新型冠状病毒肺炎疫情对结核病防控的影响及对策

新型冠状病毒肺炎[WHO命名为“coronavirus disease 2019(COVID-19)”]已在全球大流行,也给全球公共卫生造成巨大影响。作者分析了COVID-19疫情对我国结核病防控工作的影响,并提出在今后COVID-19疫情防控常态化趋势下结核病患者发现、治疗和管理等一系列防控对策,以及加强结核病防治体系和能力建设等建议。     

新型冠状病毒肺炎疫情防控经验对结核病防治工作的启示

我国新型冠状病毒肺炎(COVID-19)疫情防控的成功经验和科学实践,为传染病防控树立了典范。笔者通过分析、学习和借鉴我国在COVID-19疫情防控中取得的经验,结合当前我国结核病防治现状,浅析当前我国结核病防治在服务体系、政策保障和科学研究等方面需要着重考虑和解决的问题。     

新型冠状病毒肺炎疫情期间糖尿病基层管理专家建议

自2019年12月以来,我国发生新型冠状病毒肺炎(COVID-19)疫情。糖尿病患者COVID-19感染风险增高,且预后差。COVID-19疫情期间,基层医疗在糖尿病预防和血糖控制管理方面面临严峻挑战。中国糖尿病专家、基层医疗服务提供者和公共卫生管理者提出专家建议,旨在提高全国基层医疗卫生机构在COVID-19疫情期间的临床诊治能力并提供标准化的基本公共卫生和医疗服务。本建议的主要内容包括管理的基本要求、健康管理的工作流程、转诊、治疗和长期随访。     

新型冠状病毒肺炎疫情期间基层卫生机构对慢病患者健康管理

目的探究新型冠状病毒肺炎(COVID-19)疫情期间指导慢病患者做好COVID-19防护和健康管理对基础病控制的作用。方法从社区健康档案中随机抽取110例慢病患者,采用自制问卷、通过电话随访进行调查,电话调查有专人完成。剔除不配合调查或其他原因未完成者,共完成有效问卷100份。结果慢病患者对社区卫生机构COVID-19防控和慢病管理措施的满意度分别为93%和92%;同时,不同年龄、学历患者对疫情的负面反应不同,对获得健康服务的方式和途径的需求也有差别。结论基层卫生服务机构通过多措并举对慢病患者进行COVID-19防护指导和健康管理,确保了辖区慢病患者COVID-19防控和基础病治疗。     

《结核病免疫治疗专家共识（2022年版）》要点解读

《2022年全球结核病报告》显示,2021年全球结核病、耐药结核病和结核病死亡患者数量均增长,对WHO终止结核病目标的实现构成了严峻挑战。TB/HIV/COVID-19的三重感染重创了全球结核病防治成果,故全球终止结核病策略的如期实现必将是任重道远。全球结核病疫情的新变化,对结核病治疗提出了新的挑战。虽然敏感结核病和耐药结核病患者的化学药物治疗在缩短疗程和提高疗效等方面取得了较大新进展,但是短程全口服新方案仍未在全球推广使用,一线和二线抗结核药物的不良反应较大,结核病的免疫治疗可能为目前化疗困境提供了新的机遇。作者就《结核病免疫治疗专家共识(2022年版)》要点进行解读,希望对提高结核病治疗成功率发挥一定的积极作用。     

复工期间新型冠状病毒疾病个人科学防控知识与管理策略

新型冠状病毒疾病(COVID-19)疫情发展至今防控形势持续向好,很多省市根据国家有关法律规定和当前COVID-19疫情防控形势,陆续展开复工、复产、复学工作。但目前疫情的拐点尚未出现,零增加不等于零风险,为全面、有效地做好疫情控制,本文基于国内外相关传染病的防控要求和规范,结合临床实践经验并查阅相关文献,从个人科学防控知识与管理策略着手,形成COVID-19疫情在大量复工期间个人防控管理的相关建议。     

