====== Shanghai Expert Consensus on Comprehensive Treatment of Coronavirus 2019 Disease ======

The Shanghai Expert Consensus on Covid-19 Treatment is a set of medical guidelines and recommendations for diagnosing and treating the coronavirus disease (COVID-19). The consensus was published in the Chinese Journal of Infectious Diseases on March 1st, 2020 and was produced by a team of experts from Shanghai-based Fudan University’s Zhongshan Hospital and experts from other hospitals and universities near Shanghai. The consensus is based on the latest scientific evidence that was available until February 2020 and provides detailed guidance for the diagnosis and management of COVID-19, including information on prevention, diagnosis and treatment, as well as management of comorbidities and complications associated with the virus. The consensus also contains recommendations for the optimization of health care resources and patient management during the pandemic.

Citation can be made this way (the original document is written in chinese, url stored on web.archive.org):

Shanghai Expert Group on Clinical Treatment of Novel Coronavirus Disease. Shanghai Expert Consensus on Comprehensive Treatment of Coronavirus Disease 2019 (J/OL). Chinese Journal of Infectious Diseases, 2020, 38 (2020-03-01). [[https://web.archive.org/web/20200305121832/rs.yiigle.com/yufabiao/1183266.htm|rs.yiigle.com/yufabiao/1183266.htm]] DOI: 10.3760/cma.j.issn.1000-6680.2020.0016. ( pre-pubblicazione internet).

===== Abstract =====

With the deepening of the understanding of corona virus disease 2019 (COVID-19), the Shanghai COVID-19 Clinical Treatment Expert Group followed the National COVID-19 Diagnosis and Treatment Program, and fully absorbed the experience of domestic and foreign peers in the treatment, and continuously optimized and refined the treatment protocol. This expert consensus was formed from the three aspects of etiology and epidemiological characteristics, clinical characteristics and diagnosis, and treatment protocol.

===== Available english translations =====

[[https://www.drwlc.com/blog/2020/03/21/shanghai-expert-consensus-on-covid-19-treatment/|Translation by Dr. Qi Chen, posted by Dr. Richard Chen on March 21th, 2020]]

[[https://covid19-evidence.paho.org/handle/20.500.12663/1098|Automatic translation posted by Dr. Paul Anderson on March 24th, 2020]]

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===== Index of the document (sections and subsections) =====

I. Etiology and epidemiological characteristics

II. Clinical characteristics and diagnosis

(A) clinical characteristics

(B) diagnostic criteria

1. Suspected cases

2. Confirmed cases

(C) Differential diagnosis

(D) clinical classification

1. Mild type

2. Moderate (common) type

3． Severe type

4． Critical type

(E) Clinical monitoring

III. Treatment plans

(A) antiviral treatment

(B) treatment for mild and moderate types

(C) Organ function supportive treatment for severe and critically ill patients

1. Protection and maintenance of cyclic functions

7. Sedation and Artificial Hibernation

8. Oxygen therapy and respiratory support

9. ECMO implementation 

(D) Some Specific issues and managements

1. Application of glucocorticoids (use with caution)

2. Use of immunomodulatory drugs

3． Accurate diagnosis and treatment of bacterial and fungal infections

4． Nosocomial infection prevention and control

5． Treatment of infants and young children

(E) Integrated traditional Chinese and western medicine

(F) discharge standards

(G) Self-management of discharged patients

===== Summary of the main points of the protocol =====

For detailed information open the [[https://web.archive.org/web/20200305121832/rs.yiigle.com/yufabiao/1183266.htm|full version]]. Information reported hre for study by specialized doctors and for historical documentation. Only hospital facilities with qualified healthcare personnel can evaluate the usefulness and possible opportunity to follow these guidelines. This protocol may have superseded by new more advanced protocols.

In this protocol was suggested the experimental use of:

* hydroxychloroquine sulfate or chloroquine phosphate, or abidol for oral administration, 

* interferon atomization and inhalation, preferably interferon κ 

(not recommended to use 3 or more antivirals at the same time)

It is stated that the efficacy of these antiviral drugs remains to be evaluated in further clinical studies.

Other suggested strategy:

* For severe and critical patients, plasma from recovered patients can be used. 

Other recommendations from this protocol:

Enhanced supportive treatment to ensure sufficient heat; 

maintenance of water and electrolyte balance for internal environment stability; 

close monitoring of patient vital signs and finger oxygen saturation. 

Give effective oxygen therapy in time. 

Antibacterials and glucocorticoids are not recommended in principle. 

The patient’s condition needs to be closely monitored. 

Low-dose short-course glucocorticoids can be used with caution (in case of risk of disease progression). 

Heparin anticoagulation and high-dose vitamin C treatment are recommended.

Broad-spectrum protease inhibitors (in case of lung lesions).

Intermittent short veno-venuous hemofiltration (ISVVH) (in case of cytokine storm).

Fluid therapy should be initiated as soon as possible after admission.

Additional advices are given for severe and critically ill patients.

Complete details here: [[https://web.archive.org/web/20200305121832/rs.yiigle.com/yufabiao/1183266.htm|rs.yiigle.com/yufabiao/1183266.htm]]

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