Maintenance hemodialysis patients face great risk and challenges in the current coronavirus disease 2019 (COVID-19) epidemic, and adequate and reasonable nutrition is an important weapon in the prevention and treatment of COVID-19. Therefore, the Chinese Society of Parenteral and Enteral Nutrition proposed Dietary Expert Advice on Prevention and Treatment of COVID-19 in Hemodialysis Patients for hemodialysis patients. In this paper, the nine pieces of advice on hemodialysis patients’ staple food, intake of high-quality protein, vegetables and fruits, food types and combinations, prevention of virus transmission, fluid intake, nutritional supplements, regular rest and adequate sleep, as well as supplement of anti-inflammatory and antioxidant preparations are interpreted in detail.
ObjectiveTo investigate the epidemiological characteristics of the first cluster of patients with coronavirus diseases 2019 (COVID-19) in Gansu.MethodsAll 6 COVID-19 patients from a non-familial cluster in Gansu, were extracted from Gansu Provincial Health Information System until Feb 20, 2020. The patients were confirmed by nucleic acid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The analyses were included via retrospective method: patient clinical characteristics, the summary of epidemiology, and CT image characteristics.ResultsThis clustered outbreak was the first non-family clustered outbreak in Gansu after traveled to Thailand. All 6 COVID-19 confirmed patients were a kindergarten staff in Gansu, aged from 26 to 51 years, and were female. They traveled to Thailand in the same period, and had the same epidemiological exposure history. They were diagnosed as COVID-19 by transnasopharyngeal swab real-time fluorescent reverse transcription-PCR for SARS-CoV-2 nucleic acid examination at different time points after return to Gansu. The first patient was ill on January 21, 2020, with fever as first symptom. She was diagnosed at the Xigu District People’s Hospital in Lanzhou and was transferred to Lanzhou Pulmonary Hospital after being diagnosed. She was cured with one week’s antiviral treatment. The remaining 5 patients were treated in Longxi People’s Hospital. The common clinical symptoms were fever, throat discomfort, headache, and fatigue. Through 7 to 10 days’ antiviral treatment, they all were cured. All patients belonged to common type and had good prognosis.ConclusionThe COVID-19 patients in a non-familial cluster have the same epidemiological history. Early medical observation, SARS-CoV-2 nucleic acid examination and comprehensive chest CT should be arranged promptly to make diagnosis and give responsive treatment, so that the prognosis is often good.
Since December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has gradually spread all over the world. With the implementation of class B infectious disease management policy for coronavirus disease 2019 (COVID-19), China has experienced a pandemic. For patients receiving a time-sensitive or emergency surgery, SARS-CoV-2 infection may increase the risk of postoperative pulmonary complications. An appropriate perioperative mechanical ventilation strategy, such as lung protective ventilation strategy, is particularly important for preventing postoperative pulmonary complications in patients undergoing general anesthesia. In addition, how to protect medical personnel from being infected is also the focus we need to pay attention to. This article will discuss the perioperative mechanical ventilation strategy for COVID-19 patients and the protection of medical personnel, in order to provide reference for the development of guidelines.
Previous studies have shown that rehabilitation can relieve clinical symptoms, prevent complications, and improve physical function and quality of life in patients with pneumonia. This consensus summarizes the rehabilitation assessment, self-protection, rehabilitation goals, rehabilitation programs, indications for termination of treatment, nutrition support and psychological rehabilitation for patients with mild, moderate, severe and critical types of coronavirus disease 2019 based on the relevant literature and previous practice of coronavirus disease 2019. We hope this consensus can provide a reference for rehabilitation of coronavirus disease 2019.
Most patients with coronavirus disease 2019 (COVID-19) have a good prognosis, but a certain proportion of the elderly and people with underlying diseases are still prone to develop into severe and critical COVID-19. Kidney is one of the common target organs of COVID-19. Acute kidney injury (AKI) is a common complication of severe COVID-19 patients, especially critical COVID-19 patients admitted to intensive care units. AKI associated with COVID-19 is also an independent risk factor for poor prognosis in patients. This article mainly focuses on the epidemiological data, possible pathogenesis, diagnostic criteria, and prevention and treatment based on the 5R principle of AKI associated with COVID-19. It summarizes the existing evidence to explore standardized management strategies for AKI associated with COVID-19.
