Research on the treatment based on syndrome differentiation of COVID-19 according to the theory of Guangwenyilun

COVID-19is highly infectious and epidemic, which belongs to the " plague" disease of traditional Chinese medicine and seriously endangers the safety of human life. Based on the theory of Guangwenyilun combined with the treatment experience of COVID-19 in TCM, syndrome differentiation-based treatment and the clinical characteristic of COVID-19is be- ing deeply analysed. COVID-19began because of the" epidemic pathogenic factors", and the pathogenesis is that the dampness and heat generated toxin which blocked the qi movement. The early onset of this disease is in the pleurodiaphragmatic inter- space, and its transmission can be divided into sequential transmission and reverse transmission. Regardless of the direction of its transmission, grasping the transmission of" epidemic pathogenic factors" on the diagnosis and treatment combined with " five distinguishing thought, exterior and interior, accompanying symptoms" theory will be of great importance to help to im- prove the effect of treatment. At the same time, this clinical approach will also provide reference for the diagnosis and treat- ment of any possible new diseases.

Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China.

BACKGROUND: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infected over 3300 healthcare workers in early 2020 in China. Little information is known about nosocomial infections of healthcare workers in the initial period. We analysed data from healthcare workers with nosocomial infections in Wuhan Union Hospital (Wuhan, China) and their family members. METHODS: We collected and analysed data on exposure history, illness timelines and epidemiological characteristics from 25 healthcare workers with laboratory-confirmed coronavirus disease 2019 (COVID-19) and two healthcare workers in whom COVID-19 was highly suspected, as well as 10 of their family members with COVID-19, between 5 January and 12 February 2020. The demographics and clinical features of the 35 laboratory-confirmed cases were investigated and viral RNA of 12 cases was sequenced and analysed. RESULTS: Nine clusters were found among the patients. All patients showed mild to moderate clinical manifestation and recovered without deterioration. The mean period of incubation was 4.5 days, the mean±sd clinical onset serial interval (COSI) was 5.2±3.2 days, and the median virus shedding time was 18.5 days. Complete genomic sequences of 12 different coronavirus strains demonstrated that the viral structure, with small irrelevant mutations, was stable in the transmission chains and showed remarkable traits of infectious traceability. CONCLUSIONS: SARS-CoV-2 can be rapidly transmitted from person to person, regardless of whether they have symptoms, in both hospital settings and social activities, based on the short period of incubation and COSI. The public health service should take practical measures to curb the spread, including isolation of cases, tracing close contacts, and containment of severe epidemic areas. Besides this, healthcare workers should be alert during the epidemic and self-quarantine if self-suspected of infection.