Pub Date : 2020-03-07DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.0022
P. Bai, Wei He, Xichun Zhang, Shi Liu, Jian-min Jin
Objective To analyzethe clinical features of severe or critical 2019 novel coronavirus pneumonia (COVID-19) patients. Methods Clinical data of 58 patients with severe or critical COVID-19 in Wuhan Union Hospital, Tongji medical college of Huazhong University of Science and Technology from January 29 to February 26 in 2020 were collected. The general information, clinical symptoms, resultsofblood testand chest computed tomography (CT) imaging, treatments and outcomes of patients were analyzed retrospectively. Results 36 severe cases (62.1%) and 22 critical cases (37.9%) , 28 males (48.3%) and 30 females (51.7%) , with average age of (62.12±12.95) years were enrolled. 48.2% of the patients had underlying disease including Hypertension (21 cases, 36.2%), Diabetes mellitus (11 cases, 19.0%), Coronary heart disease (6 cases,10.3%), Chronic renal failure (2 cases, 3.4%) and Malignant tumor (1 case, 1.7%). The symptoms included fever (54 cases, 93.1%), dyspnea (48 cases, 82.8%),cough (46 cases, 79.3%), muscle soreness (32 cases, 55.2%), sore throat (15 cases, 25.9%) and diarrhea (6 cases, 10.3%). Decreased or increased white blood cell count was found in 12.1% and 10.3% of the patients.Decreased percent of lymphocyte, increased percent of neutrophil, and decreased hemoglobin level were found in 60.3%, 46.6%, and 41.4% of the patientsrespectively. Elevated CRP, PCT and D-dimmer level were demonstrated in 65.5%, 62.1%, and 77.5% of the cases. Increased level of ALT, AST, LDH and decreased serum albumin were found in 55.2%, 43.1%, 67.2% and 74.1% of all the patients respectively.The main features of CT were patchy shadows and ground glass shadows, bilateral and peripheral distribution, consolidation and interlobular septal thickening were found in most of the patient’s lungs. 29 cases (50.0%) were treated with antibiotics, and 14 cases (24.1%) with systemic glucocorticoid. In addition to supportive and antivirustreatment,oxygen therapy methods including nasal catheter (9 cases, 15.5%), oxygen mask (33 cases, 56.9%), high-flow nasal catheter (8 cases, 13.3%) and invasive mechanical ventilation were adopted in 15.5%, 56.9%, 13.3% and 13.3% of the patients. 21 patients (36.2%) had been discharged from the hospital, 27 patients (46.6%) in remission were still in the isolation wards, 3 patients (5.2%) had been to the ICU as the disease got worse, and 7 patients were dead. Conclusions Abouthalfofthe patients with severe/critical COVID-19 had underlying disease. severe/criticalCOVID-19 patients often showed extrapulmonary abnormity as well as lung dysfunction. Comprehensive treatment as early as possibly may be important for prognosis improvement of these patients. Key words: 2019 novel coronavirus pneumonia; Clinical features; Disease severity
{"title":"Analysis of clinical features of 58 patients with severe or critical 2019 novel coronavirus pneumonia","authors":"P. Bai, Wei He, Xichun Zhang, Shi Liu, Jian-min Jin","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.0022","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.0022","url":null,"abstract":"Objective \u0000To analyzethe clinical features of severe or critical 2019 novel coronavirus pneumonia (COVID-19) patients. \u0000 \u0000 \u0000Methods \u0000Clinical data of 58 patients with severe or critical COVID-19 in Wuhan Union Hospital, Tongji medical college of Huazhong University of Science and Technology from January 29 to February 26 in 2020 were collected. The general information, clinical symptoms, resultsofblood testand chest computed tomography (CT) imaging, treatments and outcomes of patients were analyzed retrospectively. \u0000 \u0000 \u0000Results \u000036 severe cases (62.1%) and 22 critical cases (37.9%) , 28 males (48.3%) and 30 females (51.7%) , with average age of (62.12±12.95) years were enrolled. 48.2% of the patients had underlying disease including Hypertension (21 cases, 36.2%), Diabetes mellitus (11 cases, 19.0%), Coronary heart disease (6 cases,10.3%), Chronic renal failure (2 cases, 3.4%) and Malignant tumor (1 case, 1.7%). \u0000 \u0000The symptoms included fever (54 cases, 93.1%), dyspnea (48 cases, 82.8%),cough (46 cases, 79.3%), muscle soreness (32 cases, 55.2%), sore throat (15 cases, 25.9%) and diarrhea (6 cases, 10.3%). Decreased or increased white blood cell count was found in 12.1% and 10.3% of the patients.Decreased percent of lymphocyte, increased percent of neutrophil, and decreased hemoglobin level were found in 60.3%, 46.6%, and 41.4% of the patientsrespectively. Elevated CRP, PCT and D-dimmer level were demonstrated in 65.5%, 62.1%, and 77.5% of the cases. Increased level of ALT, AST, LDH and decreased serum albumin were found in 55.2%, 43.1%, 67.2% and 74.1% of all the patients respectively.The main features of CT were patchy shadows and ground glass shadows, bilateral and peripheral distribution, consolidation and interlobular septal thickening were found in most of the patient’s lungs. 