Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression

meizhu chen; changli tu; Cuiyan Tan; Xiaobin Zheng; xiaohua wang; jian wu; Yiying Huang; zhenguo wang; yan yan; zhonghe li; hong shan; Jing Liu; jin huang

On the basis of respecting the clinical characteristics and current known pathological process of COVID-19, our team mainly adopts symptomatic supportive treatment measures. Blind medication was avoided during the treatment. All medicines used are considered to effectively protect and support the patient's own immune function against viruses. As shown in table 5, due to the common hypoproteinemia (89.7%) and hypokalemia (70.1%), we provided corresponding supplements to maintain body fluid electrolytes and internal environment and nutrition balance. Especially in all severe patients, 20-40g albumin / d was given, adjusted according to the heart function. Appropriate plasma supplementation had been applied in 68.8% severe and all critical cases, which could supply immunoglobulins and lymphokines to support the body's normal antiviral effect. We think that plasma (especially fresh plasma) supplementation has better supportive treatment effects than extracted immunoglobulins. For critically ill patients, an appropriate dose of methylprednisolone had been given to exert anti-inflammatory effects, suppressing the inflammatory storm caused by the body's excessive immunity. Oxygen therapy had been given in 89.7% of all patients at early stage. When OI declined below 300mmHg ， medium-high flow rate to inhale oxygen through the nasal catheter to maintain SaO2 higher than 95%, but if OI declined continually ， high-flow nasal cannula oxygen therapy (HFNC) should be applied as early as possible. We found that . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.