Since the establishment in 2016, especially after the outbreak of coronavirus disease 2019 (COVID-19) epidemic, the Hospital Infection Management Quality Control Center of Shuangliu District has carried out quality management and technical ability training for full-time and part-time infection prevention and control personnel through various methods, and used grid management to organize examinations and assessments, inspections and supervision, as well as consultation and assistance. As a result, the culture of infection prevention and control has been deeply rooted in the hearts of the people, the health administrative departments have increased investment in infrastructure and equipment, the funds for infection prevention and control have continued to increase, and the prevention and control quality of COVID-19 and daily works in the region has been continuously improved. The center plays a leading role in the promotion of the standardization, homogenization, and quality improvement of the prevention and control of hospital infection in the district.
With the in-depth understanding of the severe acute respiratory syndrome coronavirus 2, it has been found that the virus not only causes serious damage to the human respiratory system, but also damages the kidney system, which can be manifested as acute kidney injury, and in severe cases, renal failure can occur. Patients with coronavirus disease 2019 and chronic kidney disease are at higher risk of worsening their condition and even death. Therefore, early recognition and intervention of renal injury is particularly important for prognosis. In this paper, the clinical data of renal injury in patients with coronavirus disease 2019 were reviewed, and the possible pathogenesis, incidence, clinical features, diagnosis and treatment were proposed for reference in clinical decision-making.
According to the requirements for the “three districts and two channels” in the sanitary industry standard Technique Standard for Isolation in Hospitals, combining with the spirit of current documents related to the prevention and control of coronavirus disease 2019, in order to guide medical institutions at all levels to conduct standardized design of fever clinics in accordance with the principle of “combining normal time and epidemic period”, this article explains the design points of the fever clinics for the prevention and control of coronavirus disease 2019, introduces the specific methods for the fever clinics to achieve “three districts and two channels”, draws a schematic diagram of the fever clinics in general hospitals, and explains the functional layout and medical procedures of the clean area, potential contaminated area, and contaminated area in detail; at the same time, a schematic diagram of the change of fever clinics from “normal” to “during the epidemic” is drawn, and the ideas for the conversion and the process after the conversion are introduced. It proposes design ideas and drawing references for the construction, transformation, and expansion of fever clinics.
This paper expounds the experiences and thinking of enclosed emergency management under emergency coronavirus disease 2019 (COVID-19) epidemic in a Grade A tertiary hospital in Shanghai. The main emergency prevention and control measures included accurately controlling information of all people in the hospital, implementing strict hospitality prevention and control programs, providing strongly logistics support services, ensuring the safety of medical services, stabilizing mood of all people in the hospital, and guiding the correct public opinion. During the enclosed management period, the hospital worked smoothly and orderly, and no infection or transmission ocurred. Practice shows that the use of enclosed emergency management model is an effective way to respond to emergency COVID-19 epidemic, which can provide scientific reference for the hospital facing public health emergencies.
ObjectiveTo explore and analyze the nutritional risk and dietary intake of patients with coronavirus disease 2019 (COVID-19), and provide data support for nutritional intervention.MethodsCOVID-19 inpatients were investigated in Wuhan Wuchang Hospital and the People’s Hospital of Wuhan University (East Area) from March 9th to 16th, 2020 by Nutrition Risk Screening 2002 (NRS 2002) scale and designed questionnaire. The energy and protein requirements were calculated according to the standard of 30 kcal/(kg·d) and 1.2 g/(kg·d). The nutritional risk, energy and protein intake, body weight and body mass index and their changes in the mild and severe patients were analyzed. The energy and protein intake of the two types of nutritional risk patients was analyzed.ResultsA total of 98 patients with COVID-19 completed the investigation, in whom 46 (46.94%) had nutritional risk, including 32 (39.02%) with mild type and 14 (87.50%) with severe type; and the difference was statistically significant (P<0.001). Compared with the usual condition, the body weight and body mass index of the two types of patients significantly decreased (P<0.01 or P<0.001); the energy and protein intake in mild type patients were significantly higher than those in the severe type patients (P<0.001); compared with the requirement, the protein intake in the two types of patients were significantly lower than the demand, while the energy and protein intake in the mild type patients were significantly lower than the requirement (P<0.05 or P<0.01). The proportion of energy and protein intakes in patients with nutritional risk was significantly higher than that in patients without nutritional risk (P<0.001 or P<0.01); the energy and protein intakes in patients without nutritional risk was significantly higher than that in patients with nutritional risk (P<0.001); the protein intakes in patients with nutritional risk was obviously insufficient (P<0.001); while the energy intake of the patients without nutritional risk was higher than the requirement (P<0.001).ConclusionsCOVID-19 patients has high incidence of nutritional risk which was higher in the severe patients compared with the mild patients. Higher incidence and lower intake of energy and protein are in the severe patients compared with those in the mild patients. Patients with nutritional risk has a higher proportion of energy and protein inadequate intake and lower intake compared with the patients without nutritional risk.