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Experience sharing: control COVID-19 transmission in Shanghai, a population of 24 million metropolis

Mar. 24, 2020. Wenhong Zhang, Leader of the Shanghai Anti-COVID-19 Clinical Expert Team. CABS (Chinese-American Bio/Pharmaceutical Society) WEBINAR

Dr. Zhang introduces the first hand experiences on how to prevent Covid-19 transmission in Shanghai, a population of 24 million metropolis in China. The patients data in Shanghai are compared with Wuhan, and the experiences gained on diagnosis, prevention, treatment, and medical staff protection are also discussed. Some information are quoted below.

 

The epidemic trend in Shanghai from 1/20/2020-3/22/2020 is provided in the talk (partial results are also presented in Ref 1).

The diagnostic flow chart that has been adopted by the Shanghai medical team is recommended (Ref 2).

As suggested by the Shanghai medical team, early control of the local transmission with timely diagnosis and timely quarantine is the key solution to stop the diseases from spreading and overwhelming the medical facilities. Based upon the 265 lab-confirmed cases, the mean incubation period was 6.4 days, and the mean onset-admission interval was 5.5 days in Shanghai (Ref 1).

Currently, there are no effective antiviral treatments. In the hospitals, sufficient respiratory support is the fundamental treatment solution. Among the ARDS (Acute Respiratory Distress Syndrome) patients:

Invasive mechanical ventilation support rate: 7% (Wuhan, Ref 3), 100% (Shanghai)

Mortality rate: 52.4% (Wuhan, Ref 3), 23% (Shanghai)

Some other medical treatments are also introduced, such as early anticoagulation which may block clotting formation and reduce microthrombus (Ref 4), and the use of corticosteroids at the low-to-moderate dose (Ref 5).

References

1. A descriptive study of the impact of disease control and prevention on the epidemics dynamics and clinical features of SARS-CoV-2 outbreak in Shanghai, lessons learned for metropolis epidemics prevention. H. Lu, J. Ai, Y., Shen, et al., Feb., 2020. medRxiv,

https://www.medrxiv.org/content/10.1101/2020.02.19.20025031v1

2. Optimizing diagnostic strategy for novel coronavirus pneumonia, a multi-center study in Eastern China. Ai, J., Zhang, H., and Xu, T.,et al. Feb., 2020. medRxiv

https://www.medrxiv.org/content/10.1101/2020.02.13.20022673v1

3. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. Wu, C., Chen, X., and Cai, Y., et al., Mar. 2020. JAMA Internal Medicine.

4. Clinical observation and management of COVID-19 patients. Li., T., Lu, H., and Zhang, W., Mar. 2020.Emerging Microbes & Infections.

5. On the use of corticosteroids for 2019-nCoV pneumonia. Shang, L., Zhao, J., Hu, Y. Du, R., and Cao, B. Feb. 2020. Lancet 395.10225 (2020):683-684.

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