新型冠状病毒肺炎引起肝损伤的致病机制及病毒性肝炎肝硬化患者的防护策略

新型冠状病毒肺炎(COVID-19)蔓延至全球多个国家,疫情期间部分患者表现出肝损伤。为了提高病毒性肝炎肝硬化患者对COVID-19的认识,加强疫情期间患者的自我防护和疾病管理,针对COVID-19引起肝损伤的致病机制及该类患者合理防疫、规范就医、科学用药等方面进行探讨和建议,以保证病毒性肝炎的常规管理,降低该类人群感染风险。     

新型冠状病毒肺炎患者的营养管理建议

定点医院作为新型冠状病毒肺炎(COVID-19)相关病例的集中收治场所, 是落实疫情防控工作的重要环节;营养治疗是临床综合治疗的核心内容之一, 在改善COVID-19患者的营养状态、提高康复率、降低病死率等方面具有关键作用。为规范定点医院临床营养诊疗工作有序开展, 保障临床营养诊疗工作的医疗安全和质量, 上海市临床营养质量控制中心组织专家根据国家卫生健康委员会发布的《新型冠状病毒肺炎诊疗方案(试行第九版)》, 结合临床营养相关指南和诊疗经验编写了此建议, 有助于在疫情防控期间, 指导各医疗机构合理、有效开展COVID-19患者的营养诊疗工作。本指导意见重点针对成人及儿童COVID-19患者的营养管理建议进行阐述, 为临床营养诊疗工作的开展提供参考。     

新型冠状病毒肺炎暴发期间儿科病房护理防控策略

2019年12月以来，新型冠状病毒肺炎（coronavirus disease-2019, COVID-19）迅速在国内外传播，受感染人群短期内大幅增加，不仅包括成年人，还包括不同年龄段儿童，甚至新生儿。儿童因免疫系统发育不成熟、抵抗力低下，成为COVID-19易感人群之一，尤其是COVID-19流行期间住院患儿更易受感染。因此，做好儿科病房疫情期间的防控工作，采取切实可行措施对于预防和控制儿童感染新型冠状病毒显得尤为重要。本文根据国家卫生部门关于COVID-19疫情最新管理规定，结合本医院COVID-19防控经验，从护理角度探讨综合性医院儿科病房感染防控措施，为国内其他医院儿科病房疫情防控与护理工作提供参考。     

常态化疫情防控体系建设思考下的血液净化中心管理

终末期肾脏病(ESRD)已经成为全球重大公共卫生问题,新型冠状病毒肺炎(COVID-19)疫情的大流行,给ESRD现有的医疗救治体系带来了更加严峻的挑战.我国血液透析与腹膜透析技术应用及发展相对失衡,血液透析占主导地位的肾脏替代治疗模式在COVID-19疫情期间暴露了诸多弱点.常态化疫情防控下,亟需推动血液净化疫情防控...     

新型冠状病毒肺炎暴发期间介入导管室的管理策略与建议

新型冠状病毒肺炎暴发期间,介入导管室作为医院内部多个临床科室的"桥梁"和"纽带",既是科学防控的关键部门,也是抢救急危重症患者、挽救患者生命的重要科室。导管室涉及医、技、护等多岗位的工作协调,承担着血管造影机等多种医疗设备的保养和维护。因此,为科学防控疫情、提高医、技、护人员的自我防护意识和能力,避免院内交叉感染,展现现代导管室的综合救治能力,我们在此对介入导管室疫情期间的管理提出相应的策略和建议。     

Management of COVID-19 patients in Fangcang shelter hospital: clinical practice and effectiveness analysis

