Section 3.2: Diagnostic criteria (from DOI: 10.1080/22221751.2020.1735265)

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ArticleDiagnosis and clinical management of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection: an operational recommendation of Peking Union Medical College Hospital (V2.0) (DOI: 10.1080/22221751.2020.1735265)
Sections in this Publication
SectionSection 1: Introduction (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 2: Protection requirements of medical personnel (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 2.1: Selection of front-line personnel (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 2.2: Isolation and protection requirements (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 2.3: Isolation and observation of medical personnel after close contact with SARS-CoV-2 (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3: Diagnosis and treatment of SARS-CoV-2 infected patients (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.1: Screening criteria (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.2: Diagnostic criteria (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.3: Examination routines of SARS-CoV-2 infected patient (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.3.1: Screening cases on the day of visit (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.3.2: Sequential examination of confirmed patients (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.4: Place of treatment according to the severity of the disease (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.4.1: Severe type (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.4.2: Critically ill type (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.5: Treatment (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.5.1: General treatment (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.5.2: Oxygen therapy (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.5.2.1: Choice of oxygen therapy (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.5.2.2: The way of respiratory support (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.5.3: Antiviral treatment (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.5.4: Glucocorticoid therapy (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.5.5: Intravenous immunoglobulin (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 3.5.6: Empirical antimicrobial therapy (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 4: Protection and transfer (from DOI: 10.1080/22221751.2020.1735265)
SectionSection 5: Criteria of isolation release and discharge (from DOI: 10.1080/22221751.2020.1735265)
Named Entities in this Section

From publication: "Diagnosis and clinical management of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection: an operational recommendation of Peking Union Medical College Hospital (V2.0)" in the journal Emerg Microbes Infect (2020)
https://doi.org/10.1080/22221751.2020.1735265

Section 3.2: Diagnostic criteria

Supportive epidemiological history

Clinical manifestation: Fever; normal or low levels of white blood cells or decreased lymphocyte counts at onset. Chest radiology at early stage is characteristic of multiple small patchy shadows and interstitial changes, more prominent in the extrapulmonary bands. Multiple ground-glass opacities and infiltrations may develop bilaterally with disease progression, with possible consolidation in severe cases.

Diagnosis: SARS-CoV-2 nucleic acid positive in samples of sputum, pharynx swabs, and secretions of lower respiratory tract tested by real-time reverse-transcriptase-polymerase-chain reaction (rRT-PCR) assay.

For patients with acute fever (>37.5 C within 72 hours) and normal chest imaging, if the absolute count of peripheral lymphocytes is less than 0.8 x 109/L, or the count of CD4+ and CD8+ T cells decreases significantly, isolation and close observation should be conducted at home even if the first SARS-CoV-2 nucleic acid test is negative. Repeat of rRT-PCR should be considered after 24 h, and a chest CT scan should be performed when necessary.

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