29 cases (50.0%) were treated with antibiotics, and 14 cases (24.1%) with systemic glucocorticoid. In addition to supportive and antivirustreatment,oxygen therapy methods including nasal catheter (9 cases, 15.5%), oxygen mask (33 cases, 56.9%), high-flow nasal catheter (8 cases, 13.3%) and invasive mechanical ventilation were adopted in 15.5%, 56.9%, 13.3% and 13.3% of the patients. 21 patients (36.2%) had been discharged from the hospital, 27 patients (46.6%) in remission were still in the isolation wards, 3 patients (5.2%) had been to the ICU as the disease got worse, and 7 patients were dead. \u0000 \u0000 \u0000Conclusions \u0000Abouthalfofthe patients with severe/critical COVID-19 had underlying disease. severe/criticalCOVID-19 patients often showed extrapulmonary abnormity as well as lung dysfunction. Comprehensive treatment as early as possibly may be important for prognosis improvement of these patients. \u0000 \u0000 \u0000Key words: \u00002019 novel coronavirus pneumonia; Clinical features; Disease severity","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48035275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-05DOI: 10.3760/CMA.J.ISSN.1671-0282.2020022.009
Dacan Li, Min Huang, Cailian Zhao, Yuanyuan Gong, Yan Zhang
Objective: To analyze application fields of 5G communication technology in Corona Virus Disease 2019 (COVID-19) epidemic prevention and control, and build a 5G intelligent medical service system for COVID-19 epidemic prevention and control in China. Methods: We collected and analyzed 5G technology application cases used in the fight against COVID-19 from December 2019 to February 2020: 5G + telemedicine application cases, 5G + negative pressure ambulance cases, 5G + remote monitoring cases, 5G + artificial intelligence cases, 5G + infrared thermography temperature detection cases, 5G + big data analysis cases for epidemic prevention and control. Results: Through the analysis of 5G application cases in COVID-19 epidemic prevention and control, we found out the key elements of 5G intelligent medical service system in COVID-19 epidemic prevention and control. By optimizing and upgrading the internal service mode of the hospital, breaking the internal and external barriers, integrating internal and external resources, and strengthening 5G intelligent medical security, we can form a 5G intelligent medical service system for COVID-19 epidemic prevention and control, including application layer, technical service layer, network support layer and security system layer. Conclusion: 5G communication technology has the characteristics of faster speed, shorter time delay and denser capacity. In COVID-19 epidemic prevention and control work, it can further improve the efficiency of doctors' diagnosis, improve patients' medical experience, realize the remote sharing of high-quality medical resources and real-time information exchange, effectively block the spread of epidemic, alleviate the shortage of medical resources and medical staff, and make the epidemic prevention and control more efficient. Key words: 5G communication technology; Artificial intelligence; COVID-19; Epidemic prevention and control; Intelligent medical treatment
{"title":"Construction of 5G intelligent medical service system in novel coronavirus pneumonia prevention and control/ 中华急诊医学杂志","authors":"Dacan Li, Min Huang, Cailian Zhao, Yuanyuan Gong, Yan Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2020022.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020022.009","url":null,"abstract":"Objective: \u0000To analyze application fields of 5G communication technology in Corona Virus Disease 2019 (COVID-19) epidemic prevention and control, and build a 5G intelligent medical service system for COVID-19 epidemic prevention and control in China. \u0000 \u0000 \u0000Methods: \u0000We collected and analyzed 5G technology application cases used in the fight against COVID-19 from December 2019 to February 2020: 5G + telemedicine application cases, 5G + negative pressure ambulance cases, 5G + remote monitoring cases, 5G + artificial intelligence cases, 5G + infrared thermography temperature detection cases, 5G + big data analysis cases for epidemic prevention and control. \u0000 \u0000 \u0000Results: \u0000Through the analysis of 5G application cases in COVID-19 epidemic prevention and control, we found out the key elements of 5G intelligent medical service system in COVID-19 epidemic prevention and control. By optimizing and upgrading the internal service mode of the hospital, breaking the internal and external barriers, integrating internal and external resources, and strengthening 5G intelligent medical security, we can form a 5G intelligent medical service system for COVID-19 epidemic prevention and control, including