As the designated hospital for COVID-19 treatment in the southern branch of Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, since April 2022, patients over 70 years old in the ICU ward accounted for 51%, and patients with underlying diseases accounted for about 96%.
Imagine going back to more than two years ago. Virologists, medical experts, economists, and sociologists tried to predict how the new coronavirus that had just emerged would affect the world. They compared the epidemics of infectious diseases from ancient times to the present, but I am afraid that Still no one has an answer that comes close to the world we see today.
All countries suffer from it. At the Tokyo Olympics in the summer of 2021, when the world's healthiest and most physically fit champions stood on the podium, they had to use masks to block the virus, which was too small to be seen by the naked eye.
Humans have not encountered such a huge epidemic of infectious diseases in 100 years. After a few generations, the fear of viruses has been sealed in the history books. The emergence of the new coronavirus has once again awakened the memory of the "plague" in our genes.
After more than two years of the epidemic, should we be pessimistic or optimistic about the control of the future epidemic?
The answer given by many scholars is optimistic, because after all, the world today has undergone tremendous changes compared with 100 years ago. Compared with any infectious disease outbreak in history, vaccines and drugs for the new coronavirus have been developed and marketed faster, prevention and control measures have been taken more timely, and people's overall nutritional level, medical technology, and protective materials are better than It used to be so much better.
At present, the main new coronavirus in the world, Omicron, makes prevention and control difficult. However, Academician Wen Yumei of Fudan University recently mentioned in a popular science lecture that it is necessary to correct the fear of the new coronavirus Omicron strain , Because scientific researchers around the world are tracking the mutation, global cooperation makes it easier for us to grasp the mutation direction and characteristics of the strain, and we have a way to block the spread of the virus. "We must guard against this virus, but don't be afraid."
Of course, the epidemic of the new crown epidemic will continue for a period of time, which will still be a huge test for the prevention and control measures, prevention and treatment of countries around the world. Especially in terms of treatment - if the new strain is still very transmissible, then our expectations for improving the treatment effect will be higher. The COVID-19 special drug, which has attracted much attention since the beginning of the epidemic, has been released and used in many countries. Its development speed and approval speed have created a history, and it seems that the therapeutic effect has also been affirmed.
On March 14 this year, the National Health and Medical Commission released the "New Coronary Virus Pneumonia Diagnosis and Treatment Plan (Trial Version 9)", and the latest version of the guideline was unanimously considered by domestic experts to be the most scientific and effective version of the guideline. Among them, two special drugs, nematevir tablets/ritonavir tablets, are packaged in combination, and ambavirumab/romisevirumab injection is included in the guidelines, which points out the direction for clinical first-line doctors to use drugs.
In the new round of domestic epidemics, the elderly with underlying diseases and unvaccinated people are at high risk of developing severe disease. Therefore, preventing the reproduction of the virus and blocking the development of the disease as soon as possible is a way to reduce severe and severe disease. A key link in reducing deaths.
Next, popularizing vaccination among the elderly, stockpiling special medicines, optimizing and upgrading emergency plans, etc. will become the basis for controlling the epidemic.
We are so eager to return to the way of life before the epidemic, how can we go back? It depends on the advancement of science and technology, the improvement of emergency response capabilities of medical institutions, and the confidence of everyone.
From "white lung" to the treatment of "other diseases"
"White lung" - the word that doctors are most afraid to hear during the Wuhan epidemic. Once the patient's imaging report shows "white lung", the patient will be "difficult".
In the early days of the Wuhan epidemic in 2020, "Xinmin Weekly" interviewed a number of front-line medical experts and doctors who participated in the treatment. When describing the treatment process of those patients who developed severe illness or even died, the most common sentence they said was: "How many times? It was fine an hour ago, but suddenly it's gone." Behind these words are the characteristics of the first-generation strain of the new crown.
The elderly and children line up in an orderly line for nucleic acid testing in Zhongtong Yayuan, Yangpu District, Shanghai. photography / species of nan
At that time, the new coronavirus was highly pathogenic and could directly reach the lower respiratory tract – the lungs, causing the patient’s blood oxygen saturation to drop off a cliff in a short period of time.
