CCTV News:After being infected with new coronavirus pneumonia, will it definitely show fever and respiratory symptoms?
On January 24th, the research group of Wuhan University People’s Hospital released "Attach great importance to the first symptoms of non-respiratory system — — Identification and protection of patients with new coronavirus pneumonia (2019-nCOV) reminds medical staff and the public to be highly alert to the invisible source of infection with non-respiratory symptoms as the first symptom.
The Notice on Printing and Distributing the Diagnosis and Treatment Plan for Pneumonia Infected in novel coronavirus (Trial Third Edition) issued by the authoritative department points out that the main clinical manifestations of new coronavirus pneumonia are fever, fatigue and dry cough. At present, many "atypical" cases have been found in the process of diagnosis and treatment of new pneumonia in the Department of Gastroenterology, Respiratory and Critical Care Medicine of Wuhan University People’s Hospital.
Professor Yu Honggang, director of the Department of Gastroenterology, People’s Hospital of Wuhan University, introduced an atypical case. A 45-year-old man went to the gastroenterology clinic for three days because of diarrhea. The doctor repeatedly asked about his medical history and confirmed that he had a history of contact with new coronavirus pneumonia, but he had no obvious fever and related respiratory symptoms. The attending doctor considers that he is in the epidemic development period and has a clear contact history, and performs chest CT after fully communicating with the patient. The results suggested that there were multiple flaky ground-glass images in both lungs, and the novel coronavirus nucleic acid test in throat swab showed positive, which was finally diagnosed as a new type of coronavirus pneumonia.
Professor Chen Guozhong, director of Department I of Respiratory and Critical Care, People’s Hospital of Wuhan University, said that in the above-mentioned clinical cases, patients did not have typical respiratory symptoms such as fever and cough when they saw a doctor, but only recently appeared non-respiratory symptoms after contact with suspected or confirmed novel coronavirus patients. Digestive system: such as mild anorexia (anorexia), fatigue, poor spirit, nausea and vomiting, diarrhea, etc. Nervous system: such as headache; Cardiovascular system: such as palpitation, chest tightness, etc. Ophthalmology: such as conjunctivitis; Other aspects, such as only mild limb or back muscle pain.
The results highly warn medical staff and the public that we should further strengthen the understanding of the symptoms of new coronavirus pneumonia, and at the same time strengthen the identification and protection. Experts remind that the above-mentioned patients with non-respiratory system as the first manifestation are easy to go to relevant departments (such as gastroenterology, neurology, cardiovascular medicine, etc.), especially in gastroenterology. Because these patients lack obvious specific clinical manifestations, it obviously increases the difficulty of diagnosis, easily leads to missed diagnosis or misdiagnosis, and increases the chance of infection.
The results also warn that patients are easy to ignore themselves because they have no fever and respiratory symptoms. Because the patients in the incubation period are also contagious, the infectivity will be enhanced before and after the onset of the disease, so this kind of "atypical" patients will also be a very important hidden source of infection, and self-isolation needs to be strengthened.
The research team specially reminded that medical staff should ask the patient’s medical history in more detail, especially for the contact history of patients with suspected diagnosis or confirmed diagnosis, and whether there was a history of fever in the past two weeks. At the same time, for this kind of "atypical" cases, blood routine and respiratory tract pathogen detection should be carried out in time, and chest CT examination should be carried out if conditions permit. At the same time, we should fully communicate with patients and their families. If it is abnormal, the detection of coronavirus should be further improved. The research team particularly emphasized that it is not recommended to have chest X-ray examination of patients during the epidemic period, because chest X-ray can not find early exudative lesions, which may easily lead to missed diagnosis.
For the public, it is more important to realize that "early prevention, early detection, early diagnosis, early isolation and early treatment" is the key to prevent and treat the new type of coronavirus pneumonia. We should further raise our awareness of protection every day, wear masks when going out, avoid going to crowded public places, and especially emphasize reducing family gatherings; Wash your hands and face frequently, and pay attention to regular disinfection of mobile phones and public computer keyboards; Learn the correct way to cough and sneeze, and no spitting; Don’t throw away the used masks at will, put them in garbage bags and seal them. (Ren Yixuan)
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