application layer, technical service layer, network support layer and security system layer. \u0000 \u0000 \u0000Conclusion: \u00005G communication technology has the characteristics of faster speed, shorter time delay and denser capacity. In COVID-19 epidemic prevention and control work, it can further improve the efficiency of doctors' diagnosis, improve patients' medical experience, realize the remote sharing of high-quality medical resources and real-time information exchange, effectively block the spread of epidemic, alleviate the shortage of medical resources and medical staff, and make the epidemic prevention and control more efficient. \u0000 \u0000 \u0000Key words: \u00005G communication technology; Artificial intelligence; COVID-19; Epidemic prevention and control; Intelligent medical treatment","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42857205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-05DOI: 10.3760/CMA.J.ISSN.1671-0282.2020022.008
Jia Liu, Hangyan Zhao, Jinjin Huang, Sheng Ye, Wei Wang, Junfen Fu, Fei Qiu, Yong Fu
The prevention and control of 2019 novel coronavirus (2019-nCoV) is currently the primary task of all industries in China. People can be infected through respiratory droplets, airborne and close contact. Pediatric airway foreign body is a common otorhinolaryngology emergency, especially occurred in 1 to 3-year-old children. It usually causes complications like airway obstruction, suffocation and pneumonia, which may become an acute threat to life. The common practice in otorhinolaryngology emergency room is to perform direct laryngoscope, bronchoscope and foreign body removal. Medical staff need to be closely contacted with these children during surgical operation, who may produce massive droplets and aerosols during examination. With a combination of characteristics of surgical operation, this article intends to provide advices on diagnosis and treatment of airway foreign body removal for pediatric otorhinolaryngology colleagues during the prevention and control of 2019-nCoV. Adjustments could be made subsequently due to changes of the epidemic situation and the recognition of 2019-nCoV.
{"title":"Pediatric Airway Foreign Body Retrieval During the Prevention and Control of 2019 Novel Coronavirus","authors":"Jia Liu, Hangyan Zhao, Jinjin Huang, Sheng Ye, Wei Wang, Junfen Fu, Fei Qiu, Yong Fu","doi":"10.3760/CMA.J.ISSN.1671-0282.2020022.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020022.008","url":null,"abstract":"The prevention and control of 2019 novel coronavirus (2019-nCoV) is currently the primary task of all industries in China. People can be infected through respiratory droplets, airborne and close contact. Pediatric airway foreign body is a common otorhinolaryngology emergency, especially occurred in 1 to 3-year-old children. It usually causes complications like airway obstruction, suffocation and pneumonia, which may become an acute threat to life. The common practice in otorhinolaryngology emergency room is to perform direct laryngoscope, bronchoscope and foreign body removal. Medical staff need to be closely contacted with these children during surgical operation, who may produce massive droplets and aerosols during examination. With a combination of characteristics of surgical operation, this article intends to provide advices on diagnosis and treatment of airway foreign body removal for pediatric otorhinolaryngology colleagues during the prevention and control of 2019-nCoV. Adjustments could be made subsequently due to changes of the epidemic situation and the recognition of 2019-nCoV.","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47808722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-04DOI: 10.3760/CMA.J.ISSN.1671-0282.2020.0019
Wei Zhang, S. Tian, Ying Wang, Hui Chen, Jinjun Zhang
Objective@#To explore the regularity and characteristics of the transmission of Novel Coronavirus Pneumonia(NCP) in crowd, for provide a reference for pre-hospital first aid to identify and screen NCP and close contact, at the same time to improve protection awareness and reduce infection rates.@*Method@#Retrospective analysis about the cases of familial aggregation transferred by Beijing Emergency Medical Center between January 20 and February 10, 2020,collect relevant information,including basic information,contact history,symptoms and signs, clinical outcome, etc.@*Results@#The mean incubation period of familial cluster cases was 5.6d,mean time from onset of symptoms to first visit was 1.8d;Among the 5 family cluster cases, 4 had fever,mean body temperature 38oC, the Sp02 averaged 96%; Among the 5 family cluster cases, 4 had cough, 2 had fatigue, and 1 had dyspnea.@*Conclusion@#People are susceptible to infection to NCP,it spreads easily between close contacts, effective isolation is the focus of prevention and control among family members, it is also one of the difficulties of prevention and control.
