Serveur d'exploration Covid

Attention, ce site est en cours de développement !
Attention, site généré par des moyens informatiques à partir de corpus bruts.
Les informations ne sont donc pas validées.

[Management of corona virus disease-19 (COVID-19): the Zhejiang experience].

Identifieur interne : 000477 ( PubMed/Corpus ); précédent : 000476; suivant : 000478

[Management of corona virus disease-19 (COVID-19): the Zhejiang experience].

Auteurs : Kaijin Xu ; Hongliu Cai ; Yihong Shen ; Qin Ni ; Yu Chen ; Shaohua Hu ; Jianping Li ; Huafen Wang ; Liang Yu ; He Huang ; Yunqing Qiu ; Guoqing Wei ; Qiang Fang ; Jianying Zhou ; Jifang Sheng ; Tingbo Liang ; Lanjuan Li

Source :

RBID : pubmed:32096367

English descriptors

Abstract

The current epidemic situation of corona virus disease-19 (COVID-19) still remained severe. As the National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine is the primary medical care center for COVID-19 inZhejiang Province. Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance"strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance. Meanwhile, integrated multidisciplinarypersonalized treatment was recommended to improve therapeutic effect. The importance of early viralogical detection, dynamic monitoring of inflammatory indexes and chest radiograph was emphasized in clinical decision-making. Sputum was observed with the highest positive rate of RT-PCR results. Viral nucleic acids could be detected in10% patients'blood samples at acute periodand 50% of patients had positive RT-PCR results in their feces. We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifyingcytokine storms and application of artificial liver blood purification system. The "Four-Anti and Two-Balance"strategyeffectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviraleffects in COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favoredthe balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness. For cases of severe illness, early and also short periods of moderate glucocorticoid was supported. Patients with oxygenation index below 200 mmHg should be transferred to intensive medical center. Conservative oxygen therapy was preferred and noninvasive ventilation was not recommended. Patients with mechanical ventilation should be strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis should be prescribed rationally and was not recommended except for patients with long course of disease, repeated fever and elevated procalcitonin (PCT), meanwhile secondary fungal infection should be concerned.Some patients with COVID-19 showed intestinal microbialdysbiosis with decreasedprobiotics such as Lactobacillus and Bifidobacterium. Nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation. Anxiety and fear were common in patients with COVID-19. Therefore, we established dynamic assessment and warning for psychological crisis. We also integrated Chinese medicine in treatment to promote disease rehabilitation through classification methods of traditional Chinese medicine. We optimized nursing process for severe patients to promote their rehabilitation. It remained unclear about viral clearance pattern after the SARS-CoV-2 infection. Therefore, two weeks' quarantine for discharged patients was required and a regular following up was also needed.The Zhejiang experience above and suggestions have been implemented in our center and achieved good results. However, since COVID-19 was a newly emerging disease, more work was warranted to improve strategies of prevention, diagnosis and treatment for COVID-19.

