Clinical management of COVID-19.
Clinical management of COVID-19.
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DOI：
10.4103/ijmr.ijmr_957_20
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发表时间：
2020-05
期刊：
影响因子：
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通讯作者：
Abraham OC
中科院分区：
文献类型：
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作者：
Varghese GM;John R;Manesh A;Karthik R;Abraham OC
2019新型冠状病毒病（COVID-19）早期起源于中国武汉市，现已演变为全球大流行病。大多数处于战争状态的国家都提出了最大限度的预防措施和资源，以减轻传播和降低死亡率。本文旨在回顾临床管理的证据，并处理高危人群的识别，警告信号，适当的调查，适当的样本采集确认，一般和具体的治疗措施，策略以及医疗机构的感染控制。已发现高龄、心血管疾病、糖尿病、高血压和癌症是严重疾病的危险因素。对于疑似COVID-19的患者，发热持续5天以上并伴有呼吸急促、心动过速或低血压是需要紧急关注和住院治疗的指征。目前，上呼吸道样本的逆转录-聚合酶链反应（RT-PCR）是首选的诊断测试。虽然许多药物在体外显示出对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的活性，但没有足够的临床数据来促进或劝阻它们的使用。在目前可用的药物中，对于重度COVID-19感染的患者，可能会考虑使用羟氯喹和洛匹那韦/利托那韦，等待进一步的临床试验。严格的液滴和接触预防措施将保护医护人员免受大多数COVID-19临床暴露。
The novel coronavirus disease 2019 (COVID-19) with its early origin from Wuhan city in China has evolved into a global pandemic. Maximal precautionary measures and resources have been put forward by most nations in war footing to mitigate transmission and decrease fatality rates. This article was aimed to review the evidence on clinical management and to deal with the identification of high-risk groups, warning signs, appropriate investigations, proper sample collection for confirmation, general and specific treatment measures, strategies as well as infection control in the healthcare settings. Advanced age, cardiovascular disease, diabetes, hypertension and cancer have been found to be the risk factors for severe disease. Fever lasting for >five days with tachypnoea, tachycardia or hypotension are indications for urgent attention and hospitalization in a patient with suspected COVID-19. At present, reverse transcription-polymerase chain reaction (RT-PCR) from the upper respiratory tract samples is the diagnostic test of choice. While many drugs have shown in vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there are insufficient clinical data to promote or dissuade their usage. Among the currently available drugs, hydroxychloroquine and lopinavir/ritonavir may be considered for patients with severe COVID-19 infection, awaiting further clinical trials. Stringent droplet and contact precautions will protect healthcare workers against most clinical exposures to COVID-19.