{"title":"Analysis of family cluster infection with Novel Coronavirus Pneumonia/ 中华急诊医学杂志","authors":"Wei Zhang, S. Tian, Ying Wang, Hui Chen, Jinjun Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2020.0019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020.0019","url":null,"abstract":"Objective@#To explore the regularity and characteristics of the transmission of Novel Coronavirus Pneumonia(NCP) in crowd, for provide a reference for pre-hospital first aid to identify and screen NCP and close contact, at the same time to improve protection awareness and reduce infection rates.@*Method@#Retrospective analysis about the cases of familial aggregation transferred by Beijing Emergency Medical Center between January 20 and February 10, 2020,collect relevant information,including basic information,contact history,symptoms and signs, clinical outcome, etc.@*Results@#The mean incubation period of familial cluster cases was 5.6d,mean time from onset of symptoms to first visit was 1.8d;Among the 5 family cluster cases, 4 had fever,mean body temperature 38oC, the Sp02 averaged 96%; Among the 5 family cluster cases, 4 had cough, 2 had fatigue, and 1 had dyspnea.@*Conclusion@#People are susceptible to infection to NCP,it spreads easily between close contacts, effective isolation is the focus of prevention and control among family members, it is also one of the difficulties of prevention and control.","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44702785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An outbreak of novel coronavirus pneumonia that began in Wuhan, China, has spread rapidly in December 2019, with cases now confirmed in multiple countries. As the number of cases increases, we pay more and more attention to asymptomatic novel coronavirus pneumonia,We report the first case of Asymptomatic novel coronavirus pneumonia presenting as acute cerebral infarction and describe the identification, diagnosis, clinical course, and emergency treatment, including. This case highlights the the importance of emergency medical teams in initial assessment of emergency public health emergencies, as well as the necessary of the emergency chest CT for screening asymptomatic novel coronavirus pneumonia. Key words: Asymptomatic 2019-novel coronavirus pneumonia; acute cerebral infarction
{"title":"Asymptomatic novel coronavirus pneumonia presenting as acute cerebral infarction:case report and review of the literature/ 中华急诊医学杂志","authors":"Chen Chen, Yanbing Dong, Jian Kang, Shuang Lou, Fen Wan, Hongmei Liu, Jin-song Zhang","doi":"10.3760/CMA.J.ISSN.1671-0282.2020022.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020022.007","url":null,"abstract":"An outbreak of novel coronavirus pneumonia that began in Wuhan, China, has spread rapidly in December 2019, with cases now confirmed in multiple countries. As the number of cases increases, we pay more and more attention to asymptomatic novel coronavirus pneumonia,We report the first case of Asymptomatic novel coronavirus pneumonia presenting as acute cerebral infarction and describe the identification, diagnosis, clinical course, and emergency treatment, including. This case highlights the the importance of emergency medical teams in initial assessment of emergency public health emergencies, as well as the necessary of the emergency chest CT for screening asymptomatic novel coronavirus pneumonia. \u0000 \u0000Key words: \u0000Asymptomatic 2019-novel coronavirus pneumonia; acute cerebral infarction","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42600404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-29DOI: 10.3760/CMA.J.ISSN.1671-0282.2020020.006
Yiwu Zhou, Yanqi He, Z. Jiang, Liu Peng, Yao Chen, Shi-chao Lai, Yu Cao