This single-handed way of infection has made people of all ages threatened by the first-generation new coronavirus strain, and many young people with strong bodies have not been spared.
Qiu Haibo, an expert from the Comprehensive Team of the Joint Prevention and Control Mechanism of the State Council and Vice President of Southeast University, was one of the national experts in the Wuhan epidemic. Qiu Haibo came to Shanghai in April this year.
When "Xinmin Weekly" interviewed Qiu Haibo in 2020, he described a special course of COVID-19 patients called "silent hypoxemia": the patient's own complaints were not obvious, and he himself did not feel too uncomfortable. He would say that he was a little suffocated, but not too serious. If the doctor measures the patient's blood oxygen saturation at this time, it is actually very low.
At the beginning, doctors did not find this feature, and some patients did not have time to rescue. When everyone found this feature different from previous diseases, they immediately began to take measures. Qiu Haibo said at the time: "In the absence of special drugs, the team of critical care medicine experts has explored effective methods to prevent the disease from worsening, such as moving the exit forward and ventilating in the prone position."
On May 13 this year, Qiu Haibo was interviewed by CCTV host Bai Yansong. Changes in symptoms of patients with new coronary pneumonia after the outbreak in Wuhan.
He said that in the Wuhan epidemic, the severe rate was 19.5-20%, and after the Wuhan epidemic, the severe rate dropped to 5%-7%. In the epidemic caused by the Omicron variant, the proportion of severe patients among the infected was 0.6%. . Qiu Haibo said that the biggest feature of this round of epidemics is that severe patients appear in the elderly and people with underlying diseases, especially patients with hemodialysis, tumor radiotherapy and chemotherapy, as well as unvaccinated people and elderly pregnant women.
Qiu Haibo said that although the severe case rate has decreased, due to the large base of infected people, there is still a lot of pressure on the treatment of critically ill patients. Judging from the epidemic situation in Shanghai, the proportion of deaths to the total number of infected people is still ten times higher than that of seasonal flu.
The reasons for the deterioration of the infected person's condition range from the "white lung" caused by the new crown to the deterioration of other basic diseases caused by the new crown - this is the change that has occurred after the new crown virus has been spreading in the population for two years. It is no longer a direct attack on the human respiratory system. For young adults who are fully vaccinated and have perfect immune function, the threat may become smaller, but if it is children, the elderly, and vulnerable people with other diseases, then the new crown has become a "booster" that aggravates the deterioration of underlying diseases. , putting the lives of these vulnerable groups at risk.
Protect already vulnerable populations
In mid-April, a group of COVID-19 infected patients transferred from nursing homes entered Shanghai Lingang Fangcang shelter hospital. As the medical director of a Fangcang shelter ward, Dr. Chen Yijian from the Antibiotic Research Institute of Huashan Hospital Affiliated to Fudan University immediately explained that medical staff should pay close attention to it. these old people. Chen Yijian later recalled that when these elderly patients were hospitalized, it was the most stressful period of his work in Lingang Fangcang shelter hospital, because the elderly basically suffered from a variety of underlying diseases and their physical condition was very poor. After being infected with the new coronavirus, they are much more likely to become seriously ill than other groups of people. The medical team must always monitor the physical indicators of the elderly and give them timely treatment.
In the current round of the epidemic in Shanghai, the elderly and patients with underlying diseases are obviously high-risk groups of severe illness and death.
According to the press conference on April 17th, as of 24:00 on April 16th, there were 16 severe patients receiving treatment in designated medical institutions in Shanghai, 1 case was 33 years old, and the rest were elderly, the youngest being 70 years old. , the oldest is 93 years old. One case has been vaccinated throughout the course, and the rest have not been vaccinated against the new coronary pneumonia virus.
The youngest 33-year-old patient with COVID-19 has severe autoimmune disease and hemodialysis status. On admission, CT showed that the patient had extensive lung lesions with pericardial effusion. After active antiviral symptomatic support, combined with traditional Chinese medicine treatment, At present, the patient's lung imaging has improved, and the related underlying diseases are still under active treatment.
