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Volume 14 Issue 1
Jan.  2023
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Multi-disciplinary Expert Team for COVID-19, Peking Union Medical College Hospital. Diagnosis and Clinical Management of COVID-19 Infection in Adults: Operational Recommendations of Peking Union Medical College Hospital (2023)[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(1): 50-59. DOI: 10.12290/xhyxzz.2023-0003
Citation: Multi-disciplinary Expert Team for COVID-19, Peking Union Medical College Hospital. Diagnosis and Clinical Management of COVID-19 Infection in Adults: Operational Recommendations of Peking Union Medical College Hospital (2023)[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(1): 50-59. DOI: 10.12290/xhyxzz.2023-0003
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Diagnosis and Clinical Management of COVID-19 Infection in Adults: Operational Recommendations of Peking Union Medical College Hospital (2023)

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  • Corresponding authors: WANG Mengzhao1, E-mail: mengzhaowang@sina.com
    ZHANG Shuyang2, 3, E-mail: shuyangzhang103@163.com
    1. Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    2. Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    3. State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • Received Date: January 01, 2023
  • Accepted Date: January 02, 2023
  • Available Online: January 10, 2023
  • Issue Publish Date: January 29, 2023
    Graphical Abstract
    • Abstract
  • With the adjustment of China's COVID-19 policies and measures, the treatment of infected patients, especially the severe and critically ill patients, has become the focus of all medical staff at this stage. Since the outbreak of the pandemic, Peking Union Medical College Hospital has accumulated rich experience in this field. Based on the updated international evidence-based knowledge, the multidisciplinary expert group of COVID-19 at Peking Union Medical College Hospital has compiled a set of operational recommendations. Adhering to the evidence-based, concise, and clinically operable principles, these recommendations for diagnosis and treatment integrate the latest research evidence. For clinical issues that lack evidence, certain recommendations are given based on the frontline clinical working experience and expert opinions. The purpose is to enhance medical staff's understanding of COVID-19 infection and its critical illness and improve patient care.
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  • [1]
    国务院联防联控机制综合组. 新型冠状病毒感染诊疗方案(试行第十版)[EB/OL]. (2023-01-06) [2023-01-06]. http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a/files/460b0e7b19bd42f3bba00c1efb9b6811.pdf.
    [2]
    WHO. Therapeutics and COVID-19: living guideline[EB/OL]. (2022-07-14)[2023-01-03]. https://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2022.4.
    [3]
    Singh AP, Finkelstein M, Chung M, et al. Review of Thoracic Imaging Manifestations of COVID-19 Coronaviruses and Other Pathologic [J]. Radiol Clin North Am, 2022, 60: 359-369. DOI: 10.1016/j.rcl.2022.01.004
    [4]
    CDC. Risk for COVID-19 infection, hospitalization, and death by age group[EB/OL]. (2022-12-28)[2023-01-03]. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html.
    [5]
    Fisman DN, Bogoch I, Lapointe-Shaw L, et al. Risk factors associated with mortality among residents with coronavirus disease 2019 (COVID-19) in long-term care facilities in Ontario, Canada [J]. JAMA Netw Open, 2020, 3: e2015957-e. DOI: 10.1001/jamanetworkopen.2020.15957
    [6]
    Suthar AB, Wang J, Seffren V, et al. Public health impact of covid-19 vaccines in the US: observational study [J]. BMJ, 2022, 377: e069317.
