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      A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)

      research-article
      1 , 2 , 3 , 4 , 1 , 5 , 6 , 7 , 1 , 1 , 6 , 7 , 1 , 2 , 8 , 8 , 1 , 5 , 9 , 10 , 2 , 1 , 8 , 1 , 8 , 9 , 11 , 5 , 12 , 13 , 1 , 1 , 3 , 4 , 14 , 10 , 15 , 16 , 2 , 17 , 15 , 17 , 2 , 6 , 7 , 14 , 1 , 1 , 5 , 1 , 18 , , 6 , 7 , , 1 , 2 , , , for the Zhongnan Hospital of Wuhan University Novel Coronavirus Management and Research Team, Evidence-Based Medicine Chapter of China International Exchange and Promotive Association for Medical and Health Care (CPAM)
      Military Medical Research
      BioMed Central
      2019 novel coronavirus, 2019-nCoV, Respiratory disease, Pneumonia, Infectious diseases, Rapid advice guideline, Clinical practice guideline, Evidence-based medicine

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          Abstract

          In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named “2019 novel coronavirus (2019-nCoV)” by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

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          Most cited references8

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          [Glucocorticoid-induced diabetes in severe acute respiratory syndrome: the impact of high dosage and duration of methylprednisolone therapy].

          Over-dose glucocorticoid was frequently used in patients with severe acute respiratory syndrome (SARS), the aim of the present study is to investigate the frequency and risk factors of corticosteroid-induced diabetes in this situation. One hundred thirty-three cases of SARS admitted from May to June 2003 in our hospital were included in the study. Maximal dose, average daily dose, treatment course and fasting plasma glucose level (FPG) were recorded. Corticosteroid-induced diabetes was diagnosed if FPG was equal to or higher than 7 mmol/L twice or more after the administration of glucocorticoids. Ninety five patients (71.9%) were prescribed with glucocorticoid among the 132 patients. Thirty-three patients (36.3%) were diagnosed as corticosteroid-induced diabetes according to the FPG. Significant differences were found in daily maximal dosage, duration of treatment and average dosage of methylprednisolone between the patients with and without corticosteroid-induced diabetes (275 mg/d vs 136 mg/d, 24 d vs 16 d, 139 mg/d vs 91 mg/d, P < 0.01). As compared with the lowest tertile, the frequency of diabetes in SARS patients treated with highest tertile of maximal daily dosage, treatment duration, average dosage or total dosage were significantly higher (64.7% vs 13.0, 61.9% vs 17.4%, 62.5% vs 21.7%, and 59.2% vs 13.6%, P < 0.05 for all comparisons). If the patients were treated with an average dose less than 90 mg/d and treatment duration shorter than 15 days, the diabetes incidence was 10.5%. After adjusting age and sex, the daily maximal dosage of methylprednisolone was the only factor that might predict the occurrence of diabetes. Over-dose administration of methylprednisolone in SARS patients leads to a high frequency of diabetes. Decreasing the daily maximal dosage may be beneficial to the reduction of corticosteroid-induced of diabetes.
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            [Use of glucocorticoid in treatment of severe acute respiratory syndrome cases].

            To explore the effect of glucocorticoid in the treatment for severe acute respiratory syndrome (SARS).
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              The possibility of using lopinave/ritonawe (LPV/r) as treatment for novel coronavirus 2019-nCov pneumonia: a quick systematic review based on earlier coronavirus clinical studies.

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                Author and article information

                Contributors
                zengxiantao1128@163.com
                wangyyanpublic@bta.net.cn
                wangxinghuan1965@163.com
                Journal
                Mil Med Res
                Mil Med Res
                Military Medical Research
                BioMed Central (London )
                2095-7467
                2054-9369
                6 February 2020
                6 February 2020
                2020
                : 7
                : 4
                Affiliations
                [1 ]GRID grid.413247.7, Center for Evidence-Based and Translational Medicine, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [2 ]ISNI 0000 0001 2331 6153, GRID grid.49470.3e, Institute of Hospital Management, Wuhan University, ; Wuhan, 430071 China
                [3 ]GRID grid.413247.7, Department of Respiratory Medicine, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [4 ]GRID grid.413247.7, Department of Pharmacy, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [5 ]ISNI 0000 0000 9139 560X, GRID grid.256922.8, Institute of Evidence-Based Medicine and Knowledge Translation, Henan University, ; Kaifeng, 475000 China
                [6 ]ISNI 0000 0004 0632 3409, GRID grid.410318.f, China Academy of Chinese Medical Sciences, ; Beijing, 100700 China
                [7 ]China Center for Evidence Based Traditional Chinese Medicine (CCEBTCM), Beijing, 100700 China
                [8 ]GRID grid.413247.7, Department of Critical Care Medicine, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [9 ]GRID grid.413247.7, Department of Clinical Laboratory, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [10 ]GRID grid.413247.7, Department of Infectious Diseases, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [11 ]GRID grid.413247.7, Division of Medical Affairs, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [12 ]GRID grid.413247.7, Division of Nursing Affairs, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [13 ]GRID grid.413247.7, Office of Nosocomial Infection Control, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [14 ]GRID grid.413247.7, Emergency Center, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [15 ]GRID grid.413247.7, Department of Radiology, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [16 ]ISNI 0000 0004 1936 8227, GRID grid.25073.33, Department of Health Research Methods, Evidence, and Impact, , McMaster University, ; Hamilton, ON L8S 4L8 Canada
                [17 ]GRID grid.413247.7, Department of Traditional Chinese Medicine, , Zhongnan Hospital of Wuhan University, ; Wuhan, 430071 China
                [18 ]ISNI 0000 0001 2331 6153, GRID grid.49470.3e, Global Health Institute, Wuhan University, ; Wuhan, 430072 China
                Article
                233
                10.1186/s40779-020-0233-6
                7003341
                32029004
                2ba9656f-49e5-499a-9a87-e8bcaee2e34f
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 January 2020
                : 30 January 2020
                Categories
                Position Article and Guideline
                Custom metadata
                © The Author(s) 2020

                2019 novel coronavirus,2019-ncov,respiratory disease,pneumonia,infectious diseases,rapid advice guideline,clinical practice guideline,evidence-based medicine

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