The National Health and Medical Commission issued the “New Coronary Virus Pneumonia Diagnosis and Treatment Plan (Trial Version 9)”
In order to further improve the medical treatment of new coronary pneumonia, effectively improve the standardization, To homogenize the level of diagnosis and treatment, the National Health Commission and the State Administration of Traditional Chinese Medicine organized experts to revise the “New Coronavirus Pneumonia Diagnosis and Treatment Plan (Trial Version 8 Revised Edition)”, and formed the “New Coronavirus Pneumonia Diagnosis and Treatment Plan (Trial Implementation)” Ninth Edition)”, and printed and distributed in various places for reference. The new version of the diagnosis and treatment plan is formed on the basis of careful study of the transmission characteristics and case characteristics of mutant strains such as Delta and Omicron, and in-depth analysis of relevant research results. The key revisions are as follows:
First, optimize the case finding and reporting procedures. On the basis of nucleic acid detection, antigen detection is added as a supplement to further improve the ability of early detection of cases. At the same time, the efficiency of diagnosing or excluding suspected cases is improved, and the suspected cases or those with positive antigen test results are required to undergo nucleic acid testing immediately or closed-loop transfer to a qualified higher-level medical institution for nucleic acid testing. Those with a positive nucleic acid test result will be quarantined in a centralized manner or sent to a designated hospital for treatment, and will be reported directly online in accordance with regulations.
The second is to classify and treat cases. According to the opinions reflected in various places, “patients with Omicron variant strains are mainly asymptomatic infections and mild cases, most of them do not require excessive treatment, and all admission to designated hospitals will take up a lot of medical resources” and other opinions, further Improved case classification and admission measures:
1. Mild cases are subject to centralized isolation management, and relevant centralized isolation places cannot isolate inbound personnel, close contacts and other groups at the same time. During the isolation management period, symptomatic treatment and condition monitoring should be done. If the condition worsens, it should be transferred to a designated hospital for treatment.
2. Ordinary, severe, critical cases and cases with severe high-risk factors should be centrally treated in designated hospitals, among which severe and critical cases should be admitted to ICU for treatment as soon as possible, with high-risk factors and a tendency to become severe patients should also be admitted to the ICU for treatment.
The third is to further standardize antiviral treatment. The two specific anti-new coronavirus drugs approved by the State Food and Drug Administration are written into the diagnosis and treatment plan, namely: PF-07321332/ritonavir tablet (Paxlovid) and domestic monoclonal antibody (ambavirumab/ romisevirumab injection).
Fourth, the content of TCM treatment was revised and improved. Combined with the clinical treatment experience of various places, strengthen the application of non-drug therapy of traditional Chinese medicine, and increase the content of acupuncture and moxibustion; combined with the characteristics of children, increase the content of traditional Chinese medicine for children.
The fifth is to adjust the management of release from isolation and discharge standards, as well as the precautions for management of release from isolation and after discharge. Relevant domestic studies have shown that when the nucleic acid Ct value of infected persons in the recovery period is greater than or equal to 35, the virus cannot be isolated from the samples, and close contacts have not been found to be infected. Accordingly, in the new version of the diagnosis and treatment plan, the “two consecutive negative nucleic acid tests of respiratory specimens (sampling time interval of at least 24 hours)” in the criteria for release of isolation management and discharge was revised to “two consecutive new coronavirus nucleic acid tests for N gene and ORF gene Ct All values ≥ 35 (fluorescence quantitative PCR method, the threshold value is 40, and the sampling time is at least 24 hours apart), or two consecutive new coronavirus nucleic acid tests are negative (fluorescence quantitative PCR method, the threshold value is less than 35, and the sampling time is at least 24 hours apart) Hour)”. “Continue 14-day isolation management and health monitoring after discharge” is revised to “Release isolation management or continue to conduct 7-day home health monitoring after discharge”.
Editor in charge: Xu Rongguang_0999