PubMed: 32096367

Links to Exploration step

pubmed:32096367

Le document en format XML

<record>
<TEI>
<teiHeader>
<fileDesc>
<titleStmt>
<title xml:lang="en">[Management of corona virus disease-19 (COVID-19): the Zhejiang experience].</title>
<author>
<name sortKey="Xu, Kaijin" sort="Xu, Kaijin" uniqKey="Xu K" first="Kaijin" last="Xu">Kaijin Xu</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Cai, Hongliu" sort="Cai, Hongliu" uniqKey="Cai H" first="Hongliu" last="Cai">Hongliu Cai</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Shen, Yihong" sort="Shen, Yihong" uniqKey="Shen Y" first="Yihong" last="Shen">Yihong Shen</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Ni, Qin" sort="Ni, Qin" uniqKey="Ni Q" first="Qin" last="Ni">Qin Ni</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Chen, Yu" sort="Chen, Yu" uniqKey="Chen Y" first="Yu" last="Chen">Yu Chen</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Hu, Shaohua" sort="Hu, Shaohua" uniqKey="Hu S" first="Shaohua" last="Hu">Shaohua Hu</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Li, Jianping" sort="Li, Jianping" uniqKey="Li J" first="Jianping" last="Li">Jianping Li</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Wang, Huafen" sort="Wang, Huafen" uniqKey="Wang H" first="Huafen" last="Wang">Huafen Wang</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Yu, Liang" sort="Yu, Liang" uniqKey="Yu L" first="Liang" last="Yu">Liang Yu</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Huang, He" sort="Huang, He" uniqKey="Huang H" first="He" last="Huang">He Huang</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Qiu, Yunqing" sort="Qiu, Yunqing" uniqKey="Qiu Y" first="Yunqing" last="Qiu">Yunqing Qiu</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Wei, Guoqing" sort="Wei, Guoqing" uniqKey="Wei G" first="Guoqing" last="Wei">Guoqing Wei</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Fang, Qiang" sort="Fang, Qiang" uniqKey="Fang Q" first="Qiang" last="Fang">Qiang Fang</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Zhou, Jianying" sort="Zhou, Jianying" uniqKey="Zhou J" first="Jianying" last="Zhou">Jianying Zhou</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Sheng, Jifang" sort="Sheng, Jifang" uniqKey="Sheng J" first="Jifang" last="Sheng">Jifang Sheng</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Liang, Tingbo" sort="Liang, Tingbo" uniqKey="Liang T" first="Tingbo" last="Liang">Tingbo Liang</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Li, Lanjuan" sort="Li, Lanjuan" uniqKey="Li L" first="Lanjuan" last="Li">Lanjuan Li</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
</titleStmt>
<publicationStmt>
<idno type="wicri:source">PubMed</idno>
<date when="2020">2020</date>
<idno type="RBID">pubmed:32096367</idno>
<idno type="pmid">32096367</idno>
<idno type="wicri:Area/PubMed/Corpus">000477</idno>
<idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000477</idno>
</publicationStmt>
<sourceDesc>
<biblStruct>
<analytic>
<title xml:lang="en">[Management of corona virus disease-19 (COVID-19): the Zhejiang experience].</title>
<author>
<name sortKey="Xu, Kaijin" sort="Xu, Kaijin" uniqKey="Xu K" first="Kaijin" last="Xu">Kaijin Xu</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Cai, Hongliu" sort="Cai, Hongliu" uniqKey="Cai H" first="Hongliu" last="Cai">Hongliu Cai</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Shen, Yihong" sort="Shen, Yihong" uniqKey="Shen Y" first="Yihong" last="Shen">Yihong Shen</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Ni, Qin" sort="Ni, Qin" uniqKey="Ni Q" first="Qin" last="Ni">Qin Ni</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Chen, Yu" sort="Chen, Yu" uniqKey="Chen Y" first="Yu" last="Chen">Yu Chen</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Hu, Shaohua" sort="Hu, Shaohua" uniqKey="Hu S" first="Shaohua" last="Hu">Shaohua Hu</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Li, Jianping" sort="Li, Jianping" uniqKey="Li J" first="Jianping" last="Li">Jianping Li</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Wang, Huafen" sort="Wang, Huafen" uniqKey="Wang H" first="Huafen" last="Wang">Huafen Wang</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Yu, Liang" sort="Yu, Liang" uniqKey="Yu L" first="Liang" last="Yu">Liang Yu</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Huang, He" sort="Huang, He" uniqKey="Huang H" first="He" last="Huang">He Huang</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Qiu, Yunqing" sort="Qiu, Yunqing" uniqKey="Qiu Y" first="Yunqing" last="Qiu">Yunqing Qiu</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Wei, Guoqing" sort="Wei, Guoqing" uniqKey="Wei G" first="Guoqing" last="Wei">Guoqing Wei</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Fang, Qiang" sort="Fang, Qiang" uniqKey="Fang Q" first="Qiang" last="Fang">Qiang Fang</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Zhou, Jianying" sort="Zhou, Jianying" uniqKey="Zhou J" first="Jianying" last="Zhou">Jianying Zhou</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Sheng, Jifang" sort="Sheng, Jifang" uniqKey="Sheng J" first="Jifang" last="Sheng">Jifang Sheng</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Liang, Tingbo" sort="Liang, Tingbo" uniqKey="Liang T" first="Tingbo" last="Liang">Tingbo Liang</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Li, Lanjuan" sort="Li, Lanjuan" uniqKey="Li L" first="Lanjuan" last="Li">Lanjuan Li</name>
<affiliation>
<nlm:affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</nlm:affiliation>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences</title>
<idno type="ISSN">1008-9292</idno>
<imprint>
<date when="2020" type="published">2020</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Antibiotic Prophylaxis</term>
<term>Antiviral Agents (therapeutic use)</term>
<term>China</term>
<term>Coronavirus Infections (diagnosis)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Coronavirus Infections (psychology)</term>
<term>Coronavirus Infections (therapy)</term>
<term>Critical Illness (therapy)</term>
<term>Humans</term>
<term>Medicine, Chinese Traditional</term>
<term>Nutritional Support</term>