Objective To investigate the role of epidemiological history in the screening of Corona Virus Disease 2019 (COVID-19) in fever clinic, to improve the efficiency in fever clinic and reduce the incidence of cross infection. Methods This is a retrospective study. Patients who were admitted to the fever clinic in West China Hospital of Sichuan University from January 23th, 2020 to February 11th, 2020 included the study. According to epidemiological history, the patients were divided into epidemiological history group (the experimental group) and no epidemiological history group (the control group). The two groups of patients were admitted and treated separately. The clinical data, NEWS score, etiology results, viral pneumonia showed on CT, time of visit, COVID-19 patient ratio, and admission composition ratio were compared between the two groups. The measurement data were presented as the mean ± standard deviation (SD), and the numeration data were expressed as ratio or constituent ratio. The measurement data of normal distribution between the two groups were compared by independent sample t test. The measurement data of skewed distribution are expressed by the median (interquartile range), and the comparison between the two groups is tested by non-parameter. The differences between enumeration data were assessed by chi-square test. A P<0.05 was considered statistically significant. Results A total of 2423 patients were included, including 927 patients in the experimental group and 1296 patients in the control group. There were no significant differences in gender, NEWS score and clinical symptoms between the two groups (P> 0.05). The age (35.00 ± 12.80 vs 38.13 ± 15.57 years) , the proportion of fever patients (28.80% vs 32.75%) and waiting time (31.72 vs 58.08 min) of the experimental group were lower than the control group, the difference was statistically significant (P 0.05). Conclusion It is necessary to adjust the management mode of fever clinic during the Corona Virus Disease 2019, and to manage the patients according to the epidemiological history which can improve the screening efficiency and reduce the risk of cross infection. Key words: Corona Virus Disease 2019; Fever clinic; Management; epidemic period; Epidemiological history; Infection; Zonal treatment; Screening
目的探讨流行病学史在发热门诊2019冠状病毒病(COVID-19)筛查中的作用，提高发热门诊工作效率，降低交叉感染发生率。方法回顾性研究。2020年1月23日至2020年2月11日在四川大学华西医院发热门诊就诊的患者纳入本研究。根据流行病学史将患者分为有流行病学史组(实验组)和无流行病学史组(对照组)。两组患者分别入院治疗。比较两组患者的临床资料、NEWS评分、病因学结果、CT显示的病毒性肺炎、就诊时间、COVID-19患者比例、住院构成比例。计量资料以均数±标准差(SD)表示，计数资料以比值或构成比表示。两组间正态分布计量资料比较采用独立样本t检验。偏态分布的计量数据以中位数(四分位数间距)表示，两组间的比较采用非参数检验。计数资料间的差异采用卡方检验。p < 0.05)。实验组患者的年龄(35.00±12.80岁vs 38.13±15.57岁)、发热患者比例(28.80% vs 32.75%)、等待时间(31.72 vs 58.08 min)均低于对照组，差异有统计学意义(P 0.05)。结论2019冠状病毒病期间，有必要调整发热门诊管理模式，根据流行病学史对患者进行管理，以提高筛查效率，降低交叉感染风险。关键词:2019冠状病毒病;发烧门诊;管理;流行周期;流行病学历史;感染;纬向治疗;筛选
{"title":"Discussion on the Management of Fever Clinic during the Epidemic Period of Corona Virus Disease 2019","authors":"Yiwu Zhou, Yanqi He, Z. Jiang, Liu Peng, Yao Chen, Shi-chao Lai, Yu Cao","doi":"10.3760/CMA.J.ISSN.1671-0282.2020020.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020020.006","url":null,"abstract":"Objective \u0000To investigate the role of epidemiological history in the screening of Corona Virus Disease 2019 (COVID-19) in fever clinic, to improve the efficiency in fever clinic and reduce the incidence of cross infection. \u0000 \u0000 \u0000Methods \u0000This is a retrospective study. Patients who were admitted to the fever clinic in West China Hospital of Sichuan University from January 23th, 2020 to February 11th, 2020 included the study. According to epidemiological history, the patients were divided into epidemiological history group (the experimental group) and no epidemiological history group (the control group). The two groups of patients were admitted and treated separately. The clinical data, NEWS score, etiology results, viral pneumonia showed on CT, time of visit, COVID-19 patient ratio, and admission composition ratio were compared between the two groups. The measurement data were presented as the mean ± standard deviation (SD), and the numeration data were expressed as ratio or constituent ratio. The measurement data of normal distribution between the two groups were compared by independent sample t test. The measurement data of skewed distribution are expressed by the median (interquartile range), and the comparison between the two groups is tested by non-parameter. The differences between enumeration data were assessed by chi-square test. A P<0.05 was considered statistically significant. \u0000 \u0000 \u0000Results \u0000A total of 2423 patients were included, including 927 patients in the experimental group