How important are the criteria for confirming the diagnosis of neocoronavirus pneumonia?

  The new coronavirus pneumonia has been in our country for more than a month since the beginning of the outbreak, and recent data show that the situation has begun to improve, and it is believed that the war “epidemic” will soon be over. At the beginning of the outbreak, the speed of its spread was obvious to everyone, and one of the reasons why the virus spread across the country in a short time was because it was spread by the massive population movement during the Spring Festival, which is one of the aspects, and on the other hand, the speed of the diagnosis of New Coronavirus pneumonia is also an important factor affecting the prevention and control of the outbreak.  So, how is the diagnosis of NCCV pneumonia made?  When the country started to pay attention to the epidemic, measures were taken to test suspected patients by means of nucleic acid testing kits. The kits were widely used in the outbreak because of their advantages of being more hands-on, lower cost, and faster identification. However, there are several disadvantages of nucleic acid testing: the number of tests and their effectiveness are constrained, and patients who have been tested may turn negative to positive. The drawbacks of nucleic acid testing directly affect the accuracy of the test results, and this impact cannot be ignored.  In the early stage of epidemic prevention and control, in order to quickly detect confirmed patients and arrange isolation and treatment to achieve prevention and control purposes, there is no excuse for using nucleic acid testing nationwide, and there is even a scarcity of kits in some areas. However, after a period of prevention and control efforts, the shortcomings of simple nucleic acid testing have gradually become apparent.  As mentioned earlier, the lack of accuracy of the test results led to some patients not being diagnosed with novel coronavirus pneumonia. Therefore, the confirmation of the diagnosis of the new coronavirus pneumonia is also a top priority for the prevention and control of the epidemic.  In this regard, on February 5, the National Health and Wellness Commission released the “Pneumonia Treatment Protocol for Novel Coronavirus Infection (Trial Version 5),” which emphasizes the role of CT imaging of the lungs in the diagnosis of novel coronavirus pneumonia.  Of course, there are limitations to CT diagnosis, and there is still considerable controversy as to whether CT can distinguish neoplastic pneumonia infection from other infections. However, the latest version of the “Treatment Protocol, Fifth Edition” does not mean that CT can replace nucleic acid testing. At the very least, the use of CT as a screening method for patients is beneficial to enhance the effectiveness of the current outbreak prevention and control efforts.  As the hardest hit area, Hubei, based on the diagnostic role of CT, distinguishes itself from other provinces by treating suspected cases with pneumonia imaging as “clinically diagnosed” cases. From February 13, the number of clinically diagnosed cases was also included in the number of confirmed cases for publication.  This is the reason why the number of confirmed cases in Hubei increased by tens of thousands overnight. This initiative expanded the scope of isolation, and those who were previously insidious due to the lack of accuracy of testing were also arranged for isolation and treatment, making up for the lack of hidden transmission of the epidemic.  In summary, we can see that from the initial outbreak of the epidemic to the present day, the state has been stepping up its efforts to prevent and control the epidemic, from the beginning of the scarcity of medical resources to the beginning of strict screening of suspected patients. According to the latest data of the epidemic in recent days, most of the areas have turned around, which confirms the good results of the prevention and control work, so that this “farce” that lasted for more than a month will be over.