Because the new koronavirusny infection has various weight of course, is characterized by various clinical forms and also can proceed asymptomatically, introduction of the differentiated approach to maintaining cases of diseases is advisable. Depending on reference of a specific case to this or that group, health workers have an opportunity to differentiate medical, preventive and anti-epidemic actions concerning each group of patients. It, in turn, will promote more effective fight against a pandemic.
So, allocate several groups of cases COVID-19:
Case, suspicious concerning COVID-19
Probable (that is confirmed clinically) COVID-19 case
The confirmed COVID-19 case (that is confirmed laboratory)
The differentiated approach to COVID-19 cases
The case, suspicious on COVID-19, differs in the fact that clinical manifestations of an acute respiratory infection (SARS), such as the increased body temperature (37.5 °C and more) and one or several of the following signs take place: cough (dry, or with a poor phlegm), an asthma, feeling of constraint in a thorax, blood saturation indicators oxygen according to a pulsoksimetriya less or are equal to 95%, a pharyngalgia, congestion of a nose or a moderate rhinorrhea, disturbance or loss of sense of smell, loss of taste, conjunctivitis, weakness, muscular pains, a headache, vomiting, diarrhea, skin rash in the absence of other known reasons which explain a clinical picture, regardless of the epidemiological anamnesis.
The probable (clinically confirmed) case of COVID-19 differs in a combination of clinical manifestations of a SARS and epidemiological signs. Body temperature more than 37.5 °C and one or more signs is noted: cough (dry or with a poor phlegm), an asthma, feeling of constraint in a thorax, pulsoksimetriya indicators less or are equal to 95%, a pharyngalgia, congestion of a nose or a moderate rhinorrhea, disturbance or loss of sense of smell, loss of taste, conjunctivitis, weakness, muscular pains, a headache, vomiting, diarrhea, skin rash). At the same time it is important to have at least one of the listed below epidemiological signs:
Return from a foreign trip in 14 days prior to emergence of symptoms;
Existence of close contacts for the last 14 days with the person which is under observation on COVID-19 which in the subsequent ached;
Existence of close contacts for the last 14 days with the person at whom the diagnosis of COVID-19 is laboratory confirmed;
Existence of professional contacts with persons at whom the suspicious or confirmed COVID-19 case is revealed.
At the same time the importance of the first sign is more and more called in question as in the conditions of global prevalence of a koronavirusny infection, in fact, the fact is not of particular importance, were the patient on foreign trips or not. This sign mattered at the beginning of a pandemic when arrival of the patient from an epidochag of a koronavirusny infection with the corresponding symptomatology could carry a case in the category probable on COVID-19.
Also in the category of probable cases existence of the specified clinical manifestations in combination with changes in lungs according to a computer tomography or a X-ray analysis of lungs belongs. To typical signs of COVID-19 according to KT numerous bilateral subpleural consolidations of pulmonary fabric as "opaque glass", including with consolidation and/or with a symptom of "cobblestone road" and also numerous bilateral roundish sites of consolidation as "opaque glass" in the depth of pulmonary fabric, including in combination with consolidation and/or a symptom of "cobblestone road" and sites of consolidation of pulmonary fabric in the form of a combination of "opaque glass" and consolidation with a symptom of "the return aura" as symptoms of the organized pneumonia treat. At the same time it is necessary to remember that at initial stages of a disease results of KT can be negative. Also dynamics of changes in lungs matters.
At impossibility of carrying out laboratory researches on availability of RNA of a virus the specified changes according to KT in combination with a characteristic clinical picture can be used for reference of a specific clinical case in the category probable on COVID-19.
The confirmed case of COVID-19 is characterized by existence of a positive take of a laboratory research on availability of RNA of the SARS-CoV-2 virus with use of methods of amplification of nucleic acids or SARS-CoV-2 antigen with use of an immunostratographic analysis regardless of clinical manifestations. Also carry a positive take at the patient on antibodies of a class of IGA, IgM or IgG at patients with clinically confirmed COVID-19 infection to the confirmed case of COVID-19.