Abstract
[1–3] To better standardize and guide the diagnosis and treatment of severe and critical COVID-19 patients and improve the treatment success rate, the frontline medical experts across China first identified the problems relevant to the diagnosis and treatment of severe and critical COVID-19, then defined the clinical problems using the population, interventions, comparisons, and outcomes framework to guide the literature search. Based on a comprehensive review (analysis, consolidation, and summarization) of the treatment protocols, management consensuses, and relevant literature on COVID-19 and the experience gained from the diagnosis and treatment of severe and critical COVID-19 patients during the fight against the pandemic in China, a draft of this consensus was produced. The expert consensus involves etiology, pathology, pathophysiology, clinical features, classification, diagnostic criteria, early warning, clinical monitoring and treatment, traditional Chinese medicine, rehabilitation therapy, patients transfer, protection of health care workers, and vaccine. Close monitoring and evaluation of patients with severe COVID-19 undergoing HFNC oxygen therapy and NIV are indispensable, and a light sedation protocol should probably be used for less-tolerable patients.
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1 Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
2 Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510010, China
3 Department of Emergency and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
4 Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China
5 Department of Critical Care Medicine, Jiangsu Provincial Key Laboratory of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China
6 Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, Jilin 130021, China
7 Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
8 Department of Critical Care Medicine, Shaanxi Provincial Hospital, Xi’an, Shannxi 710068, China
9 Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
10 Department of Critical Care Medicine, Fujian Provincial Hospital, Fujian Provincial Center for Critical Care Medicine, Fuzhou, Fujian 350001, China
11 Department of Critical Care Medicine, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
12 Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China
13 Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
14 Department of Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui 230001, China
15 Department of Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
16 Department of Critical Care Medicine, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150001, China
17 Department of Critical Care Medicine, Zhejiang Hospital Affiliated to Medical College of Zhejiang University, Hangzhou, Zhejiang 310013, China
18 Department of Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, Shannxi 710032, China
19 Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China