    [7]
    Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus disease 2019 case surveillance-United States, January 22-May 30, 2020 [J]. MMWR Morb Mortal Wkly Rep, 2020, 69: 759. DOI: 10.15585/mmwr.mm6924e2
    [8]
    Lighter J, Phillips M, Hochman S, et al. Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission [J]. Clin Infect Dis, 2020, 71: 896-897. DOI: 10.1093/cid/ciaa415
    [9]
    Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area [J]. JAMA, 2020, 323: 2052-2059. DOI: 10.1001/jama.2020.6775
    [10]
    Goldman JD, Robinson PC, Uldrick TS, et al. COVID-19 in immunocompromised populations: implications for prognosis and repurposing of immunotherapies [J]. J Immunother Cancer, 2021, 9: e002630. DOI: 10.1136/jitc-2021-002630
    [11]
    Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China [J]. JAMA, 2020, 323: 1061-1069. DOI: 10.1001/jama.2020.1585
    [12]
    Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study [J]. Lancet, 2020, 395: 1054-1062. DOI: 10.1016/S0140-6736(20)30566-3
    [13]
    Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study [J]. Lancet, 2020, 395: 507-513. DOI: 10.1016/S0140-6736(20)30211-7
    [14]
    Rubin GD, Ryerson CJ, Haramati LB, et al. The role of chest imaging in patient management during the COVID-19 pandemic: a multinational consensus statement from the Fleischner Society [J]. Radiology, 2020, 296: 172-180. DOI: 10.1148/radiol.2020201365
    [15]
    NIH. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines[EB/OL]. (2022-12-06)[2023-01-03]. https://www.ncbi.nlm.nih.gov/books/NBK570371/.
    [16]
    Bradley MC, Perez-Vilar S, Chillarige Y, et al. Systemic Corticosteroid Use for COVID-19 in US Outpatient Settings From April 2020 to August 2021 [J]. JAMA, 2022, 327: 2015-2018. DOI: 10.1001/jama.2022.4877
    [17]
    EUA HOEUA. Fact Sheet for Healthcare Providers: Emergency Use Authorization for EvusheldTM(Tixagevimab Co-Packaged with Cilgavimab)[EB/OL]. (2022-12)[2023-01-03]. https://www.fda.gov/media/154701/download.
    [18]
    Food UATJL, Cooperative PA. Evidence used to update the list of underlying medical conditions that increase a person's risk of severe illness from COVID-19[EB/OL]. (2022-12)[2023-01-03]. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/evidence-table.html.
    [19]
    Hiremath S, McGuinty M, Argyropoulos C, et al. Prescrib-ing nirmatrelvir/ritonavir for COVID-19 in advanced CKD [J]. Clin J Am Soc Nephrol, 2022, 17: 1247-1250. DOI: 10.2215/CJN.05270522
    [20]
    辉瑞公司. PAXLOVID(奈玛特韦/利托那韦)—经肠内饲管给药[Z]. 2022.
    [21]
    卫生健康委办公厅, 中医药局办公室. 关于将阿兹夫定片纳入新型冠状病毒肺炎诊疗方案的通知[EB/OL]. (2022-08-09)[2023-01-03]. http://www.gov.cn/zhengce/zhengceku/2022-08/10/content_5704788.htm.
    [22]
    Agarwal A, Rochwerg B, Lamontagne F, et al. A living WHO guideline on drugs for covid-19 [J]. BMJ, 2020, 370: n2219.
    [23]
    Chu VT, Schwartz NG, Donnelly MAP, et al. Comparison of Home Antigen Testing With RT-PCR and Viral Culture During the Course of SARS-CoV-2 Infection [J]. JAMA Intern Med, 2022, 182: 701-709. DOI: 10.1001/jamainternmed.2022.1827
    [24]
    White H, McDonald SJ, Barber B, et al. Care for adults with COVID-19: living guidelines from the National COVID-19 Clinical Evidence Taskforce [J]. Med J Aust, 2022, 217: 368-378. DOI: 10.5694/mja2.51718
    [25]
    Mohammadi M, Khafaee Pour Khamseh A, Varpaei HA. Invasive Airway "Intubation" in COVID-19 Patients; Statistics, Causes, and Recommendations: A Review Article [J]. Anesth Pain Med, 2021, 11: e115868.
