關於是否使用皮質類固醇藥物來治療新冠肺炎當中患有肺損傷的病患,至今沒有明確臨床證據可以支持,中國胸腔學會日前發表專家聲明,是否使用皮質類固醇藥物治療新冠肺炎提出下列建議:第一、須謹慎評估使用皮質類固醇藥物治療的利害得失。第二、皮質類固醇藥物治療應使用於新冠肺炎重症病例。第三、使用皮質類固醇藥物於治療患有氧血症,或已定期使用皮質類固醇藥物的病患須十分謹慎。第四、應使用中低劑量,例如:每天≤0.5–1 mg/kg  methylprednisolone 或以 methylprednisolone為參考基準,並使用小於7天。是否使用皮質類固醇藥物治療新冠肺炎病患需有更多臨床試驗結果支持,才能做出正確的臨床治療指引。

(財團法人國家衛生研究院 蔡慧如博士摘要整理)

The world that is grappling with 2019 novel coronavirus (2019-nCoV) is different from how it was during the SARS and H1N1 pandemics. The disease itself, and information and disinformation, now travel faster than ever.

I worked as a clinician in West Africa during the Ebola outbreak, and in New York City hospitals during the H1N1 one. Now, I’m working in Boston, Massachusetts, to prepare for potential cases of 2019-nCoV acute respiratory disease. And many of the challenges are the same as those faced in previous outbreaks.

The specifics of each virus are important, but so is an overarching question: what do you do when large numbers of people arrive wanting care for suspected infections of an unfamiliar disease? This comes down to three decisions: how to quickly identify infected people, how to isolate and care for them and how to keep health-care workers safe.

Identify and confirm cases

As this epidemic grows, two trends will make it harder to identify people with 2019-nCoV infections while coping with those showing similar symptoms in the middle of the current influenza season. First, the 2013 and 2016 Ebola outbreaks taught us the importance of travel history. But with more countries reporting 2019-nCoV cases, it will be harder to teach hospital workers what locations to ask people about, and hospitals will need to devise strategies to keep staff aware of the changing geography of risk.

Author:Lianhan Shang, Jianping Zhao, Yi Hu, et al.
原文連結: https://is.gd/Y4IeCg