The frequent occurrence of false negative suggested that the duration of the disease should be considered

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 The frequent occurrence of false negative suggested that the duration of the disease should be considered


Hubei: 10 to 12 days after reaching the national standard

Earlier, Jiao Yahui, deputy director of the medical administration of the National Health Commission, said at the conference that according to the national discharge standard, two nucleic acid tests should be carried out after the clinical symptoms disappear, with an interval of 24 hours. Wuhan needs to observe for another 10-12 days after completing the test and reaching the standard, so the average hospitalization time of discharged patients in Hubei Province and Wuhan is longer.

Shanghai: two times of nucleic acid detection in faeces

Compared with the discharge standard issued by the national health and Health Commission, with the deepening of the prevention and control of the virus, local governments have also formulated discharge standards in accordance with local conditions, which are generally stricter than the general version.

It is reported that the discharge standard of Zhejiang Province is also stricter than the national standard. At present, the new coronavirus nucleic acid test is negative twice in a row, the fecal nucleic acid test is negative, the body temperature is normal for more than 6 days in a row, and the chest CT Reexamination shows that the inflammation is obviously absorbed, which is determined by the expert group and meets the discharge standard. After discharge, the two patients will continue to have 14 days of medical observation.

Guangdong: the duration of the disease is 14 days or more

It is reported that Guangdongs standard for lifting isolation is an additional one based on the national plan, which requires patients to have a course of disease greater than or equal to 14 days before they are allowed to leave the hospital.

In addition, the specific discharge standard also involves the specific patients situation, such as the young patients who usually do not have basic diseases, whose clinical diagnosis and treatment meet the requirements, and whose nucleic acid is negative twice.

In Guangzhou, for the sake of safety, some patients received three throat swab tests, all of which were negative. They can only be discharged after the comprehensive judgment of the expert group.

In Meizhou, in terms of discharge and de isolation standards, fecal nucleic acid detection has also been added, which is stricter than the national regulations.

Hainan: additional detection of nucleic acid in whole blood and feces

According to reports, some hospitals in Hainan Province have adopted the principle of wide access and strict exit for the new type of coronavirus pneumonia. After positive clinical treatment, the confirmed cases shall be managed in strict accordance with the discharge standard of the national health and Health Commission.

Expert: the time of onset should be considered in discharge

Tong Zhaohui, an expert of the central guidance group and vice president of Chaoyang Hospital in Beijing, believes that when judging whether a patient can be discharged from hospital, the time of onset should be taken into account.

In those days, SARS was discharged after 21 days of Yin examination. Now some patients are discharged within 10 days, which is not necessarily good. He said that PCR detection has a high specificity, but sampling methods and reagents may affect the results. The positive rate is low, only 20% - 30% on average, and it is not stable. Good hospitals can reach about 50%, and some hospitals only have more than 10%. This feature brings the problem of false negative, which shows that many suspected cases can not be confirmed. If PCR detection is taken as discharge standard, it may be possible The actual positive patient was discharged. Therefore, he believes that clinical diagnosis is very important.

He said, new crown infection may peak in the second week, some people will have suffocation, respiratory failure, and imaging progress. At present, the discharge standard does not emphasize the discharge of 21 days after the onset of SARS. He believes that at least two weeks after the onset of the disease, reexamination of the image and two times of negative discharge should be considered, and self isolation and follow-up should be carried out after discharge.

No lung image was seen in discharge standard

On the morning of September 9, the national health and Health Commission released the latest version of the treatment plan for pneumonia caused by coronavirus infection, namely the fifth revised version. The conditions for de isolation and discharge criteria were unchanged from the fifth edition.

As of February 5, the national health and Health Commission has formulated five versions of the diagnosis and treatment plan, among which the third to fifth versions are open to the public. In the three versions of the plan, the discharge standard has changed.

(function() {(window. Slotbydup = window. Slotbydup| []). Push ({ID: u5811557, container: ssp_, async: true});)) (); in the third version of the treatment plan released on January 23, there are four requirements for the release of isolation and discharge standards, including: the temperature returns to normal for more than three days, the respiratory symptoms improve significantly, the pulmonary imaging shows that inflammation is absorbed significantly, and the respiratory pathogenic nucleic acid is recovered twice in a row Negative test (sampling interval at least 1 day). To meet these four requirements, we can release the isolation and discharge or transfer to the corresponding department for treatment of other diseases according to the condition. On January 27, the national health and Health Commission issued the fourth edition of the diagnosis and treatment plan, which reduced one discharge standard and no longer needed to meet the requirement of pulmonary imaging shows obvious absorption of inflammation. On February 5, the fifth edition of the diagnosis and treatment plan was released. In the standards of de isolation and discharge, on the basis of body temperature returned to normal for more than 3 days, respiratory symptoms improved significantly, and respiratory pathogenic nucleic acid test was negative for two consecutive times (the sampling interval was at least 1 day), the pulmonary imaging showed obvious absorption of inflammation was added again. Beijing CDC: the office can not determine the risk of wearing medical masks experts: dont be afraid! Existing measures have taken into account the possibility of aerosol transmission. Experts respond to aerosol transmission: there will be no new coronavirus in the air. Source: responsible editor of Beijing News: Liu Yuxin, b12060

In the third edition of the diagnosis and treatment plan released on January 23, there are four requirements for the release of isolation and discharge standard, including: the body temperature returns to normal for more than three days, the respiratory tract symptoms are obviously improved, the pulmonary imaging shows that the inflammation is obviously absorbed, and the detection of respiratory pathogenic nucleic acid is negative for two consecutive times (the sampling interval is at least one day). To meet these four requirements, we can release the isolation and discharge or transfer to the corresponding department for treatment of other diseases according to the condition.

On January 27, the national health and Health Commission issued the fourth edition of the diagnosis and treatment plan, which reduced one discharge standard and no longer needed to meet the requirement of pulmonary imaging shows obvious absorption of inflammation.

On February 5, the fifth edition of the diagnosis and treatment plan was released. In the standards of de isolation and discharge, on the basis of body temperature returned to normal for more than 3 days, respiratory symptoms improved significantly, and respiratory pathogenic nucleic acid test was negative for two consecutive times (the sampling interval was at least 1 day), the pulmonary imaging showed obvious absorption of inflammation was added again.