    [26]
    El-Boghdadly K, Wong DJN, Owen R, et al. Risks to healthcare workers following tracheal intubation of patients with COVID-19: a prospective international multicentre cohort study [J]. Anaesthesia, 2020, 75: 1437-1447. DOI: 10.1111/anae.15170
    [27]
    Camous L, Pommier JD, Martino F, et al. Very late intubation in COVID-19 patients: a forgotten prognosis factor? [J]. Crit Care, 2022, 26: 1-4. DOI: 10.1186/s13054-021-03885-y
    [28]
    Ospina-Tascon GA, Calderón-Tapia LE, Garcia AF, et al. Effect of high-flow oxygen therapy vs conventional oxygen therapy on invasive mechanical ventilation and clinical recovery in patients with severe COVID-19: a randomized clinical trial [J]. JAMA, 2021, 326: 2161-2171. DOI: 10.1001/jama.2021.20714
    [29]
    Frat JP, Thille AW, Mercat A, et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure [J]. N Engl J Med, 2015, 372: 2185-2196. DOI: 10.1056/NEJMoa1503326
    [30]
    Bellani G, Laffey JG, Pham T, et al. Noninvasive ventila-tion of patients with acute respiratory distress syndrome. Insights from the LUNG SAFE study [J]. Am J Respir Crit Care Med, 2017, 195: 67-77. DOI: 10.1164/rccm.201606-1306OC
    [31]
    Ding L, Wang L, Ma W, et al. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study [J]. Crit Care, 2020, 24: 1-8. DOI: 10.1186/s13054-019-2683-3
    [32]
    Thompson AE, Ranard BL, Wei Y, et al. Prone positioning in awake, nonintubated patients with COVID-19 hypoxemic respiratory failure [J]. JAMA Intern Med, 2020, 180: 1537-1539. DOI: 10.1001/jamainternmed.2020.3030
    [33]
    Weiss TT, Cerda F, Scott JB, et al. Prone positioning for patients intubated for severe acute respiratory distress syndrome (ARDS) secondary to COVID-19: a retrospective observational cohort study [J]. Br J Anaesth, 2021, 126: 48-55. DOI: 10.1016/j.bja.2020.09.042
    [34]
    Horby P, Lim WS, Emberson JR, et al. Dexamethasone in Hospitalized Patients with COVID-19 [J]. N Engl J Med, 2021, 384: 693-704. DOI: 10.1056/NEJMoa2021436
    [35]
    NHS. Interleukin-6 inhibitors (tocilizumab or sarilumab) for hospitalised patients with COVID-19 pneumonia (adults) [EB/OL]. (2021-02-17)[2023-01-03]. https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103144.
    [36]
    Kramer A, Prinz C, Fichtner F, et al. Janus kinase inhibitors for the treatment of COVID-19 [J]. Cochrane Database Syst Rev, 2022, 6: CD015209.
    [37]
    Gordon AC, Mouncey PR, Al-Beidh F, et al. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19 [J]. N Engl J Med, 2021, 384: 1491-1502. DOI: 10.1056/NEJMoa2100433
    [38]
    Schiff MH, Kremer JM, Jahreis A, et al. Integrated safety in tocilizumab clinical trials [J]. Arthritis Res Ther, 2011, 13: 1-13.