Other elderly critically ill patients have serious underlying diseases, including diabetes, cardiovascular and cerebrovascular diseases, malignant tumors, chronic obstructive pulmonary disease, severe pulmonary bacterial infection, and pulmonary embolism.
On April 17, three people infected with COVID-19 died in Shanghai, all of them were of advanced age and had serious underlying diseases such as acute coronary syndrome, diabetes, hypertension, and cerebral infarction sequelae, and none of them had received the COVID-19 virus vaccine.
In Shanghai, more than 600,000 people have been infected and nearly 600 people have died. Qiu Haibo introduced that among the severe patients in Shanghai, about 15% are mainly symptomatic of the new crown, and about 85% have other underlying diseases aggravated by the new crown. Then, the focus of treatment comes to the new crown "stimulating" the deterioration of other underlying diseases.
As can be seen in the new crown epidemic caused by Omicron, the vulnerable elderly, children, patients with underlying diseases, pregnant women... are high-risk groups that can bring serious consequences from the new virus strain. All prevention and treatment measures revolve around protection. They unfold.
Stop the progression of the disease
The current research shows that the existing new crown vaccine is effective in reducing the severe rate. Whether it is an inactivated vaccine or a vaccine produced by other technical routes, the severe rate can be significantly reduced.
But there is a paradox in the fact that vulnerable groups are also the ones with the lowest vaccination rates.
A group of citizens who met the discharge requirements were discharged from the Fangcang shelter hospital and went home. Chen Erzhen, the leader of the medical treatment team at the Shanghai centralized isolation point and the vice president of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine, gave them a thumbs up to show their encouragement. Photography / Ding Yanmin
According to the report of the National Health Commission, as of May 12, about 230 million people over the age of 60 have been vaccinated against the new coronavirus in the country, with a vaccination coverage rate of 86% and a full-course vaccination rate of 82%, which is 91% of the national population. Compared with the vaccination rate of 89%, it is still low.
According to the data of the 192nd press conference on the prevention and control of the new coronary pneumonia epidemic in Shanghai, as of May 22, the coverage rate of the complete vaccination of the new coronavirus vaccine for people aged 60 and above in Shanghai was 62.11%, of which the coverage of the booster immunization was completed. The rate is only 39.26%. Recently, the epidemic in Shanghai has been effectively controlled, and the vaccination work has been restarted.
The Omicron strain is very contagious, so the base of infected people will be relatively large. Under such a realistic situation, it is more urgent to expect special drugs to prevent the aggravation of the infection of infected people.
On April 29, the State Council Information Office held a press conference on the situation of "dynamic clearing" to do a good job in epidemic prevention and control. Liang Wannian, head of the expert group of the National Health Commission's Leading Group for Epidemic Response and Disposal, said that if China's vaccination coverage The rate is relatively high, and all regions have made preparations for medical resources, isolation beds, effective drugs, material supply, emergency mechanisms, etc. At the same time, effective drugs can be widely used, and the virus does not appear worse or new mutations, but more mild , the risk of death is within an acceptable range. Using the time window set aside by "dynamic clearing" to make these relevant preparations will surely be able to defeat the new crown pneumonia epidemic.
As of May 8, 6 new coronavirus treatment drugs have been approved in China. The "New Coronary Virus Pneumonia Diagnosis and Treatment Program (Trial Ninth Edition)" released on March 15 included small molecule specific drugs. Professor Zhang Wenhong, director of the Department of Infectious Diseases of Huashan Hospital Affiliated to Fudan University and director of the National Center for Infectious Diseases Medicine, believes that the ninth edition of the diagnosis and treatment plan is the most scientific version so far.
