Analysis of implementation status and effectiveness of treatments in the Chinese diagnosis and treatment recommendation for COVID-19 at local hospitals

Background: Since the outbreak of coronavirus disease 2019 (COVID-19), China updated a total of seven editions of the official guidelines. We analyzed the treatment of patients to understand how the several editions of diagnosis and treatment recommendation guided the local medical institutions from a regional perspective. Methods: This study included a total of 93 patients who were suspected or confirmed cases of COVID-19. We analyzed the use of antiviral treatments, antibiotics, steroid, and life support measures in these patients. Based on the time of admission and the update of the official recommendations, we compared the treatments complied with the updated versions of the diagnosis and treatment recommendation. Results: All the 93 cases received different types of antiviral drugs. There were 41 cases of the use of antiviral drugs did not comply with the recommendations. There were 82 cases who received antibiotics, and 31 cases did not comply with the recommendations. 53 patients who received steroids, but only 3 patients comply with the recommendations. One patient was treated with extracorporeal membrane oxygenation (ECMO), but the timing was delayed compared with the recommendations. 91 patients were cured and discharged, one died, and one was still treated in hospital for other diseases after being tested negative. Conclusions: The antiviral treatment initially involved too many types of drugs, and the duration of medication was too long. There was also an overuse of antibiotics. In addition, the use of steroids did not comply with the recommendations. The timing of intubation for mechanical ventilation and the timing of using ECMO were more conservative.