A ＂smoke screen＂ to identify fever —— How to distinguish common cold, flu and pneumonia infected in novel coronavirus？

　　Hubei Daily All-Media Reporter Hu Man Correspondent Du Wei

　　Fever and headache are not only symptoms of the common cold, but also flu and pneumonia in novel coronavirus. After being on duty for 6 days in the fever clinic, I have received more than 300 patients with fever. Dr. Feng Gaoke from the Cardiovascular Department of Wuhan University People’s Hospital taught you to understand and distinguish the common cold, influenza and pneumonia infected in novel coronavirus through three typical cases.

　　Common cold (upper respiratory tract infection)

　　Condition: The patient, a 26-year-old male, had intermittent nasal congestion and runny nose (watery nose) after catching cold at night three days ago. Today, he developed fever. His body temperature was measured at home at 38.7℃ and he took Ganmaoling Granule, but his symptoms did not improve. No obvious symptoms of cough, expectoration, chest tightness and dyspnea. In the past, he was in good health and had no history of rhinitis, asthma or chronic respiratory diseases.

　　Epidemiological contact history: no contact with live chickens and ducks, no contact with patients with confirmed influenza and novel coronavirus infection.

　　Examination: There are no obvious abnormalities in blood routine, respiratory pathogens and influenza virus detection.

　　Diagnostic considerations: upper respiratory tract infection (cold).

　　Treatment: Phenol-ephedrine hydrochloride tablets (one tablet each time, three times a day) were given.

　　Case analysis: fever is accompanied by cough, runny nose, sneezing, nasal congestion and other upper respiratory symptoms. The symptoms are mild, and the flu virus is negative. Considering the common cold, as long as you pay attention to ventilation, keep warm, drink plenty of water and increase nutrition, you can generally recover in 5 to 7 days.

　　Influenza (influenza A)

　　Condition: The patient was a 19-year-old male. Two days ago, he developed chills and fever without obvious inducement, accompanied by headache, muscle aches and fatigue, and his body temperature was up to 38.9℃. After taking acetaminophen at home, the fever was reduced, and there was no obvious cough, expectoration, chest tightness and dyspnea. In the past, he was in good health and had no history of rhinitis, asthma or chronic respiratory diseases.

　　Epidemiological contact history: 5 days ago, I had contact with a classmate who was diagnosed with influenza; No contact with live chickens or ducks, and no contact with patients diagnosed with novel coronavirus infection.

　　Examination: Blood routine, respiratory pathogens and influenza virus detection, and the results showed that influenza A virus was positive.

　　Diagnostic considerations: Influenza (A).

　　Treatment: Take isolation measures at home, and treat with Phenomena-Meimin tablets (one tablet three times a day), oseltamivir capsules (one tablet twice a day), acetaminophen (one tablet when the body temperature is higher than 38.5℃) and Lianhua Qingwen capsules (four tablets three times a day).

　　Case analysis: fever with physical symptoms, respiratory cough, runny nose and other minor symptoms, influenza virus positive, consider influenza. Pay attention to isolation, ventilation and warmth, drink plenty of water, increase nutrition, and take antiviral drugs. Generally, you can recover in 5 to 7 days.

　　Novel coronavirus contracted pneumonia.

　　Condition: The patient, a 54-year-old male, developed chills and fever with no obvious inducement three days ago, with the highest body temperature of 40.1℃. He did not take special drugs, and coughed two days ago, mainly with dry cough, accompanied by fatigue and muscle aches. No obvious nasal congestion, runny nose, no obvious wheezing and dyspnea. He had a history of hypertension for 3 years, but had no history of rhinitis, asthma or chronic respiratory diseases. i

　　Epidemiological contact history: No contact with live chickens and ducks, no visit to South China seafood market, but close contact with suspected novel coronavirus infected patients.

　　Examination: respiratory pathogen (negative), influenza virus detection (negative), blood routine (leukopenia), novel coronavirus nucleic acid detection (positive), lung CT: viral pneumonia of left lower lobe.

　　Diagnostic considerations: novel coronavirus is infected with pneumonia.

　　Treatment: The patient is mild, so it is recommended to take home isolation measures, pay attention to rest, drink plenty of water, and keep warm with ventilation. The drugs are oseltamivir capsules (one tablet twice a day), Abidor hydrochloride (two tablets three times a day), acetaminophen (one tablet when the body temperature is higher than 38.5℃) and Lianhua Qingwen capsules (four tablets three times a day).

　　Case analysis: Middle-aged patients with high fever, fatigue, cough and respiratory symptoms, and novel coronavirus nucleic acid test positive, lung CT showed viral pneumonia, consider the diagnosis of pneumonia in novel coronavirus. The patient’s pneumonia is mild, so it is suggested to strictly isolate at home, take antiviral drugs and symptomatic supportive drugs, pay attention to rest and strengthen nutrition. Generally, symptoms will gradually ease after 5 to 7 days at home, and you need to be isolated at home for at least 2 weeks before going out.

　　How to distinguish the common cold, flu and pneumonia infected in novel coronavirus?

　　Professor Hook, an expert from Hubei Medical Treatment Team and the Department of Respiratory and Critical Care Medicine of Wuhan University People’s Hospital, said that the common cold, flu and pneumonia infected by novel coronavirus are all caused by viruses, and their symptoms are similar. The symptoms of the common cold are relatively mild, while the flu will have more severe fever and physical symptoms.

　　Symptoms of pneumonia in novel coronavirus usually include: high fever with chills, headache, dry cough, loss of appetite, extreme fatigue, dyspnea, chest pain aggravated when breathing deeply or coughing, and cold and wet skin caused by frequent sweating. A few people have digestive tract symptoms such as diarrhea.

　　In winter and spring, if you have high fever (body temperature is greater than 38.5℃) and general weakness, it may be flu, and if you have chest tightness, wheezing, dyspnea and frequent cough, it may be pneumonia. These two diseases should go to the hospital fever clinic as soon as possible.

　　Whether it’s the common cold, flu or pneumonia infected by novel coronavirus, in addition to symptomatic treatment with drugs, we should also improve our own resistance: pay attention to rest and avoid catching cold, getting caught in the rain and being overtired; Resolutely quit smoking and drinking, and drink at least 2000 ml of water every day; Eat more foods that are high in protein, calories, vitamins, fat and digestible.