最后审核时间: 二月 2020
最近更新时间: 三月  2020
27 Mar 2020

COVID-19 大流行信息更新

现在,美国已超过中国和意大利,成为全球 COVID-19 病例最多国家,据报道有近 86,000 例病例。全球而言,根据约翰·霍普金斯大学系统科学与工程中心整理数据,报道了超过 537,000 例 COVID-19 病例和 24,000 例死亡。超过 123,000 例已康复。西班牙、德国、法国、伊朗、英国、瑞士,和韩国目前拥有这三个国家之外最多的病例。意大利死亡人数仍然最多,超过 8200 例,其次为西班牙,超过 4300 例。

Johns Hopkins University: coronavirus COVID-19 global cases external link opens in a new window

“为了减缓COVID-19的传播,众多国家采取了前所未有的措施,付出了巨大的社会和经济代价 – 如关闭学校和工商业,取消体育赛事,要求人们呆在家里,保全健康,”世界卫生组织总干事 Tedros Adhanom Ghebreyesus 在周三的媒体通报会上谈道。“这些行动的目的是实行更精准和有的放矢的措施,阻止传播和拯救生命。你们已经营造了第二个机会之窗,”他说道。

今日更新

  • 病因:可能的垂直传播新数据。

  • 病史和检查:肿瘤患者风险新数据。

  • 治疗流程:慢性肾病和炎症性肠病患者治疗新指南。

  • 新兴:FDA 允许使用康复期患者血浆;羟氯喹和氯喹新证据总结。

  • 预后:最新病死率;死亡患者临床特征新数据。

参见流行病学

更新的原始来源external link opens in a new window

小结

定义

病史和查体

其他诊断因素

  • 乏力
  • 肌痛
  • 厌食
  • 痰液产生/排出
  • 咽痛
  • 意识模糊
  • 头晕
  • 头痛
  • 咯血
  • 鼻溢
  • 胸痛
  • 胃肠道症状
  • 结膜充血
  • 嗅觉缺失/味觉障碍
  • 支气管呼吸音
  • 呼吸急促
  • 心动过速
  • 紫绀
  • 听诊发现湿啰音/啰音

危险因素

  • 症状发作前 14 天内居住于/前往有社区传播报道的地区
  • 与确诊病例密切接触
  • 高龄和/或基础疾病
  • 恶性肿瘤
  • 吸烟

诊断性检查

首要检查

  • 脉搏血氧测定
  • 动脉血气分析(ABG)
  • 全血细胞计数(FBC)
  • 凝血筛查
  • 生化全项
  • 血清降钙素原
  • 血清 C 反应蛋白
  • 血清乳酸脱氢酶
  • 血清肌酸激酶
  • 血清肌钙蛋白水平
  • 血液和痰液培养
  • 实时逆转录聚合酶链反应 (RT-PCR)
  • 胸部 X 线检查
  • 胸部计算机体层成像(Computed Tomography, CT)
更多 首要检查

治疗流程

贡献者

Consultant and Honorary Senior Lecturer in Infectious Diseases

Royal Liverpool University Hospital and Liverpool School of Tropical Medicine

Liverpool

UK

利益冲突披露

NJB is partially supported by the National Institute of Health Research Health Protection Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine. He is affiliated with Liverpool School of Tropical Medicine. The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health, or PHE.

Senior Clinical Lecturer and Defence Consultant in Infectious Diseases

Royal Liverpool University Hospital and Liverpool School of Tropical Medicine

Liverpool

UK

利益冲突披露

TEF is a consultant/expert panel member to the World Health Organization, and is funded by the UK Surgeon General, the NHS, and Liverpool School of Tropical Medicine. TEF is partially supported by the National Institute of Health Research Health Protection Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine. He is affiliated with Liverpool School of Tropical Medicine. He has received research grants from the Wellcome Trust, Medical Research Council, and the UK Public Health Rapid Support Team (UK-PHRST). The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health, or PHE.

H. Barrie Fairley Professor of Critical Care

University Health Network and Interdepartmental Division of Critical Care Medicine

Director

Clinical Epidemiology and Health Care Research

Institute of Health Policy, Management and Evaluation

Dalla Lana School of Public Health

University of Toronto

Chief

Tory Trauma Program

Sunnybrook Hospital

Toronto

Canada

利益冲突披露

RF declares that he has no competing interests.

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Professor

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

利益冲突披露

WAP declares that he has no competing interests.

Attending Physician

The Fifth Medical Center of PLA General Hospital

Clinical Division and Research Center of Infectious Disease

Beijing

China 

利益冲突披露

XZ declares that he has no competing interests.

Associate Professor in Medicine

Department of Clinical Microbiology and Infectious Diseases

Hadassah Hebrew University Medical Center

Jerusalem

Israel

利益冲突披露

RNP has received research grants from US-Israel Binational Science Foundation, Hebrew University, Rosetrees Trust, and SpeeDx. He is chair of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycoplasma and Chlamydia Infections (ESGMAC). RNP is a consultant for and has stocks in eDAS Healthcare. He is also chairperson of the Israeli Society for Infectious Diseases guidelines committee.

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