Fangcang shelter (Cabin) hospitals were set up in order to cope with the rapid growth of confirmed cases of coronavirus disease 2019 (COVID-19) in Wuhan, China at a time when there were insufficient beds in designated hospitals. This paper describes the layout and functioning of a typical Fangcang shelter hospital, Wuhan Dongxihu Fangcang shelter Hospital, where the author has worked, the working mechanism, experience and effectiveness. A set of patient management protocols was employed for daily practice, which included preset criteria and procedure for admission, examination, medication treatment, referral and discharge. WeChat platform with different groups was used for communication, ward round, test appointments and patient data communication. All these procedures and mechanisms of working enabled the effective management of a larger number of patients with relatively few doctors. As a result, 442 mild or moderate COVID-19 patients in Hall C were successfully managed by a team of 40 doctors, with 246 (56%) patients were cured and discharged from the Fangcang shelter hospital while the remaining 196 (44%) patients were referred on to designated hospitals for further treatment. The reasons for referral included poor resolution in computerized tomography (CT) scan (59%), persistently positive severe acute respiratory syndrome coronavirus 2 by PCR after 9 days of admission (16%), deterioration in CT image (4%), development of dyspnoea (1%) and other (4%) or unclear reasons (16%) due to no record of reasons for referral on the document. There were no deaths and no complaints from the patients in Hall C. In summary, the Fangcang shelter hospital could be run successfully with a set of patient management protocols under conditions of limited facilities and medical staff. It was effective and safe in isolating patients, providing basic medical care and early identification of potential severe cases. This experience may provide a successful example of a working mechanism for the prevention and control of the COVID-19 pandemic worldwide.     

Management of acute coronary syndrome in the context of coronavirus disease 2019

Coronavirus disease 2019 (COVID-19) is still developing worldwide. The prognosis of the disease will become worse and mortality will be even higher when it is combined with cardiovascular disease. Furthermore, COVID-19 is highly infectious and requires strict isolation measures. For acute coronary syndromes (ACS), a common cardiovascular disease, infection may aggravate the occurrence and development of ACS, making the management of more difficult. It will be an enormous challenge for clinical practice to deal with ACS in this setting of COVID-19.Aim to reduce the mortality of ACS patients during the epidemic of COVID-19 by standardizing procedures as much as possible.Pubmed and other relevant databases were searched to retrieve articles on COVID-19 and articles on ACS management strategies during previous influenza epidemics. The data was described and synthesized to summarize the diagnosis and management strategy of ACS, the preparation of catheter laboratory, and the protection of the medical staff in the context of COVID-19. Ethical approval is not required in this study, because it is a review with no recourse to patient identifiable information.Standardized diagnosis and treatment advice can help reduce the mortality of COVID-19 patients with ACS. In the absence of contraindications, the third generation of thrombolytic drugs should be the first choice for thrombolytic treatment in the isolation ward. For patients who have to receive PCI, this article provides detailed protective measures to avoid nosocomial infection.     

The role of after-hours house-call medical service in the treatment of COVID-19 patients awaiting hospital admission: A retrospective cohort study

Due to the increasing number of coronavirus disease 2019 (COVID-19) cases in Japan, hospitals are unable to provide admission and immediate inpatient care. The after-hours house call (AHHC) service offers telephone consultations and in-home care to patients awaiting admission. Currently, there is no report on the management of COVID-19 patients when inpatient beds are insufficient.We aimed to describe the clinical characteristics and outcomes of COVID-19 patients treated by an AHHC medical service in Osaka and Tokyo, between April and May 2021 (during the fourth wave in Japan). Patients were classified into 2 groups: Moderate I and Moderate II, according to the severity of infection under Japanese guidelines. A retrospective study of the hospital records and follow-up telephone consultations was performed.The AHHC treated a total of 55 COVID-19 patients (17 with Moderate I, 38 with Moderate II disease). The median ages (interquartile range) were 63 (49–80.5) and 64 (50.8–81), respectively. In each group, approximately 30% of AHHC patients received out-of-hospital oxygen therapy for the duration of their treatment until it was no longer required. Major symptoms, including shortness of breath or difficulty breathing (47.1% and 78.9%, respectively) and fever or chills (41.2% and 76.3%, respectively) were lower in the Moderate I group than in the Moderate II group. Overall, 16.4% of patients died, with 17.6% in the Moderate I group and 15.8% in the Moderate II group.We found the proportion of mortality in patients treated by the AHHC was slightly higher to that of patients treated in Japanese hospitals. This study will provide an alternative management of patients requiring oxygen in situations where hospital beds are in short supply.     