and 1296 patients in the control group. There were no significant differences in gender, NEWS score and clinical symptoms between the two groups (P> 0.05). The age (35.00 ± 12.80 vs 38.13 ± 15.57 years) , the proportion of fever patients (28.80% vs 32.75%) and waiting time (31.72 vs 58.08 min) of the experimental group were lower than the control group, the difference was statistically significant (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000It is necessary to adjust the management mode of fever clinic during the Corona Virus Disease 2019, and to manage the patients according to the epidemiological history which can improve the screening efficiency and reduce the risk of cross infection. \u0000 \u0000 \u0000Key words: \u0000Corona Virus Disease 2019; Fever clinic; Management; epidemic period; Epidemiological history; Infection; Zonal treatment; Screening","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47383012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-26DOI: 10.3760/CMA.J.ISSN.1671-0282.2020022.003
Jian-cheng Zhang, Hua Jiang, Lei Deng, Kai Wang, M. Sun, Ping Zhou, Wei Chen
The digestive tract is a target organ attacked by COVID-19. It is also the earliest affected organ other than the lung and must bear side effects from the anti-virus chemotherapy such as LPV/r. In this article, we aim to provide practical recommendations for a nutritional and metabolic management strategy for severe corona virus disease-19 (COVID-19) patients. These recommendations are based on the newest pathophysiological findings on the risk factors of malnutrition for COVID-19. We also systematically retrieve literatures on nutritional therapy for acute lung injuries from international and Chinese databases according to evidence-based principles. Our suggestions are: 1) Physicians should be mindful of gut injury when they focus on respiratory support, by monitoring and managing the nutritional status; 2) Periodical and dynamic nutritional risk evaluation is needed; 3) For severe patients, the feeding target of calorie and protein should be down-regulated; 4)The using of ω-3 fatty acids products should be in accordance with pharmacological indications; the forms and dosage should be determined individually. Key words: corona virus disease-19 (COVID-19); critical illness; nutritional risk; nutritional support; energy; protein; ω-3 fatty acids
{"title":"Nutritional and Metabolic Support and the Treatment Strategy of Severe Corona Virus Disease 2019 (COVID-19)/ 中华急诊医学杂志","authors":"Jian-cheng Zhang, Hua Jiang, Lei Deng, Kai Wang, M. Sun, Ping Zhou, Wei Chen","doi":"10.3760/CMA.J.ISSN.1671-0282.2020022.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-0282.2020022.003","url":null,"abstract":"The digestive tract is a target organ attacked by COVID-19. It is also the earliest affected organ other than the lung and must bear side effects from the anti-virus chemotherapy such as LPV/r. In this article, we aim to provide practical recommendations for a nutritional and metabolic management strategy for severe corona virus disease-19 (COVID-19) patients. These recommendations are based on the newest pathophysiological findings on the risk factors of malnutrition for COVID-19. We also systematically retrieve literatures on nutritional therapy for acute lung injuries from international and Chinese databases according to evidence-based principles. Our suggestions are: 1) Physicians should be mindful of gut injury when they focus on respiratory support, by monitoring and managing the nutritional status; 2) Periodical and dynamic nutritional risk evaluation is needed; 3) For severe patients, the feeding target of calorie and protein should be down-regulated; 4)The using of ω-3 fatty acids products should be in accordance with pharmacological indications; the forms and dosage should be determined individually. \u0000 \u0000 \u0000Key words: \u0000corona virus disease-19 (COVID-19); critical illness; nutritional risk; nutritional support; energy; protein; ω-3 fatty acids","PeriodicalId":9981,"journal":{"name":"中华急诊医学杂志","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45864324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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