新冠肺炎門診病患處置之新進展

Outpatient Evaluation and Management of Coronavirus Disease 2019

王保山(Pao-Shan Wang) ； 劉旺達(Wang-Da Liu) ； 鄭高珍(Kuo-Chen Cheng)

《內科學誌》 33卷6期 (2022/12) Pp. 410-415

https://doi.org/10.6314/JIMT.202212_33(6).03

摘要

台灣於2022年4月起，爆發以Omicron變異株為主的新冠肺炎（coronavirus disease 2019, COVID-19）疫情。感染Omicron變異株，症狀以上呼吸道症狀為主，相較於之前的變異株，傳染力較高，但症狀較輕微。大多數感染者為輕症，可接受門診診療與居家照護。門診評估包含臨床症狀的嚴重程度，是否適合居家照護，有無重症風險因子以決定是否使用抗病毒藥物，以及是否有影響抗病毒藥物使用之藥物交互作用。以輕症病患而言，若無相關重症風險因子，可考慮症狀治療等支持性療法，若有相關重症風險因子，可考慮使用Nirmatrelvir/Ritonavir（NMV/r, Paxlovid）以及Molnupiravir。此外，需衛教患者注意有無重症的警示症狀，若有相關警示症狀，應盡速就醫治療。

關鍵字

新冠肺炎（Coronavirus disease 2019, COVID-19） ； 新冠病毒（Severe acute respiratory syndrome coronavirus 2, SARS-CoV-2） ； 倍拉維（Nirmatrelvir/Ritonavir） ； 莫納皮拉韋（Molnupiravir）

並列摘要

An outbreak of SARS-CoV-2 Omicron variant infection occurred in Taiwan since April 2022. With Omicron infection, upper respiratory symptoms appear to be more common and the risk of severe disease or death is lower than prior variants. Outpatient management and home care are appropriate for most patients with mild COVID-19. The outpatient evaluation with COVID-19 is to assess the severity of symptoms, the safety of home care, the risk for progression to severe disease and to determine appropriateness antiviral agent of COVID-19. For symptomatic outpatients with risk for progression to severe disease, Nirmatrelvir/ritonavir or molnupiravir are preferred options for COVID-19 therapy, which reduces the risk of hospitalization and mortality in outpatients with mild disease and associated risk factors. If patients developed warning signs of severe COVID-19, they should visit emergency medical care immediately.