On May 23, Professor Zhang Wenhong gave a speech entitled "Implementation of Prevention and Control Strategies in my country under the Background of the Global Epidemic of New Coronary Pneumonia" at the 7th Academic Conference on Prevention and Control of Respiratory Diseases of the Chinese Preventive Medicine Association. Regarding "drug therapy", he said: "antiviral therapy, anti-inflammatory therapy, and anticoagulation therapy are the three major types of drug therapy that are recognized globally. In addition to several drugs recommended for antiviral therapy in the world In addition, immunotherapy and anticoagulation therapy are also recommended. Therefore, if there is still a chance to fight back against the challenge of Omicron in the future, these major treatments are the key. As long as you master these major treatments, plus our country's unique With traditional Chinese medicine therapy, we are basically sure to deal with Omicron." The
unprecedented speed of developing new drugs In the struggle of
human beings with viruses and bacteria for thousands of years, there are winners and losers. When a specific drug appears, we can Victory overall. Successful examples include the invention of antibiotics to deal with bacterial infections, and, of course, some diseases that have not yet been eliminated, such as AIDS.
After the outbreak of the new crown epidemic in 2020, Chinese scientists shared the virus gene sequence for the first time, and global researchers started the research and development of vaccines and specific drugs.
Professor Cao Bin of the China-Japan Friendship Hospital introduced in an article published in February this year that as of November 2021, there are many new drug research and development pipelines for COVID-19, with 264 antiviral drug candidates, which can be divided into three categories: 1. Vaccine drugs, second, protein drugs against the new coronavirus, and third, small molecule drugs.
He believes that oral antiviral drugs are expected to have broad application prospects after they are marketed, because of their ease of use and sufficient evidence of clinical benefits.
Ding Sheng, Dean of the School of Pharmacy of Tsinghua University, delivered a speech entitled "What Kind of New Crown Vaccines and Drugs Do We Need?" in the "Jing Guan Lecture Hall" in April this year. Vaccines and drugs are a 'combination punch', but they each play a different role."
Ding Sheng recalled that after the outbreak of the epidemic, to quickly develop specific drugs, the first approach that came to mind was "reuse of old drugs". The advantage of "new use of old drugs" is that it is fast, and the limitation is limited pertinence.
Remdesivir is one of the earliest "old medicine new uses", which was originally developed for Ebola virus. But in the end, Remdesivir was not used on a large scale clinically. There are many reasons behind it, such as the drug needs to be injected intravenously, cannot be taken orally, and the price of the drug is surprisingly high.
There is also a drug targeting HIV that was initially thought to be effective against the new coronavirus, but has since been shown to have no significant effect.
As can be seen in the new crown epidemic caused by Omicron, the vulnerable elderly, children, patients with underlying diseases, pregnant women... are high-risk groups that can bring serious consequences from the new virus strain. All prevention and treatment measures revolve around protection. They unfold.
Like drug research and development for other diseases, the research and development of specific drugs for the new crown has also gone through big waves, but this process is like opening a "double speed", and the time is greatly shortened. Ding Sheng introduced that two targets soon became hot targets for research and development. Among them, the main protease 3CL was the target of Pfizer's Paxlovid, which was later approved.
Ding Sheng said that at present, Paxlovid is taken twice a day for a total of 5 days, which is relatively simple. From a more ideal point of view, it would be more convenient to take it once a day.
On November 5, 2021, Pfizer announced the clinical trial results of its own specific drug: In the Phase II and Phase III clinical trials of nelmatevir tablets/ritonavir tablets (ie, Pfizer’s new crown oral drug Paxlovid), adult patients Taking the drug within 3 to 5 days of onset of symptoms can reduce the risk of severe hospitalization or death by 89%, with no deaths in the experimental group compared with 10 deaths in the placebo group. The new drug's mechanism of action is that the drug binds to specific enzymes that prevent the virus from replicating itself.
On December 22, 2021, local time, the U.S. Food and Drug Administration (FDA) granted emergency use authorization for Pfizer’s oral anti-coronavirus drug Paxlovid.
Zhang Jing is a doctoral supervisor of Fudan University and deputy director of the Antibiotic Research Institute of Huashan Hospital Affiliated to Fudan University.
