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> потащили на ИВЛ даже бессимптомников. Это опять-таки случай так называемого вранья. V. Diagnosis and Clinical Classification of COVID-19 Early diagnosis, treatment and isolation should be carried out whenever possible. Dynamic monitoring of lung imaging, oxygenation index and cytokine levels are helpful for early identification of patients who may develop into severe and critical cases. A positive result of the nucleic acid of SARS-CoV-2 is the gold standard for the diagnosis of COVID-19. However, considering the possibility of false negatives in nucleic acid detection, suspected cases characteristic manifestations in CT scans can be treated as confirmed cases even if the nucleic acid test is negative. Isolation and continuous tests of multiple specimens should be carried out in such cases. The diagnostic criteria follow Protocols for the Diagnosis and Treatment of CDVID-2019. A confirmed case is based on epidemiological history (including cluster transmission), clinical manifestations (fever and respiratory symptoms), lung imaging, and results of SARS-CoV-2 nucleic acid detection and serum-specific antibodies. Clinical Classifications: 1) Mild Cases The clinical symptoms are mild and no pneumonia manifestations can be found in imaging. 2) Moderate Cases Patients have symptoms such as fever and respiratory tract symptoms, etc. and pneumonia manifestations can be seen in imaging. 3) Severe Cases Adults who meet any of the following criteria: respiratory rate ;;, 30 breaths/min; oxygen saturations; 93% at a rest state; arterial partial pressure of oxygen (PaO,)/oxygen concentration (FiO,) s; 300 mm Hg. Patients with> 50% lesions progression within 24 to 48 hours in lung imaging should be treated as severe cases. 4) Critical Cases Meeting any of the following criteria: occurrence of respiratory failure requiring mechanical ventilation; presence of shock; other organ failure that requires monitoring and treatment in the ICU. Critical cases are further divided into early, middle and late stages according to the oxygenation index and compliance of respiratory system. • Early stage: 100 mmHg <oxygenation index s;lSO mm Hg; compliance of respiratory system ;;,30 ml/ cmH,O; without organ failure other than the lungs. The patient has a great chance of recovery through active antiviral, anti-cytokine storm, and supportive treatment. • Middle stage: 60 mmHg < oxygenation index s;lOO mmHg; 30 mL/cmH,O > compliance of respiratory system ;;el 5 mL/cmH,O; may be complicated by other mild or moderate dysfunction of other organs. • Late stage: oxygenation index s; 60 mmHg; compliance of respiratory system <15 mL/cmH,O; diffuse consolidation of both lungs that requires the use of ECMO; or failure of other vital organs. The mortality risk is significantly increased Добавить комментарий: |
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