COVID-19 Pneumonia Treatment Guidelines

Supportive Care

Patients should be monitored for vital signs with regular assessment of blood routine, organ function, and chest imaging 1
Nutritional support is essential, with protein-rich foods and ideal energy intake of 25-30 kcal/(kg·d) and protein intake of 1.5 g/(kg·d) for patients with nutrition risk scores <3 points 2
For patients with nutrition risk scores ≥3 points, increase protein intake through oral supplements 2-3 times daily (≥18g protein/time) 2
Use H2 receptor antagonists or proton pump inhibitors in patients with gastrointestinal bleeding risk factors 3
Evaluate risk of venous embolism and use low-molecular-weight heparin or heparin in high-risk patients without contraindications 4

Effective oxygen therapy is crucial, with options including nasal catheter, mask oxygen, high flow nasal oxygen therapy (HFNO), non-invasive ventilation (NIV), or invasive mechanical ventilation based on severity 1
Consider Extracorporeal Membrane Oxygenation (ECMO) for patients with refractory hypoxemia that is difficult to correct with protective lung ventilation 1

For patients with rapid disease progression or severe illness, methylprednisolone 40-80 mg per day can be considered, not exceeding 2 mg/kg daily 5
Corticosteroids should be used cautiously and typically for short periods (3-5 days) according to the degree of dyspnea and progression on chest imaging 6

For patients with dyspnea, cough, wheeze, and respiratory distress due to increased respiratory secretions, selective (M1, M3) receptor anticholinergic drugs are recommended to reduce secretion and improve pulmonary ventilation 7
For septic shock, recognize early and administer vasopressors when shock persists after fluid resuscitation, with norepinephrine as first choice 6
Avoid blind or inappropriate use of antibacterial drugs; however, if bacterial infection cannot be ruled out, appropriate antibiotics should be administered 1
For mild cases with suspected bacterial infection, consider antibiotics effective against community-acquired pneumonia (amoxicillin, azithromycin, or fluoroquinolones) 1

Body temperature returned to normal for more than 3 days 6
Respiratory symptoms significantly improved 6
Lung inflammation showing obvious signs of absorption 6
Respiratory nucleic acid negative for two consecutive tests (one-day sampling interval) 6