Zhang Jing, a doctoral supervisor of Fudan University and deputy director of the Antibiotics Research Institute of Huashan Hospital Affiliated to Fudan University, has participated in several important clinical research projects on new anti-new coronavirus drugs. progress on and entry into treatment guidelines.
Professor Zhang Jing introduced that the WHO has updated the guidelines for the treatment of new coronary pneumonia in 2020, mainly based on the changes brought about by the mutation of the new coronavirus strain. The new guidelines highlight the use of antiviral small molecule drugs, which shows that the new mutation After the emergence of the strain, antiviral small molecule drugs have received more and more clinical attention.
She explained that with the emergence of the Omicron variant, most of the patients infected with the virus are mild and asymptomatic, so there will be an increasing demand for specific drugs that are convenient for oral administration. The current small-molecule drugs have fast onset and short course of treatment, and they can block virus replication and control disease progression at the first time for disease control.
Professor Zhang Jing said that small molecule drugs have always been a mature and commonly used drug in diseases caused by bacteria, fungi, viruses and other pathogenic microorganisms. Because the target of small molecule drugs is clear, clinicians have always trusted this type of drugs. .
The small-molecule drug Paxlovid, which entered the ninth edition of China's new crown diagnosis and treatment guidelines, is actually not a single drug, but a combination of two drugs: nematicavir tablet/ritonavir tablet. Professor Zhang Jing explained that this design is very clever. One drug targets the main protease target of the virus and blocks the replication of the virus; the second drug inhibits the metabolic enzymes in liver cells that can clear the previous drug, thus inhibiting the previous one of the new coronavirus. The drug molecule will not be metabolized quickly, ensuring that it works better.
Professor Zhang Jing said that with the launch of anti-coronavirus small molecule specific drugs, clinicians will accumulate more experience in medication, and the scope of application of drugs will be further expanded in the future.
After the outbreak of the new crown epidemic, Professor Zhang Jing participated in the early clinical research of nucleic acid vaccines, anti-new coronavirus neutralizing antibodies including monoclonal antibodies and double antibodies, and small molecule drugs. Professor Zhang Jing said that from a historical point of view, infectious diseases have always accompanied the development of human beings, and viruses are constantly evolving. We need to constantly develop weapons to deal with viruses and promote human development in mutual games. maintain your own balance.
It has only been more than two years since the emergence of the new coronavirus, and effective drugs have been developed and marketed. Such research and development has surpassed any previous infectious disease prevention and treatment. This is one of the reasons why medical experts are optimistic about the new coronavirus.
Lu Hongzhou, president of Shenzhen Third People's Hospital and head of the first Shenzhen epidemic prevention and control public health expert group.
Rescue confidence comes from a scientific attitude
In early April, Shenzhen kindergartens and primary and secondary schools resumed classes one after another. After two months of suspension, children in Shenzhen re-entered the campus. The resumption of classes is an important sign that the epidemic is under control.
Shenzhen Third People's Hospital is the only designated hospital for patients with confirmed new coronary pneumonia in Shenzhen. During the current round of epidemic in Shenzhen, more than 3,000 patients were admitted and most of them were infected with the new coronavirus Omicron BA.2 strain.
On April 23, Lu Hongzhou, president of Shenzhen Third People's Hospital and head of the first Shenzhen Public Health Expert Group on Epidemic Prevention and Control, was interviewed by Xinmin Weekly and introduced some of the experiences Shenzhen has gained in the treatment of patients infected with the new coronavirus.
Dean Lu Hongzhou said that the incubation period of Omicron variant infection is about 3 days. After 1 day of infection, the virus begins to replicate, some patients develop symptoms, and the viral load generally begins to decline after 7 days. Therefore, antiviral therapy should choose to block the rapid replication of the virus in the early stage of virus replication.
On February 11 this year, the National Medical Products Administration, in accordance with the special drug approval process, conditionally approved the import registration of Pfizer's new crown virus treatment drug nematevir tablet/ritonavir tablet combination package (ie Paxlovid). On the evening of March 17, 21,200 boxes of imported Pfizer's new crown oral drug Paxlovid entered the customs from Shanghai and were distributed to at least 8 provinces, districts and municipalities directly under the Central Government including Jilin, Shanghai, Guangdong, Fujian, Jiangxi, Shandong, Zhejiang and Guangxi for new crown treatment. Clinical first line.
