Diagnosis, Treatment and medicine
The basic ways to diagnosis of COVID-19 is that a case from the infected area, or suspected patient and the types of information have had from the past of history, and to approach the infection diagnosis we have some scientific tests will help to identify the infection such as CT imaging findings, and laboratory tests like (reverse transcriptase polymerase chain reaction [RT-PCR] tests on respiratory tract specimens) according to standards of either the WHO (2020a) or the National Health Commission of China (2020a). The meaning of a single negative RT-PCR test result from suspected patients is that the patient does not exclude infection. Because of some epidemiological history problems we should inform that the case may be awareness, and also if the suspected case with COVID-19 symptoms it will be the way to obtain the result and also another way to diagnosis is that the patient with the positive CT imaging results. And if not there has been no evidence from randomized controlled trials to recommend any specific anti-nCoV treatment, so the management of COVID-19 has been largely supportive (WHO 2020a).
First of all to treatment, Mild illnesses should be treated at home while maintaining the ill person’s body hydrated, controlling fever and cough, consuming nutrition, and using antibiotics regularly. It was suggested by China Oseltamivir Guidelines to avoid antivirals in short-term treatment; also, corticosteroids could be used in acute respiratory distress syndrome (ARDS) COVID-19. The WHO has published a detailed guide for critical care management, which could be updated according to new findings.There is no fully approved therapy for COVID- 19 yet, although researches are still ongoing. Antiviral drugs, for example, ribavirin and lopinavir/ritonavir, ( Del Rio and Malani 2020). were found beneficial based on the experience from SARS and MERS. Before recommending these drugs, we need more evidence. Further medicines are suggested for pro treatments, such as chloroquine, arbidol, intravenous immunoglobulin, plasma, and interferon. in addition to using traditional Chinese herbs. Grein et al. conducted a study of using remdesivir on 53 patients who received at least one dose of the medication(Amin, Florez et al. 2018). Basically, 30 patients, 57% of the total number, needed mechanical ventilation, and 4 patients (8%) have treated with extracorporeal membrane oxygenation. The follow-up period was 18 days, where 36 patients (68%) experienced an increase in oxygen support, including 17 among 30 patients (57%) who received extubated mechanical ventilation. It was reported that 25 patients (47%) have successfully recovered, and seven patients (13%), unfortunately, died. Death cases were 18% (6 out of 34) among patients who received invasive ventilation and 5% (1 of 19) among those who did not obtain invasive ventilation.In a study by Shen et al. about administrating blood plasma therapy obtained from COVID-19 patients who had recovered, 5 patients received mechanics ventilation. After treated with plasma transfusion, body temperature became normal in 3 days for 4 out of the 5 patients, sequential organ failure assessment (SOFA) scores decreased, and PAO2 / FIO increased in 12 days (range: 172-276 before and 284-366 after). Viral load also decreased and became negative within 12 days after the transfusion. From this achievement of their clinical findings, it can be concluded that the administration of plasma is quite effective, but because the sample is limited, further clinical trials are needed with a larger sample size.(Chen, Xiong et al. 2020)