Symptoms of Shanghanlun and Jinkui Yaolue

Treatment guidelines of Australia: The symptoms of COPD

Chinese protocol related clinical symptoms and clinical classification

WHO temporary document: acute respiratory distress syndrome (ARDS) symptoms

Initial manifestations (with Mahuang Xingren Shigao Gancao Decoction) (after sweating): pulse float, head and neck strong pain, aversion to cold, fever, mild fever, Somatalgia, retching and hiccup, vomiting

Initial manifestations: shortness of breath, cough, repeated respiratory infection, expectoration, wheezing

Mild cases: The clinical symptoms were mild, and no manifestations of pneumonia were found on imaging. Mild hypothermia and slight weakness

Onset: New respiratory symptoms or aggravation of existing symptoms appear within one week after the diagnosis of clinical disease

Mild cases (with Wuling Powder) (after sweating): Dysphoria, insomnia, inhibited urination, mild fever

Mild cases: symptoms are less, respiratory distress after moderate activity, repeated lung infections, no impact on daily activities. FEV1 ≈ 60% - 80% expected value

Ordinary cases: Symptoms such as fever and respiratory tract, and manifestations of pneumonia can be seen on imaging

Worse: Chest imaging: Bilateral pulmonary turbidity, which cannot be fully explained by pulmonary effusion, lobar or pulmonary atrophy, or pulmonary nodules. Cause of edema: respiratory failure, which cannot be fully explained by heart failure or fluid overload. If there are no risk factors, an objective assessment (e.g. echocardiography) should be performed to exclude hydrostatic pressure edema

Mild to moderate cases (with Xiaochaihu Decoction): Typhoid for five-six days, Taiyang disease, fever, sweating, Typhoid for five-six days, stroke, chill and fever alternation, chest tightness, nausea, vomiting, inhibited urination, slight fever, cough

Moderate cases: exacerbation of shortness of breath, shortness of breath during normal walking, restricted daily activities, cough and expectoration of sputum, acute exacerbation requiring corticosteroids. FEV1 ≈ 40% - 59% expected value

Degree of oxygenation (adult): Mild ARDS: 200 mmHg < PaO2/FiO2 ≤ 300 mmHg (PEEP or CPAP ≥ 5 cm H2O or nonmechanical ventilation)

Moderate to severe cases (with Shegan Mahuang decoction): Cough and breathless, expectoration

Severe cases: shortness of breath after mild activity, severe restriction of daily activities, frequent expectoration of sputum, chronic cough, acute exacerbation requiring glucocorticoids, FEV1 < 40% expected value

Severe cases: Adults who conform to any of the following criteria: 1) Onset of shortness of breath, RRN30 times/min; 2) In resting state, oxygen saturation < 93%; 3) Arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2) < 300 mmHg (1 mmHg = 0.133 kPa) Cases with chest imaging that shows obvious lesion progression within 24 - 48 hours > 50% shall be managed as severe

Moderate ARDS: 100 mmHg < PaO2/FiO2 ≤ 200 mmHg (PEEP ≥ 5 cm H2O or nonmechanical ventilation)

Underlying diseases and complications: cardiovascular disease, anxiety and depression, osteoporosis, diabetes, pulmonary hypertension or pulmonary heart disease, fatigue

Critical cases: 1) Respiratory fairure and requiring mechanical ventilation; 2) Shock; 3) With other organ failure that requires ICU care

Severe ARDS: PaO2/FiO2 ≤ 100 mmHg (PEEP ≥ 5 cm H2O or nonmechanical ventilation)