The Third People's Hospital of Shenzhen purchased 1,000 boxes of Paxlovid at a price of 2,300 yuan per box, and started using the first batch of new crown patients on March 24, with a course of 5 days.
Professor Lu Hongzhou introduced that among the more than 3,000 patients infected with the new crown Omicron BA.2 strain admitted to Shenzhen Third People's Hospital, 95.3% were mild patients, only 4.7% had pneumonia, and no severe patients. Nematicavir tablets/ritonavir tablets are mainly suitable for common and mild patients, and the purpose of medication is to avoid the development of severe disease in these patients.
"Our hospital started to use the first batch of oral drugs for the treatment of COVID-19 in China from March 24th to treat patients. As of April 6th, a total of 33 patients were treated with nematevir tablets. Through comparative research, it was found that the period of negative conversion of infected patients treated with antiviral drugs was significantly shortened, and the current medication is safe and has no obvious side effects." At present, the drug has been temporarily included in my country's medical insurance. payment range.
Dean Lu Hongzhou introduced that the key is the word "early" for infected people to take medicine in the early stage of the disease. "The role of small-molecule drugs is to control the large-scale replication of the virus in the infected person. If the replication is blocked, the virus will not cause organ damage, that is, there will be no complications, and it will not develop into severe disease. The sooner the viral drug is used, the better the effect, and it is best to use it within five days of the onset of the disease. If the disease is diagnosed during the incubation period and antiviral drugs are used to control the virus replication, that is the best situation." Professor Lu Hongzhou believes that in the control of mild patients In the development of severe disease, small molecule antiviral drugs can play a very good role.
Professor Lu Hongzhou said that considering the elderly, especially those with underlying diseases such as diabetes and high blood pressure, as well as obese infected persons, these infected persons have a higher risk of developing severe disease than other groups, so antiviral drugs are mainly used for these Infected.
"Of course, in the future, according to the mutation of the virus, if the site of this enzyme changes, then we will consider combining drugs in the future to inhibit two different sites of the virus, so that the virus cannot replicate, similar to cocktail therapy. "Professor Lu Hongzhou said.
Shanghai itself is a city with a high degree of aging. In this round of epidemics, the elderly infected are at great risk of becoming seriously ill and dying. In order to ensure the safety of infected people with underlying diseases and elderly infected people, Shanghai has set up sub-designated hospitals in Fangcang shelter hospitals, investing more medical resources to take care of these infected people.
Chen Yijian, head of the medical team of the Fangcang shelter medical team of Huashan Hospital, Lingang Fangcang shelter hospital, introduced that the medical team conducts careful rounds of the infected people in the Fangcang shelter every day to measure their blood oxygen saturation. And the elderly infected, the monitoring is more strict. The purpose of this is to screen out patients who are at risk of getting worse.
"The situation in the cabin in Shanghai is different from that in the cabin in Wuhan in 2020. Many patients in the cabin in Wuhan have viral pneumonia, but only a few of the patients infected with the Omicron variant have viral pneumonia. "Chen Yijian said that because of such a situation, medical staff need to actively identify those high-risk infected persons who may become serious, and then carry out targeted treatment.
Chen Yijian said that in order to prevent the progression of the disease, the medical team will give targeted treatment, including small-molecule oral drugs nematevir tablets/ritonavir tablets, oxygen therapy, anticoagulant drugs, and changes in ventilation positions.
In addition, the valuable experience left by the Wuhan epidemic, such as timely oxygen therapy, anticoagulant drugs, and nursing in the prone position in the lateral position, is also applicable to critically ill patients infected with the Omicron strain, and good results have been achieved.
It is understood that there are still a number of antiviral drugs under development, and Chinese scientific researchers have invested in them.