    [39]
    Guimarães PO, Quirk D, Furtado RH, et al. Tofacitinib in Patients Hospitalized with Covid-19 Pneumonia [J]. N Engl J Med, 2021, 385: 406-415. DOI: 10.1056/NEJMoa2101643
    [40]
    Han MK, Antila M, Ficker JH, et al. Ruxolitinib in addition to standard of care for the treatment of patients admitted to hospital with COVID-19 (RUXCOVID): a randomised, double-blind, placebo-controlled, phase 3 trial [J]. Lancet Rheumatol, 2022, 4: e351-e361. DOI: 10.1016/S2665-9913(22)00044-3
    [41]
    Lansbury L, Lim B, Baskaran V, et al. Co-infections in people with COVID-19: a systematic review and meta-analysis [J]. J Infect, 2020, 81: 266-275. DOI: 10.1016/j.jinf.2020.05.046
    [42]
    Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19 [J]. J Thromb Haemost, 2020, 18: 1023-1026. DOI: 10.1111/jth.14810
    [43]
    Sullivan DJ, Gebo KA, Shoham S, et al. Early Outpatient Treatment for Covid-19 with Convalescent Plasma [J]. N Engl J Med, 2022, 386: 1700-1711. DOI: 10.1056/NEJMoa2119657
    [44]
    Nates JL, Nunnally M, Kleinpell R, et al. ICU Admission, Discharge, and Triage Guidelines: A Framework to Enhance Clinical Operations, Development of Institutional Policies, and Further Research [J]. Crit Care Med, 2016, 44: 1553-1602. DOI: 10.1097/CCM.0000000000001856
    [45]
    Poon LC, Yang H, Dumont S, et al. ISUOG Interim Guidance on coronavirus disease 2019 (COVID-19) during pregnancy and puerperium: information for healthcare professionals-an update [J]. Ultrasound Obstet Gynecol, 2020, 55: 848. DOI: 10.1002/uog.22061
    [46]
    Pfizer Lab. Fact sheet for healthcare providers: emergency use authorization for paxlovid[EB/OL]. (2022-03-18) [2023-01-03]. https://www.fda.gov/media/155050/down-load.
    [47]
    McCreary EK, Lemon L, Megli C, et al. Monoclonal Antibodies for Treatment of SARS-CoV-2 Infection During Pregnancy: A Cohort Study [J]. Ann Intern Med, 2022, 175: 1707-1715. DOI: 10.7326/M22-1329
    [48]
    Kabinger F, Stiller C, Schmitzová J, et al. Mechanism of molnupiravir-induced SARS-CoV-2 mutagenesis [J]. Nat Struct Mol Biol, 2021, 28: 740-746. DOI: 10.1038/s41594-021-00651-0
    [49]
    CDC. Interim infection prevention and control recommendations for healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic[EB/OL]. (2022-09-23)[2023-01-03]. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html.
    [50]
    Zhang M, Zheng H, Wang J. Strategy of using personal protective equipment during aerosol generating medical procedures with COVID-19 [J]. J Clin Anesth, 2020, 66: 109911. DOI: 10.1016/j.jclinane.2020.109911
    [51]
    Hong K, Cao W, Liu Z, et al. Prolonged presence of viral nucleic acid in clinically recovered COVID-19 patients was not associated with effective infectiousness [J]. Emerg Microbes Infect, 2020, 9: 2315-2321. DOI: 10.1080/22221751.2020.1827983
    [52]
    Kim MC, Cui C, Shin KR, et al. Duration of culturable SARS-CoV-2 in hospitalized patients with Covid-19 [J]. N Engl J Med, 2021, 384: 671-673. DOI: 10.1056/NEJMc2027040
    [53]
    Yahav D, Yelin D, Eckerle I, et al. Definitions for coronavirus disease 2019 reinfection, relapse and PCR re-positivity [J]. Clin Microbiol Infect, 2021, 27: 315-318. DOI: 10.1016/j.cmi.2020.11.028
    [54]
    Abu-Raddad LJ, Chemaitelly H, Bertollini R. Severity of SARS-CoV-2 reinfections as compared with primary infections [J]. N Engl J Med, 2021, 385: 2487-2489. DOI: 10.1056/NEJMc2108120
    [55]
    CDC. Interim Clinical Considerations for Use of COVID-19 Vaccines: Appendices, References, and Previous Updates[EB/OL]. (2022-12-09)[2023-01-03]. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us-appendix.html.
    [56]
    CDC. Ending Isolation and Precautions for People with COVID-19: Interim Guidance[EB/OL]. (2022-08-31)[2023-01-03]. https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html.
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