How to diagnose new coronavirus infection?

Views:114     Author:Site Editor     Publish Time: 2020-02-04      Origin:https://ask.dxy.com/ama/index#/disease/24677/info/3

1. What are the clinical manifestations of patients with new coronavirus pneumonia?

New type of coronavirus pneumonia often takes fever as the main symptom of onset, which can be combined with mild dry cough, asthenia, dyspnea, diarrhea and other symptoms, while runny nose, cough and other symptoms are rare.

Half of the patients developed dyspnea one week later, and the patients with severe dyspnea progressed rapidly. Within a few days, acute respiratory distress syndrome, septic shock, metabolic acidosis and coagulation dysfunction were found. Some patients have mild onset symptoms and no fever. Most patients have a good prognosis, a few patients are in critical condition, even died.

Laboratory examination: in the early stage of the disease, the total number of white blood cells was normal or decreased, the lymphocyte count was decreased, the liver enzyme, LDH, muscle enzyme and myoglobin were increased in some patients, and the troponin was increased in some critical patients. In most patients, C-reactive protein and ESR increased, and procalcitonin was normal. D-dimer increased in severe cases. The new coronavirus can be identified by real-time RT-PCR.

Chest imaging features: in the early stage, there were multiple small spot films and interstitial changes, which were obvious in the extrapulmonary zone, and then developed into multiple ground glass shadows and infiltrative shadows in both lungs. In severe cases, lung consolidation or even "white lung" may occur, and pleural effusion is rare.

2. How can doctors recognize the new coronavirus pneumonia?

The following two conditions are met:

Epidemiological history: within 14 days before the onset of the disease, there was a travel history or residential history of Wuhan city and surrounding areas, or other communities with case reports; within 14 days before the onset of the disease, there had been contact with patients from Wuhan city and surrounding areas, or from communities with case reports who had fever or respiratory symptoms; clustering disease; contact with people with new coronavirus infection. The new type of coronavirus infection refers to those with positive nucleic acid detection.

Fever and / or respiratory symptoms, with the imaging characteristics of viral pneumonia; the total number of white blood cells in the early stage of the disease was normal or decreased, or the lymphocyte count was reduced; after 3 days of antibiotic treatment, the disease did not significantly improve or worsen.

3. How can doctors diagnose the new type of coronavirus pneumonia?

On the basis of the observation of cases, the pathogenic diagnosis can be made by collecting sputum, throat swab and other respiratory samples for viral nucleic acid gene detection.

4. How can doctors diagnose critical cases?

One of the following:

Respiratory failure and need mechanical ventilation;

Shock;

Other organ failure should be monitored and treated by ICU.

5. How to differentiate and diagnose the new type of coronavirus pneumonia?

According to the "diagnosis and treatment plan for pneumonia with new coronavirus infection (trial version 3)" issued by the national health and Health Commission

In the differential diagnosis of new coronavirus pneumonia, we should consider:

It is mainly differentiated from influenza virus, parainfluenza virus, adenovirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, SARS coronavirus and other known viral pneumonia, Mycoplasma pneumoniae, Chlamydia pneumoniae and bacterial pneumonia.

In addition, it should be differentiated from non infectious diseases, such as vasculitis, dermatomyositis and organic pneumonia.

6. Temperature slightly over 37 ℃, how to deal with it?

We usually say that fever (fever), in fact, is the body surface temperature (such as armpit) more than 37 ℃.

However, due to changes in time and environment, the temperature of normal people will fluctuate. The temperature measured at different times may be different, but the fluctuation range will not exceed 1 ℃.

If the body temperature slightly exceeds 37.3 ℃, there is no other discomfort in the body, you can first observe at home.

If the body temperature is gradually normal and other symptoms are relieved, it means that the body is slowly improving.

In the same way, there are only cases of respiratory discomfort and chest tightness, for many reasons, and it is not necessarily a new type of pneumonia.

Unless there is diabetes, hypertension, hyperlipidemia, heart disease, COPD and other chronic diseases, it is recommended to go to the hospital immediately.

If there is no basic problem, you can relax first, open the window for ventilation, and try to breathe fresh air. If the chest tightness is not relieved, it is recommended to go to the hospital.


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