As early as January 21, 2020, the Ministry of Science and Technology deployed a special layout for emergency research and development to carry out research and development of new coronavirus drugs. On February 16, 2020, a special drug research and development class of the scientific research team composed of the Ministry of Science and Technology, the Health and Health Commission, the Ministry of Industry and Information Technology, the National Development and Reform Commission, the Food and Drug Administration, and the Traditional Chinese Medicine Bureau was established to fully promote the research and development of effective drugs and therapeutic technologies. At present, a variety of effective drugs for new coronary pneumonia independently developed by my country's R&D team have been used in clinical treatment.
Many domestic scientific research institutions are independently developing special drugs for the new crown.
According to statistics, there are currently six kinds of new crown specific drugs independently developed in my country. At present, the research and development of effective drugs for the new coronavirus mainly focuses on three technical routes: blocking virus entry into cells, inhibiting virus replication, and regulating the human immune system. my country has deployed these technical routes.
In June, the epidemic caused by Omicron in Shanghai was basically brought under control, but the city's economy undoubtedly suffered losses and people's lives were seriously affected. Since entering 2022, not only Shanghai, but many cities in China have been affected and lost to varying degrees by the new crown epidemic.
The new coronavirus is constantly mutating, and we need to constantly adjust prevention and control measures to deal with it. Against the background of scientific epidemic prevention, vaccines and special drugs will undoubtedly become the decisive conditions for people to return to normal life. Humanity will definitely get out of this arduous epidemic of infectious diseases.
How much do you know about the new crown?
"Xinmin Weekly" conducted random surveys on street pedestrians in March 2022 and June 2022, with a total of 207 people surveyed for the first time and 200 people for the second time, covering public officials, teachers, college students, and the Internet industry. staff, community workers, retirees, financial industry employees, etc. Age distribution: 18-30 years old 42.89%; 30-60 years old 41.91%; over 60 years old 15.93%.
The survey found that the public has a relatively good understanding of the causes of new coronary pneumonia, and has a full understanding of the elderly and patients with underlying diseases as high-risk groups. In terms of treatment, most people have confidence in the role of special drugs for the new crown, and believe that special drugs will play a key role in the prevention and control of the epidemic.
Contents of Antiviral Treatment in the Diagnosis and Treatment Plan for Novel Coronavirus Pneumonia (Trial Version 9)
1. PF-07321332/ritonavir tablet (Paxlovid). The applicable population is adults with mild and common types within 5 days of onset and with high risk factors for progression to severe disease.
Usage: 300mg PF-07321332 and 100mg ritonavir are taken at the same time, once every 12 hours for 5 consecutive days. The instructions should be read carefully before use, and it should not be used in combination with drugs such as meperidine and ranolazine, which are highly dependent on CYP3A for clearance and whose plasma concentration increases can lead to serious and/or life-threatening adverse reactions.
2. Monoclonal antibody: ambavirumab/romisevirumab injection. In combination for the treatment of adults and adolescents (12-17 years old, weight ≥40 kg) with mild and common forms and with high risk factors for progression to severe forms.
Usage: The dose of the two drugs is 1000 mg respectively. After the two drugs were diluted with 100 ml of normal saline before administration, they were administered by intravenous sequential infusion at a rate of not higher than 4 ml/min, and 100 ml of normal saline was used to flush the tube between them. Patients were clinically monitored during infusion and observed for at least 1 hour after completion of infusion.
3. Intravenous injection of COVID-19 human immunoglobulin. It can be used in patients with high risk factors, high viral load, and rapid disease progression in the early stage of the disease course.
The dosage is 100 mg/kg for light type, 200 mg/kg for ordinary type, and 400 mg/kg for heavy type, intravenous infusion. According to the improvement of the patient's condition, the infusion can be repeated the next day, and the total number of times is not more than 5 times.
4. Convalescent plasma of recovered patients. It can be used in patients with high risk factors, high viral load, and rapid disease progression in the early stage of the disease course. The infusion dose is 200 ~ 500ml (4 ~ 5ml/kg), which can be re-infused according to the patient's individual condition and viral load.
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