Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version)

Ying-Hui Jin; Qing-Yuan Zhan; Zhi-Yong Peng; Xue-Qun Ren; Xun-Tao Yin; Lin Cai; Yu-Feng Yuan; Ji-Rong Yue; Xiao-Chun Zhang; Qi-Wen Yang; Jianguang Ji; Jian Xia; Yi-Rong Li; Fu-Xiang Zhou; Ya-Dong Gao; Zhui Yu; Feng Xu; Ming-Li Tu; Li-Ming Tan; Min Yang; Fang Chen; Xiao-Ju Zhang; Mei Zeng; Yu Zhu; Xin-Can Liu; Jian Yang; Dong-Chi Zhao; Yu-Feng Ding; Ning Hou; Fu-Bing Wang; Hao Chen; Yong-Gang Zhang; Wei Li; Wen Chen; Yue-Xian Shi; Xiu-Zhi Yang; Xue-Jun Wang; Yan-Jun Zhong; Ming-Juan Zhao; Bing-Hui Li; Lin-Lu Ma; Hao Zi; Na Wang; Yun-Yun Wang; Shao-Fu Yu; Lu-Yao Li; Qiao Huang; Hong Weng; Xiang-Ying Ren; Li-Sha Luo; Man-Ru Fan; Di Huang; Hong-Yang Xue; Lin-Xin Yu; Jin-Ping Gao; Tong Deng; Xian-Tao Zeng; Hong-Jun Li; Zhen-Shun Cheng; Xiao-Mei Yao; Xing-Huan Wang; Evidence-Based Medicine Chapter of China International Exchange and Promotive Association for Medical and Health Care (CPAM); Chinese Research Hospital Association (CRHA)

doi:10.1186/s40779-020-00270-8

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Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version)

POSITION ARTICLE AND GUIDELINES | Updated：2023-06-05

- Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version)
- Military Medical Research Vol. 7, Issue 3, Pages: 249-282(2020)
- Affiliations：
  
  1.Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
  2.National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing 100029, China.
  3.Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 10029, China.
  4.Leishenshan Hospital in Wuhan, Wuhan 430200, China.
  5.Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
  6.Institutes of Evidence-based Medicine and Knowledge Translation, Henan University, Kaifeng 475000, Henan, China.
  7.Department of Medical Imaging, Guizhou Provincial People's Hospital, Guiyang 550002, China.
  8.Departments of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
  9.Department of Hepatobiliary Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
  10.National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu 610041, China.
  11.Department of Geriatrics, West China Hospital of Sichuan University, Chengdu 610041, China.
  12.Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
  13.Department of Clinical Laboratory, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College, Chinese Academy of Medical Sciences (CAMS), Beijing 100730, China.
  14.Center for Primary Health Care Research, Lund University and Region Skåne, 25002 Malmö, Sweden.
  15.Emergency Center, Zhongnan Hospital of Wuhan University, Wuhan 403371, China.
  16.Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
  17.Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 43071, China.
  18.Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China.
  19.Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong University, Jinan 250002, China.
  20.Department of Respiratory and Critical Care Medicine, Suizhou Central Hospital, Hubei University of Medicine, Suizhou 441300, Hubei, China.
  21.Department of Clinic Pharmacy, Second People's Hospital of Huaihua City, Huaihua 418000, Hunan, China.
  22.Department of Intensive Care Unit, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
  23.Department of Internal Medicine, Zhengzhou University Hospital, Zhengzhou 450001, China.
  24.Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou 450003, China.
  25.Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China.
  26.Department of Infectious Disease, West China Second Hospital, Sichuan University, Chengdu 610041, China.
  27.Department of Cardiology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China.
  28.Department of Cardiology, Yichang NO.1 Hospital, Renmin Hospital of China Three Gorges University, Yichang 443000, Hubei, China.
  29.Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
  30.Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
  31.Department of Pharmacy, Shandong Provincial Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan 250021, China.
  32.Laboratory of Integrated Acupuncture and Drugs, Nanjing University of Chinese Medicine, Nanjing 210023, China.
  33.Department of Periodical Press, West China Hospital, Sichuan University, Chengdu 610041, China.
  34.Department of Clinical Laboratory, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, Shandong, China.
  35.Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China.
  36.School of Nursing, Peking University, Beijing 100191, China.
  37.Department of Respiratory and Critical Care Medicine, Kaifeng Central Hospital, Kaifeng 475000, Henan, China.
  38.Department of Emergency, Beijing Electric Power Hospital, Beijing 100073, China.
  39.ICU Center, The Second Xiangya Hospital, Central South University, Changsha 410008, China.
  40.Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
  41.Department of Haematology, Zhongnan Hospital, Wuhan University, Wuhan 430071, China.
  42.College of Nursing and Health, Henan Medical School, Henan University, Kaifeng 475000, Henan, China.
  43.School of Nursing, Shanxi Medical University, Taiyuan 030001, China.
  44.Department of Diagnostic Radiology, Beijing You’an Hospital, Capital Medical University, Beijing 100069, China.
  45.Department of Respiratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
  46.Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario L8S 4L8, Canada.
- Author bio：
  
  * zengxiantao1128@163.com;
  lihongjun00113@126.com;
  chzs1990@163.com;
  yaoxia@mcmaster.ca;
  wangxinghuan1965@163.com
- Funds：
- DOI：10.1186/s40779-020-00270-8
  CLC：
- Published：2020-09
- Accepted：
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Jin et al.: Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version). Mil Med Res, 2020, 7: 41
DOI：

Jin et al.: Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version). Mil Med Res, 2020, 7: 41 DOI： 10.1186/s40779-020-00270-8.

摘要

Abstract

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness

coronavirus disease 2019 (COVID-19)

affecting more than seventeen million people around the world. Diagnosis and treatment guidelines for clinicians caring for patients are needed. In the early stage

we have issued "A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)"; now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline. We formed a working group of clinical experts and methodologists. The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas: chemoprophylaxis

diagnosis

treatments

and discharge management. We searched the literature for direct evidence on the management of COVID-19

and assessed its certainty generated recommendations using the Grading of Recommendations

Assessment

Development and Evaluation (GRADE) approach. Recommendations were either strong or weak

or in the form of ungraded consensus-based statement. Finally

we issued 34 statements. Among them

6 were strong recommendations for

14 were weak recommendations for

3 were weak recommendations against and 11 were ungraded consensus-based statement. They covered topics of chemoprophylaxis (including agents and Traditional Chinese Medicine (TCM) agents)

diagnosis (including clinical manifestations

reverse transcription-polymerase chain reaction (RT-PCR)

respiratory tract specimens

IgM and IgG antibody tests

chest computed tomography

chest X-ray

and CT features of asymptomatic infections)

treatments (including lopinavir-ritonavir

umifenovir

favipiravir

interferon

remdesivir

combination of antiviral drugs

hydroxychloroquine/chloroquine

interleukin-6 inhibitors

interleukin-1 inhibitors

glucocorticoid

qingfei paidu decoction

lianhua qingwen granules/capsules

convalescent plasma

lung transplantation

invasive or noninvasive ventilation

and extracorporeal membrane oxygenation (ECMO))

and discharge management (including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge). We also created two figures of these recommendations for the implementation purpose. We hope these recommendations can help support healthcare workers caring for COVID-19 patients.

关键词

Keywords

references

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