This article discusses the ways to clinically treat a patient with COVID-19 and identifies which medicines deserve better attention according to China’s existing practices.
On 03 March 2020, the Chinese government released the newest version of a treatment protocol for COVID-19. It came from a group of Chinese medical experts and has been continuously updated to its current (7th) version.
I. Etiological Characteristics
II. Epidemiological Characteristics
III. Pathological changes
IV. Clinical Characteristics
V. Case Definitions
VI. Clinical Classification
VII. Clinical early warning indicators of severe and critical cases
VIII. Differential Diagnosis
IX. Case Finding and Reporting
XI. Discharge criteria and after-discharge considerations
XII. Patients Transportation Principles
XIII. Nosocomial Infection Prevention and Control
I suggest everyone to read this material (Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia-version 7) to have a quick knowledge on which medicines will possibly work.
2.4 Antiviral therapy:
Hospitals can try Alpha-interferon (5 million U or equivalent dose each time for adults, adding 2ml of sterilized water, atomization inhalation twice daily), lopinavir / ritonavir (200 mg/50mg per pill for adults, two pills each time, twice daily, no longer than 10 days), Ribavirin (suggested to be used jointly with interferon or lopinavir / ritonavir, 500 mg each time for adults, twice or three times of intravenous injection daily, no longer than 10 days), chloroquine phosphate (500 mg bid for 7 days for adults aged 18–65 with body weight over 50 kg; 500 mg bid for Days 1&2 and 500 mg qd for Days 3–7 for adults with body weight below 50 kg), Arbidol (200 mg tid for adults, no longer than 10 days).
The report suggests five antivirals:
of which Alpha-interferon, lopinavir / ritonavir, and Chloroquine phosphate are more often mentioned by Chinese media. However, keep in mind that none of these has passed the randomised controlled trials. Nevertheless, these are the ones currently used in China’s clinical practices.
For patients with extensive lung lesions and severe cases who also show anincreased level of IL-6 in laboratory testing, Tocilizumab can be used fortreatment.
Tocilizumab is mentioned in the report as an investigational drug for the treatment of acute respiratory distress syndrome (ARDS).
In some parts of this report, I suggest further critical thinking by all readers. For instance, ‘mixed hydrogen and oxygen’ therapy is mentioned inside, but Chinese media are also questioning this method, both for its effectiveness and danger of explosion. Meanwhile, Chinese traditional medicine, whether effective or otherwise, is also hotly debated on Chinese media.
In US practice, Remdesivir is considered as the most promising drug against COVID-19.
This drug is regarded as promising and is well known amongst the Chinese. It is undergoing a scientific trial in China as well, but theresults need two months to be revealed, leaving us still another month to wait. Keep in mind that Remdesivir is not mentioned in the Chinese report.
More value information, please read the article source.
Article Source: https://www.who.int/china/news/detail/12-03-2020-china-national-experts-share-covid-19-experiences-with-international-community