Application of Artificial Intelligence in COVID-19 drug repurposing

Background and aimCOVID-19 outbreak has created havoc and a quick cure for the disease will be a therapeutic medicine that has usage history in patients to resolve the current pandemic. With technological advancements in Artificial Intelligence (AI) coupled with increased computational power, the AI-empowered drug repurposing can prove beneficial in the COVID-19 scenario.MethodsThe recent literature is studied and analyzed from various sources such as Scopus, Google Scholar, PubMed, and IEEE Xplore databases. The search terms used are ‘COVID-19′, ’ AI ′, and ‘Drug Repurposing’.ResultsAI is implemented in the field design through the generation of the learning-prediction model and performs a quick virtual screening to accurately display the output. With a drug-repositioning strategy, AI can quickly detect drugs that can fight against emerging diseases such as COVID-19. This technology has the potential to improve the drug discovery, planning, treatment, and reported outcomes of the COVID-19 patient, being an evidence-based medical tool.ConclusionsThus, there are chances that the application of the AI approach in drug discovery is feasible. With prior usage experiences in patients, few of the old drugs, if shown active against SARS-CoV-2, can be readily applied to treat the COVID-19 patients. With the collaboration of AI with pharmacology, the efficiency of drug repurposing can improve significantly.     

Operation and management of a community treatment center using telemedicine for foreign patients with mild COVID-19 symptoms

South Korean studies on coronavirus disease-2019 (COVID-19) treatment have described the use of community treatment centers (CTCs), which combine elements of the home and hospital, to isolate and treat mild COVID-19 patients. While the number of South Koreans diagnosed with COVID-19 cases has varied greatly by season, the number of confirmed cases in foreign nationals has shown no seasonality, with an average of around 25 to 30 per day. For foreign patients, accommodation arrangements and travel routes may be difficult; they may also have difficulty accessing medical care, so require careful management.We discuss our experience in operating and managing a CTC for foreign COVID-19 patients arriving in South Korea with mild symptoms. We also propose guidelines for efficient use of resources with respect to treating these patients in CTCs.We present the clinical findings of patients treated at the CTC between 7 October and 22 November 2020, and make some recommendations. We quarantined and treated foreign patients with mild symptoms of COVID-19 at the Ansan CTC. Discharge is determined based on clinical symptoms rather than polymerase chain reaction results. Medical and administrative staff use building A, while building B is used for isolating patients. Medical rounds are in the form of twice-daily video calls. Three kinds of foods with medication are served according to the patient''s country of origin.In total, 315 patients were admitted to the Ansan CTC between 7 October and 22 November 2020; 145 of them were discharged from the CTC and 26 were transferred to other hospitals.To utilize medical resources efficiently during the pandemic, it is desirable to reserve CTCs exclusively for foreign patients.     

新型冠状病毒肺炎疫情对我国消除疟疾工作的挑战及应对策略

2019年底以来,一种新型冠状病毒病肺炎（COVID-19）在我国大范围流行,不仅严重威胁人民群众的生命安全和身体健康,同时也给其他传染病防控带来了严峻挑战。目前,我国每年仍有近3 000例境外输入性疟疾病例,如不能及时开展病例诊治和疫点调查处置,不仅有可能危及患者生命,还可能引起继发传播而威胁我国消除疟疾成果。新型冠状病毒肺炎流行范围广、传播能力强,不仅疟疾患者在就医过程中有可能被感染,而且医务人员在开展临床诊治、样本检测和流行学调查时也面临感染风险。本文分析新型冠状病毒肺炎流行对我国消除疟疾工作的挑战,并探讨相应的应对策略和措施,从而为医务工作者提供参考。     

新型冠状病毒肺炎相关心肌损伤的临床管理专家建议(第一版)

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者除了典型呼吸系统表现,也有一定比例的患者出现心脏受累的临床表现。心肌损伤在COVID-19患者中比较常见,发生心肌损伤的患者预后不佳,心脏内科专科医师进行及时诊断、明确心肌损伤的发生原因、采取针对性的治疗,可降低重型及危重型COVID-19患者的死亡率。本专家组结合收治经验,针对COVID-19相关心肌损伤提出诊断和治疗建议。