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

Abstract

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 SARS-CoV-2 outbreak: What we know

“…So far, this disease has rapidly spread from Wuhan to China's other areas, and 66 countries. And then, clustered cases and confirmed cases without a history of travel to Wuhan emerged as the advancing of this disease [9] . In addition, confirmed cases without clear exposure to the seafood market of Wuhan have been spread in many foreign countries [10] .…”

“…SARS-CoV-2 is the seventh member of the family coronaviruses, which is the beta-CoV with over 70% similarity in genetic sequence to SRAS-nCoV [16]. Like SARS-CoV, MERS-CoV, and many other coronaviruses, SARS-CoV-2 likely originated in bats, but it requires further confirmation whether pneumonia infected by the SARS-CoV-2 is transmitted directly from bats or through an intermediate host [9,17,18] .Recent research has found that the virus is 96% identical at the whole-genome level to a bat coronavirus, which means bats is the most possible host of the SARS-CoV-2 [17,18] . Also, Ji and colleagues [19] demonstrated that snack as possible virus reservoir for human infection.…”

“…Up to present, the main infection source was the patients who with pneumonia infected by the SARS-CoV-2. Respiratory droplet transmission is the main route of transmission, and it can also be transmitted through aerial droplets and contact [9] . However, we also should attach importance to asymptomatic cases which may play a critical role in the transmission process [24] .…”

“…J o u r n a l P r e -p r o o f and also, from mycoplasma pneumonia, chlamydia pneumonia, and bacterial pneumonia. In addition, it should be distinguished from non-infectious diseases, such as vasculitis, dermatomyositis, and organizing pneumonia [9] . So, laboratory diagnosis is necessary.…”

The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak

“…Special attention and efforts to protect or reduce transmission should be applied in susceptible populations including children, health care providers, and elderly people. A guideline was published for the medical staff, healthcare providers, and, public health individuals and researchers who are interested in the 2019-nCoV [29]. The early death cases of COVID-19 outbreak occurred primarily in elderly people, possibly due to a weak immune system that permits faster progression of viral infection [8,12].…”