Shanghai defines COVID-19 serious, critical cases
Medical workers transport a patient at Minhang District Central Hospital.
Shanghai released its first official definition of COVID-19 serious and critical conditions on Wednesday to ensure such patients are treated earlier and more effectively.
The city's COVID-19 experts' team released the COVID-19 diagnosis and treatment standard as an official reference and guidance, mainly for grassroots medical institutes and doctors.
"The early antiviral and anti-inflammatory treatment for the vulnerable groups will significantly reduce the severe and fatal rates of COVID-19 infections," the experts' team said.
1. Patients' classifications
Mild and normal types: Suffering from fever, fatigue, dry cough, sore throat, discomfort and other symptoms, but no breathing difficulty and decreased oxygen saturation.
Those without pneumonia can be diagnosed as mild type, while those with pneumonia can be diagnosed as normal type.
Severe types:
-- Adults suffering from any of the conditions:
a. Short of breath, respiratory rate ≥30 times per minute
b. Oxygen saturation ≤93 percent when inhaling
c. Pulmonary imaging shows infections have progressed significantly (> 50 percent) within 24 to 48 hours
-- Children suffering from any of the conditions:
a. Extremely high fever or persistent high fever for more than three days
b. Short of breath
c. Oxygen saturation ≤93 percent when inhaling
d. Drowsiness and convulsions
e. Refusing to eat or difficulty in feeding with symptoms of dehydration
Critical types:
Patients suffering from any of the conditions:
a. Respiratory failure and requires mechanical ventilation
b. Recurring shocks
c. Complicated with other organ failure, requires ICU monitoring and treatment
2. High-risk groups who are likely to develop into severe conditions
At present, high-risk factors for COVID-19 serious and dangerous conditions include:
a. Age ≥60 years old
b. Cardiovascular and cerebrovascular diseases (including high blood pressure), chronic lung diseases, diabetes, chronic liver, kidney diseases, tumors, hematological malignancies, hemodialysis and other underlying diseases
c. Immune dysfunction
d. Obesity (BMI≥30)
e. Perinatal women
f. Heavy smokers
g. Children with certain underlying diseases (congenital heart disease, bronchopulmonary dysplasia, chronic lung disease, respiratory malformation, delayed development of the nervous system, neuromuscular disease, abnormal hemoglobin disease, severe malnutrition, etc.), or immunodeficiency, obesity and premature newborns
h. Those who have not received the full courses or booster shots of COVID-19 vaccines
3. Classified treatment for COVID-19 patients
For mild or normal cases, home or localized treatment will be adopted. Community health service centers can provide standard treatments.
Infected people with serious underlying diseases and some severe and critical cases were referred by community health service centers to district-level hospitals.
City-level hospitals are responsible for the treatment of severe and critical cases, while offering technical guidance for district hospitals.
Pregnant women and newborns are admitted to designated hospitals in each district. Hemodialysis, tumor radiotherapy and chemotherapy patients are given priority at their regular hospitals.
