Peking Union Medical College Hospital releases new crown treatment recommendations: clinical typing before treatment

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On January 3, Peking Union Medical College Hospital released the “Suggestions for Primary Care Program and Appropriate Technology for Novel Coronavirus Infection (First Edition)”. The protocol proposes that all patients are recommended to have perfect evaluation tests and clinical typing before proceeding with drug treatment. Primary care physicians mainly deal with light and general type patients with symptomatic supportive treatment, while for severe patients, referral to higher level hospitals is recommended for anti-inflammatory and anticoagulation treatment. For those requiring pharmacological treatment, antiviral drugs were given early in the onset of the disease and anti-inflammatory drugs were given after 7 days of the onset of the disease for severely ill patients.

In the course of treatment of newly crowned infected patients, the protocol recommends first an assessment to identify conditions requiring immediate referral through questioning and physical examination, combined with test results. Secondly, classification is performed to classify patients as general, severe or high risk after assessment based on history taking, physical examination and ancillary tests. Finally, treatment is based on the classification. For patients with severe disease, they should be referred as soon as possible; for the high-risk group, indications for antiviral small molecule drugs should be evaluated and antiviral drugs should be given. Meanwhile, the high-risk group in the general type of patients is recommended to be referred, and symptomatic treatment and supportive therapy should be intensified before referral.

In terms of pharmacological treatment, the protocol is also clarified, for example, it is recommended that antiviral drugs be given early in the course of the disease and that anti-inflammatory drugs appear to be important after 7 days of disease onset in severely ill patients. Antiviral drugs are only used to reduce the risk of developing severe disease in high-risk groups and do not prevent new crown infections. The choice of TCM drugs needs to take into account the usual physical condition, TCM treatment needs to be based on evidence, and TCM department visits are necessary to guide the use of drugs.

Flow chart of drug treatment

In the program, people with high-risk factors for progression to severe disease (including heavy and critical type), situations where immediate referral is recommended, asymptomatic, light, and common type patients for consultation and management and home self-care guidance, treatment related to neo-crown including pharmacotherapy, antiviral therapy, Chinese medicine, hormone therapy, symptomatic treatment, non-pharmacological treatment, and complications of various systems, management of underlying diseases, management of special populations, and rehabilitation Guidance is clarified.