What's Shanghai experience of COVID-19 management?

Combined Approaches toward Prevention of Disease Progression(Mild cases and Common cases):

Antiviral drugs

Oxygen Therapy and supplementation/ Oxygen saturation monitoring

Maintenance of Immune system: Medications, Sleep, Mood management

Enhance supportive care, guarantee adequate caloric intake

Focusing on water & electrolyte balance, maintenance homeostasis.

Avoidance of antibiotics and glucocorticoids.

Anticoagulants and large dose of Vitamin C

First of all, we are focusing on antiviral drugs, Oxygen Therapy and supplementation/Oxygen saturation monitoring, Maintenance of Immune system: Some patients have high anxieties, we have also been focusing in the easing of their stress & terror and try to maintain and provide a good sleep quality routine.

We are also concerned about maintenance of patients' energy level, keeping a stable environment. We have also noticed that large quantity of Vitamin C (10-20 gram daily) use seemed beneficial.

In regard to the use of antiviral drugs, anti-HIV medication Lopinavir/Ritonavir, and a broad spectrum anti-viral drug, Abitor, the overall result compared to placebo group showed no significant difference. We, clinical physicians, felt that Arbitor has a slightly better response than Lopinavir/Ritonavir. One reason is that Lopinavir/Ritonavir has caused toxic side effects onto some patients, with severe GI reactions and further reduce patients' immune responses.

We, the Shanghai COVID-19 special medical task force members have a stronger and stronger believe that Hydroxychloroquine could be a good choice. After patients' use of Hydroxychloroquine, The number of our patient's clinical progression from "mild" class to "severe" class and from "severe" to "critical" class have been significantly reduced. Furthermore, the side effects of Hydroxychloroquine has not been as severe as we had imagined.