<term>Pneumonia, Viral (diagnosis)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>Pneumonia, Viral (psychology)</term>
<term>Pneumonia, Viral (therapy)</term>
<term>Respiration, Artificial</term>
<term>Shock</term>
<term>Stress, Psychological (therapy)</term>
<term>Water-Electrolyte Balance</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en">
<term>Antiviral Agents</term>
</keywords>
<keywords scheme="MESH" type="geographic" xml:lang="en">
<term>China</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en">
<term>Coronavirus Infections</term>
<term>Critical Illness</term>
<term>Pneumonia, Viral</term>
<term>Stress, Psychological</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Antibiotic Prophylaxis</term>
<term>Humans</term>
<term>Medicine, Chinese Traditional</term>
<term>Nutritional Support</term>
<term>Respiration, Artificial</term>
<term>Shock</term>
<term>Water-Electrolyte Balance</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">The current epidemic situation of corona virus disease-19 (COVID-19) still remained severe. As the National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine is the primary medical care center for COVID-19 inZhejiang Province. Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance"strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance. Meanwhile, integrated multidisciplinarypersonalized treatment was recommended to improve therapeutic effect. The importance of early viralogical detection, dynamic monitoring of inflammatory indexes and chest radiograph was emphasized in clinical decision-making. Sputum was observed with the highest positive rate of RT-PCR results. Viral nucleic acids could be detected in10% patients'blood samples at acute periodand 50% of patients had positive RT-PCR results in their feces. We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifyingcytokine storms and application of artificial liver blood purification system. The "Four-Anti and Two-Balance"strategyeffectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviraleffects in COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favoredthe balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness. For cases of severe illness, early and also short periods of moderate glucocorticoid was supported. Patients with oxygenation index below 200 mmHg should be transferred to intensive medical center. Conservative oxygen therapy was preferred and noninvasive ventilation was not recommended. Patients with mechanical ventilation should be strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis should be prescribed rationally and was not recommended except for patients with long course of disease, repeated fever and elevated procalcitonin (PCT), meanwhile secondary fungal infection should be concerned.Some patients with COVID-19 showed intestinal microbialdysbiosis with decreasedprobiotics such as
<i>Lactobacillus</i>
and
<i>Bifidobacterium</i>
. Nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation. Anxiety and fear were common in patients with COVID-19. Therefore, we established dynamic assessment and warning for psychological crisis. We also integrated Chinese medicine in treatment to promote disease rehabilitation through classification methods of traditional Chinese medicine. We optimized nursing process for severe patients to promote their rehabilitation. It remained unclear about viral clearance pattern after the SARS-CoV-2 infection. Therefore, two weeks' quarantine for discharged patients was required and a regular following up was also needed.The Zhejiang experience above and suggestions have been implemented in our center and achieved good results. However, since COVID-19 was a newly emerging disease, more work was warranted to improve strategies of prevention, diagnosis and treatment for COVID-19.</div>
</front>
</TEI>
<pubmed>
<MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM">
<PMID Version="1">32096367</PMID>
<DateCompleted>
<Year>2020</Year>
<Month>03</Month>
<Day>16</Day>
</DateCompleted>
<DateRevised>
<Year>2020</Year>
<Month>03</Month>
<Day>16</Day>
</DateRevised>
<Article PubModel="Print">
<Journal>
<ISSN IssnType="Print">1008-9292</ISSN>
<JournalIssue CitedMedium="Print">
<Volume>49</Volume>
<Issue>1</Issue>
<PubDate>
<Year>2020</Year>
<Month>Feb</Month>
<Day>21</Day>
</PubDate>
</JournalIssue>
<Title>Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences</Title>
<ISOAbbreviation>Zhejiang Da Xue Xue Bao Yi Xue Ban</ISOAbbreviation>
</Journal>
<ArticleTitle>[Management of corona virus disease-19 (COVID-19): the Zhejiang experience].</ArticleTitle>
<Pagination>
<MedlinePgn>0</MedlinePgn>
</Pagination>
<Abstract>
<AbstractText>The current epidemic situation of corona virus disease-19 (COVID-19) still remained severe. As the National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine is the primary medical care center for COVID-19 inZhejiang Province. Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance"strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance. Meanwhile, integrated multidisciplinarypersonalized treatment was recommended to improve therapeutic effect. The importance of early viralogical detection, dynamic monitoring of inflammatory indexes and chest radiograph was emphasized in clinical decision-making. Sputum was observed with the highest positive rate of RT-PCR results. Viral nucleic acids could be detected in10% patients'blood samples at acute periodand 50% of patients had positive RT-PCR results in their feces. We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifyingcytokine storms and application of artificial liver blood purification system. The "Four-Anti and Two-Balance"strategyeffectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviraleffects in COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favoredthe balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness. For cases of severe illness, early and also short periods of moderate glucocorticoid was supported. Patients with oxygenation index below 200 mmHg should be transferred to intensive medical center. Conservative oxygen therapy was preferred and noninvasive ventilation was not recommended. Patients with mechanical ventilation should be strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis should be prescribed rationally and was not recommended except for patients with long course of disease, repeated fever and elevated procalcitonin (PCT), meanwhile secondary fungal infection should be concerned.Some patients with COVID-19 showed intestinal microbialdysbiosis with decreasedprobiotics such as
