最近审阅: 30 十月 2020
最近更新: 06 十一月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 发热
  • 咳嗽
  • 呼吸困难
  • 嗅觉/味觉改变

其他诊断因素

  • 乏力
  • 肌痛或关节痛
  • 痰液产生/排出
  • 胸闷
  • 胃肠道症状
  • 咽痛
  • 头痛
  • 头晕
  • 神经系统症状
  • 眼部症状
  • 流涕/鼻塞
  • 胸痛
  • 皮肤症状
  • 咯血
  • 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

  • 居住/工作/旅行于传播高风险地区
  • 与可能或确诊病例产生接触
  • 老年
  • 居住于长期照护机构
  • 男性
  • 种族
  • 合并症的发生
  • 心血管疾病
  • 高血压
  • 肥胖
  • 糖尿病
  • 慢性呼吸系统疾病
  • 慢性肾病
  • 恶性肿瘤
  • 镰状细胞病
  • 实质脏器移植
  • 吸烟
  • 脑血管病
  • 痴呆
  • 慢性肝病
  • 代谢功能障碍相关性脂肪性肝病
  • 手术
  • 妊娠
  • 免疫抑制
  • 自身免疫性疾病
  • 维生素 D 缺乏
  • 空气污染
  • 气候和纬度
  • 居住于城市或贫困地区
  • 使用 ACE 抑制剂/血管紧张素 II 受体拮抗剂
  • 血脂异常
  • 他汀类药物使用
  • 质子泵抑制剂的使用
  • HIV 感染
  • 地中海贫血
  • 唐氏综合征
  • 伴有某些基础疾病的儿童
  • A 型血群体
  • 消化道菌群失调

诊断性检查

首要检查

  • 实时逆转录聚合酶链反应 (RT-PCR)
  • 脉搏血氧测定
  • 动脉血气分析(ABG)
  • 全血细胞计数(FBC)
  • 生化全项
  • 血糖水平
  • 凝血筛查
  • 心脏生物标志物
  • 血清 C 反应蛋白
  • 血清红细胞沉降率
  • 血清乳酸脱氢酶
  • 血清白细胞介素-6 水平
  • 血清降钙素原
  • 血清铁蛋白水平
  • 血清淀粉样蛋白 A 水平
  • 血清肌酸激酶和肌红蛋白
  • 血液和痰液培养
  • 胸部 X 线检查
更多 首要检查

需考虑的检查

  • 胸部计算机体层成像(Computed Tomography, CT)
  • 血清学
  • 抗原检测
更多 需考虑的检查

新兴检查

  • 逆转录环介导等温扩增(RT-LAMP)
  • 肺部超声
更多 新兴检查

治疗流程

撰稿人

Consultant and Honorary Senior Lecturer in Infectious Diseases

Royal Liverpool University Hospital and Liverpool School of Tropical Medicine

Liverpool

UK

利益声明

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

利益声明

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

利益声明

RF declares that he has no competing interests.

同行评议者展开全部内容

Professor

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

利益声明

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 

利益声明

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

利益声明

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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