7 Treatment

It is suggested that “the treatment place should be determined according to the severity of the disease”, “every suspected case should be treated in single room”,and “critical cases should be admitted to ICU as soon as possible”.

In terms of antiviral therapy, no effective antiviral therapy is emphasized, but α-interferon aerosol inhalation, lopinavir/ritonavir, and ribavirin are recommended as trying drugs.

The fifth edition details the treatment of severe and critical cases.Respiratory support emphasizes close monitoring of finger-prick oxygen saturation, timely administration of oxygen therapy and respiratory support,especially if the condition does not improve or even worsen after “highflow nasal catheter oxygen therapy or non-invasive mechanical ventilation” for a short time(1–2 hours), endotracheal intubation and invasive mechanical ventilation should be performed promptly. Blind or inappropriate use of antibiotics must be avoided, especially in combination with broadspectrum antibiotics. It should be noted that higher doses of glucocorticoids would delay coronavirus clearance. That “for critically ill patients with high inflammatory response, extracorporeal blood purification technology can be considered when conditions permit” has been supplemented.

“Chloroquine phosphate(500 mg for adult, twice per day)” and “Arbidol(200 mg for adult, three times per day)” are added as trial drugs in the sixth edition. Combinations of ribavirin and interferon or lopinavir/ritonavir are recommended. The course of treatment with trial drugs should be ≤10 days and effects of trial drugs are recommended to be vealuated during clinical usage. Simultaneously use of three or more types of antiviral drugs is not recommended and relative drug treatment should stop if unbearable side effects occur.

As for treatment to severe and critical cases, “convalescent plasma therapy”is added in the sixth edition for treating rapidly developed cases, severe cases and critical cases. “Extracorporeal blood purification technology should be considered if possible” is changed to “Plasma exchange, adsorption, perfusion,blood/plasma filtering and other extracorporeal blood purification technologies should be considered if possible” for cirtical cases with severe inflammat ory reactions.