eight patients ranged from 2 months to 15 years;six were boys.The most common symptoms were polypnea (8/8),followed by fever (6/8) and cough (6/8).Chest imaging showed multiple patch-like shadows in seven patients and ground-glass opacity in six.Laboratory findings revealed normal or increased whole blood counts (7/8),increased C-reactive protein,procalcitonin and lactate dehydrogenase (6/8),and abnormal liver function (4/8).Other findings included decreased CD16 + CD56 (4/8) and Th/Ts*(1/8),increased CD3 (2/8),CD4 (4/8) and CD8 (1/8),IL-6 (2/8),IL-10 (5/8) and IFN-γ (2/8).Treatment modalities were focused on symptomatic and respiratory support.Two critically ill patients underwent invasive mechanical ventilation.Up to February 24,2020,three patients remained under treatment in ICU,the other five recovered and were discharged home.Conclusions In this series of severe pediatric patients in Wuhan,polypnea was the most common symptom,followed by fever and cough.Common imaging changes included multiple patch-like shadows and ground-glass opacity;and a cytokine storm was found in these patients,which appeared more serious in critically ill patients.

Combination of western medicine and Chinese traditional patent medicine in treating a family case of COVID-19

In December 2019,an outbreak of novel coronavirus(2019-nCoV)occurred in Wuhan,Hubei Province,China.By February 14,2020,it has led to 66492 confirmed patients in China and high mortality up to^2.96%(1123/37914)in Wuhan.Here we report the first family case of coronavirus disease 2019(COVID-19)confirmed in Wuhan and treated using the combination of western medicine and Chinese traditional patent medicine Shuanghuanglian oral liquid(SHL).This report describes the identification,diagnosis,clinical course,and management of three cases from a family,suggests the expected therapeutic effects of SHL on COVID-19,and warrants further clinical trials.

China’s local governments are combating COVID-19 with unprecedented responses——from a Wenzhou governance perspective

The COVID-19 caused by a novel strain of coronavirus has been spreading rapidly since its occurrence in December 2019.It is highly communicable through human-to-human transmission.China has been making unprecedented efforts in treating the confirmed cases,identifying and isolating their close contacts and suspected cases to control the source of infection and cut the route of transmission.China’s devotion in handling this epidemic has effectively and efficiently curbed communication domestically and across the border.Representative measures adopted by Wenzhou,the worst hit city out of Hubei Province,are examined to elucidate those massive undertakings with the aim of enhancing international understanding and building global rapport in fighting this evolving epidemic situation.

Analysis of an improved workflow of endoscope reprocessing for bedside endoscopic diagnosis and treatment on COVID-19 patients

Severe cases infected with the coronavirus disease 2019(COVID-19),named by the World Health Organization(WHO)on Feb.11,2020,tend to present a hypercatabolic state because of severe systemic consumption,and are susceptible to stress ulcers and even life-threatening gastrointestinal bleeding.Endoscopic diagnosis and treatment constitute an irreplaceable part in the handling of severe COVID-19 cases.Endoscopes,as reusable precision instruments with complicated structures,require more techniques than other medical devices in cleaning,disinfection,sterilization,and other reprocessing procedures.From 2016 to 2019,health care-acquired infection caused by improper endoscope reprocessing has always been among the top 5 on the list of top 10 health technology hazards issued by the Emergency Care Research Institute.Considering the highly infective nature of COVID-19 and the potential aerosol contamination therefrom,it is of pivotal significance to ensure that endoscopes are strictly reprocessed between uses.In accordance with the national standard"Regulation for Cleaning and Disinfection Technique of Flexible Endoscope(WS507-2016),"we improved the workflow of endoscope reprocessing including the selection of chemicals in an effort to ensure quality control throughout the clinical management towards COVID-19 patients.Based on the experience we attained from the 12 severe COVID-19 cases in our hospital who underwent endoscopy 23 times in total,the article provides an improved version of endoscopic reprocessing guidelines for bedside endoscopic diagnosis and treatment on COVID-19 patients for reference.

An evaluation of mathematical models for the outbreak of COVID-19

Mathematical modelling performs a vital part in estimating and controlling the recent outbreak of coronavirus disease 2019(COVID-19).In this epidemic,most countries impose severe intervention measures to contain the spread of COVID-19.The policymakers are forced to make difficult decisions to leverage between health and economic development.How and when tomake clinical and public health decisions in an epidemic situation is a challenging question.The most appropriate solution is based on scientific evidence,which is mainly dependent on data and models.So one of the most critical problems during this crisis is whether we can develop reliable epidemiological models to forecast the evolution of the virus and estimate the effectiveness of various intervention measures and their impacts on the economy.There are numerous types of mathematical model for epidemiological diseases.In this paper,we present some critical reviews on mathematical models for the outbreak of COVID-19.Some elementary models are presented as an initial formulation for an epidemic.We give some basic concepts,notations,and foundation for epidemiological modelling.More related works are also introduced and evaluated by considering epidemiological features such as disease tendency,latent effects,susceptibility,basic reproduction numbers,asymptomatic infections,herd immunity,and impact of the interventions.

Masks and thermometers:Paramount measures to stop the rapid spread of SARS-CoV-2 in the United States

In the United States,there is currently an exponential growth for the COVID-19 cases.The US president’s coronavirus guidelines for America“30 Days to Slow The Spread”are necessary.To effectively curb the rapid spread of SARS-CoV-2,two more control measures facemasks and thermometers are strongly suggested to be included in the Guidelines.