New crown infection serious illness treatment plan trial version 4: some patients who do not meet the criteria for serious illness can be managed by serious illness

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The National Health Commission issued a protocol for the treatment of severe cases of novel coronavirus infection (trial version 4), adjusting the term “novel coronavirus pneumonia” to “novel coronavirus infection”.

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The protocol further clarifies the high-risk group of severe cases, and patients with novel coronavirus infection pneumonia who do not meet the diagnostic criteria for severe cases, but are >65 years old, have not completed full vaccination, and have more serious chronic diseases combined, can be managed as severe cases. Vital signs monitoring should be performed for those at high risk of severe disease, especially monitoring finger oxygen saturation at rest and after activity, etc.; the role of hypoxia in clinical warning of severe disease should be emphasized, and finger oxygen saturation <94% after mild activity should be alerted to deterioration. The treatment methods proven in clinical practice were incorporated into the Protocol, and symptomatic treatments such as hyperthermia and cough were added to the general treatment; small molecule drugs approved and marketed in China were added to the antiviral treatment; anticoagulation was added; the importance of ventilation in the awake prone position was emphasized; in terms of oxygen therapy and respiratory support treatment, combining the latest understanding and research evidence, it was pointed out that transnasal high-flow oxygen therapy is superior to nasal catheter or In the area of oxygen therapy and respiratory support therapy, the latest understanding and research evidence were combined to point out that high-flow oxygen therapy via the nose is superior to nasal catheter or mask oxygenation. The section on Chinese medicine treatment has been revised and improved, with the addition of some evidence types and the content of “combined treatment of disease and evidence”, to strengthen the guidance of combined clinical treatment of heavy and critical cases, and to better utilize the characteristic advantages of Chinese medicine.

Interpretation of “Novel Coronavirus Infection Critical Care Protocol (Trial Version 4)

In order to further improve the medical treatment of severe cases of novel coronavirus infection, and to effectively improve the standardized and homogeneous treatment level, the National Health Commission, in collaboration with the State Bureau of Traditional Chinese Medicine, took into account the characteristics of the variant strain of Omicron and the disease features of the infected patients, and summarized the experience of the previous medical treatment work, and organized the revision of the “Treatment Plan for Heavy and Critical Cases of Novel Coronavirus Pneumonia (Trial Version 3)”. The “New Coronavirus Infection Treatment Plan for Serious Cases (Trial Version 4)” (hereinafter referred to as the “Plan”) was formed. The key revisions are as follows.

I. Adjustment of disease name

The name of “novel coronavirus pneumonia” was changed to “novel coronavirus infection”.

Move forward to strengthen the clinical warning of serious illness

The program further clarifies the high-risk group of severe illnesses. Patients with new coronavirus infection pneumonia who do not meet the diagnostic criteria for severe illnesses but are >65 years old, have not completed full vaccination, and have a combination of more serious chronic diseases can be managed as severe cases. Vital signs monitoring should be performed for those at high risk of severe disease, especially monitoring finger oxygen saturation at rest and after activity, etc.; the role of hypoxia in clinical warning of severe disease should be emphasized, and finger oxygen saturation <94% after mild activity should be alerted to deterioration.

III. Incorporation of proven treatments in clinical practice into the Program

In general treatment, symptomatic management such as high fever and cough is added; in antiviral therapy, small molecule drugs that have been approved and marketed in China are added; anticoagulation therapy is added; the importance of ventilation in the awake prone position is emphasized; in oxygen therapy and respiratory support therapy, combining the latest understanding and research evidence, it is pointed out that transnasal high-flow oxygen therapy is superior to nasal catheter or mask oxygenation, and the setting of positive end-expiratory pressure (PEEP) is improved The method of setting positive end-expiratory pressure (PEEP) was improved, and the lung protection measures of mechanical ventilation were strengthened.

IV. Revision and improvement of Chinese medicine treatment section

The content of some evidence types and “combined treatment of disease and evidence” has been added to strengthen the guidance of combined clinical treatment of heavy and critical cases of Chinese and Western medicine and to better utilize the characteristic advantages of Chinese medicine.