1. Home
  2. CSC COVID-19 Question and Answer
  3. Clinical Front-Line
Q: What were some of the contingency plans for healthcare providers where illness caused staff to drop - were there inter-institutional transfers? Thanks

Answer:

Yes, this is a very important problem. I think this is also a key factor for our success in fighting the epidemic. At the beginning of the epidemic in Wuhan, we didn't have enough medical resources and medical staff, which led to the spread of the disease and delayed treatment of the disease. This  brought us great harm.  With effective measures taken by the Chinese government, we have mobilized 349 national medical teams from all over the country and more than 40,000 medical staff to support Wuhan. This greatly alleviated the medical pressure in Hubei in the short term. These measures enabled more patients to get effective treatment. The mortality rate has been greatly reduced. I think Italy is facing the same problem at present. We suggest that they take the same measures as us. It's really important.

[ Clinical Front-Line]
Q: Have you seen anyone survive severe disease without anti-viral treatment ?

Answer:

No, anti-viral treatment is a regular and fundamental management for severe cases

[ Clinical Front-Line]
Q: What was your experience with mesenchymal cell therapy to modulate inflammation?

Answer:

Paradoxically would patients on immunomodulating drugs for other conditions pre-coronavirus infection have a decreased instance of SIRS? If immnumodulators work should tx begin with these drugs early, or even if high likelihood of exposure, such as in hospitals workers?

Studies have shown that mesenchymal cells have the functions of anti-inflammatory and promoting tissue repair. At present, MSCs are used in the treatment of a variety of inflammatory diseases, graft-versus-host diseases, ARDS and so on.  So, empirically, mesenchymal cells are recommended for COVID19 patients.

However，mesenchymal cell therapy is not yet clinically proven to be safe and effective for COVID19 patients. In addition, even it is proved to be safe and effective, it may not be mediated by immunomodulation.

Therefore, we do not recommend mesenchymal cell therapy to people without COVID pneumonia. For severe COVID patients, mesenchymal cell therapy can be tried.

[ Clinical Front-Line]
Q: Have you seen patients develop cardiomyopathy with COVID-19?

Answer:

1. Increase in cardiac troponin (>28 pg/mL)

2. Significantly higher blood pressure (145 mm Hg)

3. Increase in Creatinine Kinase

4. Some patients have FIRST symptom as CV presentation

5. Heart palpitations and/or tightness in the chest, with no respiratory symptoms

6. Pathological findings from limited autopsies and biopsy studies showed below regarding to the heart:

    Degenerated or necrosed myocardial cells are present, along with mild infiltration of monocytes, lymphocytes and/or neutrophils in the cardiac interstitium. Endothelial desquamation, endovasculitis and thrombi are seen in some blood vessels.

   


[ Clinical Front-Line]
Q: Can you tell us something about what it was like in the hospital? What was daily life like in the health care area? How did you manage the surge in cases ? What is the best strategy to deal with the unanticipated nee

Answer:

This is not just a test or fight for a hospital, this is a fight for the whole country. Under the orderly dispatch of our government, we took good care of all the patients. At the peak of the epidemic, a large number of COVID19 patients needed treatment. We have a well-established screening system that rapidly stratified patients based on their conditions. A number of general hospitals were quickly converted into COVID19-specialized hospitals. These hospitals were prepared for the severe cases. At the same time, we built many mobile cabin hospitals. Mild cases were quarantined and treated there. All COVID19-infected patients receive proper treatment. The key point is, we are not fight alone. Hundreds of elite medical teams were sent to support us. The Chinese government has carried out strong macro-control and material guarantee for the epidemic in Wuhan. I think this is the best strategy.

[ Clinical Front-Line]
Q: We do hear some voices in the USA that we are over-preparing and it is not as bad as we think. You have been on the front lines. What was the experience and do you think anyone are over-preparing?

Answer:

I think the COVID19 virus should be given enough attention. The truth is, this virus is highly contagious and spreads quickly. The number of COVID19 cases increased rapidly after outbreak, and about 20% of the COVID19-infected patients were severe cases. This has caused a huge shock to our medical system. So I think it is the right choice to make full preparation in advance

[ Clinical Front-Line]
Q: What were you doing with the routine patients at the time when you anticipated the epidemic would grow? Were you changing the outpatient visit process, and how do you change the way in which you provide care? Do you hav

Answer:

We routinely test lung CT, virus nucleic acid and antibody for all inpatients. All outpatients need to wear masks and check their body temperature. All patients with fever should go to the fever clinic. At the height of the epidemic, we closed all general clinics

[ Clinical Front-Line]
Q: Are there any general lessons that we should take when we go to front line?

Answer:

Yes，we should take many lessons when we go to front line. For example, prevention and control management, which including isolation area and staff management, hospital practice protocols during COVID-19 epidemic, COVID-19 related personal protection management. In addition, we also learn the diagnosis and treatment, which including diagnosis and clinical classification of COVID-19, imaging findings of COVID-19 patients, antiviral treatment, anti-shock and anti-hypoxemia treatment and so on.

[ Clinical Front-Line]