<i>Lactobacillus</i>
and
<i>Bifidobacterium</i>
. Nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation. Anxiety and fear were common in patients with COVID-19. Therefore, we established dynamic assessment and warning for psychological crisis. We also integrated Chinese medicine in treatment to promote disease rehabilitation through classification methods of traditional Chinese medicine. We optimized nursing process for severe patients to promote their rehabilitation. It remained unclear about viral clearance pattern after the SARS-CoV-2 infection. Therefore, two weeks' quarantine for discharged patients was required and a regular following up was also needed.The Zhejiang experience above and suggestions have been implemented in our center and achieved good results. However, since COVID-19 was a newly emerging disease, more work was warranted to improve strategies of prevention, diagnosis and treatment for COVID-19.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>Xu</LastName>
<ForeName>Kaijin</ForeName>
<Initials>K</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Cai</LastName>
<ForeName>Hongliu</ForeName>
<Initials>H</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Shen</LastName>
<ForeName>Yihong</ForeName>
<Initials>Y</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Ni</LastName>
<ForeName>Qin</ForeName>
<Initials>Q</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Chen</LastName>
<ForeName>Yu</ForeName>
<Initials>Y</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Hu</LastName>
<ForeName>Shaohua</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Li</LastName>
<ForeName>Jianping</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Wang</LastName>
<ForeName>Huafen</ForeName>
<Initials>H</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Yu</LastName>
<ForeName>Liang</ForeName>
<Initials>L</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Huang</LastName>
<ForeName>He</ForeName>
<Initials>H</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Qiu</LastName>
<ForeName>Yunqing</ForeName>
<Initials>Y</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Wei</LastName>
<ForeName>Guoqing</ForeName>
<Initials>G</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Fang</LastName>
<ForeName>Qiang</ForeName>
<Initials>Q</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Zhou</LastName>
<ForeName>Jianying</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Sheng</LastName>
<ForeName>Jifang</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Liang</LastName>
<ForeName>Tingbo</ForeName>
<Initials>T</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Li</LastName>
<ForeName>Lanjuan</ForeName>
<Initials>L</Initials>
<AffiliationInfo>
<Affiliation>the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>chi</Language>
<PublicationTypeList>
<PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
</Article>
<MedlineJournalInfo>
<Country>China</Country>
<MedlineTA>Zhejiang Da Xue Xue Bao Yi Xue Ban</MedlineTA>
<NlmUniqueID>100927946</NlmUniqueID>
<ISSNLinking>1008-9292</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList>
<Chemical>
<RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance>
</Chemical>
<Chemical>
<RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="C000657245">COVID-19</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList>
<MeshHeading>
<DescriptorName UI="D019072" MajorTopicYN="N">Antibiotic Prophylaxis</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D002681" MajorTopicYN="N" Type="Geographic">China</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D018352" MajorTopicYN="Y">Coronavirus Infections</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D016638" MajorTopicYN="Y">Critical Illness</DescriptorName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008516" MajorTopicYN="N">Medicine, Chinese Traditional</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D018529" MajorTopicYN="N">Nutritional Support</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D011024" MajorTopicYN="Y">Pneumonia, Viral</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D012769" MajorTopicYN="N">Shock</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D013315" MajorTopicYN="N">Stress, Psychological</DescriptorName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D014882" MajorTopicYN="N">Water-Electrolyte Balance</DescriptorName>
</MeshHeading>
</MeshHeadingList>
</MedlineCitation>
<PubmedData>
<History>
<PubMedPubDate PubStatus="entrez">
<Year>2020</Year>
<Month>2</Month>
<Day>26</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed">
<Year>2020</Year>
<Month>2</Month>
<Day>26</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline">
<Year>2020</Year>
<Month>2</Month>
<Day>26</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList>
<ArticleId IdType="pubmed">32096367</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/CovidV1/Data/PubMed/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000477 | SxmlIndent | more

Ou

HfdSelect -h $EXPLOR_AREA/Data/PubMed/Corpus/biblio.hfd -nk 000477 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    CovidV1
   |flux=    PubMed
   |étape=   Corpus
   |type=    RBID
   |clé=     pubmed:32096367
   |texte=   [Management of corona virus disease-19 (COVID-19): the Zhejiang experience].
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/PubMed/Corpus/RBID.i   -Sk "pubmed:32096367" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/PubMed/Corpus/biblio.hfd   \
       | NlmPubMed2Wicri -a CovidV1 

Wicri

This area was generated with Dilib version V0.6.33.
Data generation: Fri Mar 27 18:14:15 2020. Site generation: Sun Jan 31 15:15:08 2021