According to the website of the National Health and Medical Commission, on January 6, the "Diagnosis and Treatment Plan for Novel Coronavirus Infection (Trial Version 10)" was issued, and the important adjustments are as follows:

besides,

There are also these key points in the plan↓↓

1. Background

　　Since October 2022, subclades such as BF.7, BQ.1, and BQ.1.1, which have stronger immune escape ability and transmission ability, and recombinant mutant strains (XBB) have rapidly increased their transmission advantages, and have replaced BA in some countries and regions. .5.2 Become the dominant popular strain.

　　Evidence at home and abroad shows that the pathogenicity of the lungs of the mutant strain of Omicron is significantly weakened, and the clinical manifestations have changed from pneumonia to upper respiratory tract infection.

2. Epidemiological characteristics

Source of infection

　　The source of infection is mainly people infected with the new coronavirus, which is contagious during the incubation period, and is most contagious within 3 days after onset.

susceptible population

　　The population is generally susceptible.

　　The severe disease rate and fatality rate of the elderly and patients with serious underlying diseases after infection are higher than the general population, and the risk of severe disease and death can be reduced after vaccination.

3. Prevention

　　COVID-19 Vaccination

　　general precautions

　　Maintain good personal and environmental hygiene, balanced nutrition, moderate exercise, adequate rest, and avoid excessive fatigue.

4. Clinical features

　　Clinical manifestations:

　　The incubation period is mostly 2 to 4 days.

　　The main manifestations are dry throat, sore throat, cough, fever, etc. The fever is mostly low-to-medium fever, and some cases can also be high fever, and the duration of the fever does not exceed 3 days;

　　Some patients may be accompanied by muscle soreness, loss of sense of smell or taste, nasal congestion, runny nose, diarrhea, conjunctivitis, etc.

　　A small number of patients continued to develop, with persistent fever and pneumonia-related manifestations.

　　Severely ill patients often develop dyspnea and/or hypoxemia 5 to 7 days after onset.

　　Severe cases can rapidly progress to acute respiratory distress syndrome, septic shock, difficult-to-correct metabolic acidosis, coagulation dysfunction, and multiple organ failure.

　　A very small number of patients may also have manifestations such as central nervous system involvement.

5. Diagnosis

diagnostic principles

　　A positive nucleic acid test for the new coronavirus is the primary criterion for diagnosis.

Diagnostic criteria

　　1. Have relevant clinical manifestations of new coronavirus infection;

　　2. Have one or more of the following pathogenic and serological test results:

　　(1) The nucleic acid test of the new coronavirus is positive;

　　(2) Positive test for the new coronavirus antigen;

　　(3) Positive for the isolation and culture of the new coronavirus;

　　(4) During the recovery period, the level of IgG antibody specific to the new coronavirus is 4 times or more than that of the acute one.

6. Clinical classification

light

　　The above respiratory tract infection is the main manifestation, such as dry throat, sore throat, cough, fever and so on.

medium

heavy

Critical

　　Those who meet one of the following conditions:

　　1. Respiratory failure occurs and mechanical ventilation is required;

　　2. Shock occurs;

　　3. Combined with other organ failure requires ICU monitoring and treatment.

7. Severe/critical high-risk groups

　　Over 65 years old, especially those who have not fully vaccinated against the new coronavirus;

　　Patients with basic diseases such as cardiovascular and cerebrovascular diseases (including hypertension), chronic lung diseases, diabetes, chronic liver, kidney diseases, tumors, and maintenance dialysis;

　　Immunodeficiency (such as AIDS patients, long-term use of corticosteroids or other immunosuppressive drugs leads to immunocompromised state);

　　Obesity (body mass index ≥ 30);

　　late pregnancy and peripartum women;

　　heavy smoker.

8. Heavy/Critical Early Warning Indicators

　　Hypoxemia or progressive aggravation of respiratory distress in adults, chest imaging shows significant progression of lung lesions, etc.;

　　When children experience rapid respiratory rate, poor mental response, drowsiness, convulsions, etc., they should be alert to the deterioration of the condition.

9. Treatment

general treatment

　　1. Isolated and treated according to the requirements of respiratory infectious diseases.

　　2. Vital signs should be monitored for people at high risk of severe illness.

　　3. Carry out necessary examinations according to the condition.

　　4. Give standardized and effective oxygen therapy measures according to the condition.

　　5. Antibacterial drug treatment.

　　6. Those with underlying diseases will be given appropriate treatment.

antiviral treatment

　　1. Combination packaging of Naimatevir tablets/Ritonavir tablets

　　2. Azvudine tablets

　　3. Monogravir Capsules

　　4. Monoclonal Antibody

　　5. Intravenous injection of COVID-19 human immunoglobulin

　　6. Convalescent Plasma

　　7. Other anti-new coronavirus drugs approved by the State Drug Administration

immunity therapy

　　1. Glucocorticoids

　　2. Interleukin 6 (IL-6) inhibitors

anticoagulant therapy

prone position therapy

psychological intervention

　Severe and critical supportive care

　Chinese treatment

　　For non-key populations with early-stage COVID-19 infection, refer to the Chinese patent medicines or traditional Chinese medicines recommended in the "Guidelines for Intervention of Traditional Chinese Medicine for Patients Infected with COVID-19" and "Notice on Fully Applying Traditional Chinese Medicine Decoctions to Treat COVID-19 Infection at Urban and Rural Grassroots Levels" The parties to the agreement will carry out home treatment.

　10. Discharge Standards for Inpatients

　　The condition has improved significantly, the vital signs are stable, the body temperature has been normal for more than 24 hours, and the lung imaging shows that the acute exudative lesions have improved significantly, and oral drug treatment can be switched to. If there are no complications that require further treatment, discharge can be considered.