Patients present with symptoms such as fever

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Diagnosis and clinical classification of COVID-19

Early diagnosis, treatment, and isolation should be implemented whenever possible. Dynamic monitoring of lung imaging parameters, oxygenation index, and cytokine levels is useful for early identification of patients who may develop severe and critical disease. A positive SARS-CoV-2 nucleic acid test is the gold standard for diagnosing COVID-19. However, given the possibility of false negatives in nucleic acid detection, suspected cases with characteristic manifestations on CT scan can be considered as confirmed cases even if the nucleic acid test is negative. In such cases, isolation should be ensured and further testing of multiple samples should be carried out.

The diagnostic criteria are consistent with the diagnostic and treatment protocols for COVID-2019. A confirmed case is based on the epidemiological history (including cluster transmission), clinical manifestations (fever and respiratory symptoms), lung imaging, and the results of SARS-CoV-2 nucleic acid and serum specific antibodies.

Clinical classification:

1 Mild form

Clinical symptoms are moderate, no signs of pneumonia were detected during visualization.

2 Average form

and respiratory symptoms, etc., and visualization reveals signs of pneumonia.

3 Severe form

Adults who meet any of the following criteria: respiratory israel number data rate ≥ 30 breaths/min; oxygen saturation ≤93% at rest; arterial partial pressure of oxygen (PaO2)/oxygen concentration (FiO2) ≤300 mmHg. Progression of >50% of the lesion within 24-48 hours on lung imaging should be considered a severe case.

4 Critical cases

Meeting any of the following criteria: development of respiratory failure requiring mechanical ventilation; presence of shock; failure of another organ requiring observation and treatment in an intensive care unit.

For critical cases, early, middle and late stages are distinguished depending on the oxygenation index and compliance of the respiratory system.

Early stage: 100 mmHg <oxygenation index ≤150 mmHg; respiratory system compliance ≥30 ml/cmH2O; no failure of organs other than the lungs. The patient has a good chance of recovery thanks to active antiviral, anticytokine and supportive therapy.
Moderate stage: 60 mmHg <oxygenation index ≤100 mmHg; 30 ml/cmH2O > respiratory system compliance ≥15 ml/cmH2O; may be complicated by other mild to moderate dysfunction of other organs.
Late stage: oxygenation index ≤60 mmHg; respiratory system compliance <15 ml/H2O; diffuse consolidation of both lungs requiring ECMO; or failure of other vital organs. The risk of mortality is significantly increased.