The Ministry of Health to guide the classification of people infected with Covid-19 in Vietnam

The Ministry of Health to guide the classification of people infected with Covid-19 in Vietnam

Most patients have only mild symptoms, but the rate of severe or critical illness is much higher than with influenza viruses and other respiratory viruses.

(1) Asymptomatic infected person

The patient has no clinical symptoms.

- Breathing rate < 22 breaths/min, SpO2 > 96% when breathing air

(2) Patients with symptoms

* Low:

- Clinical

Patients with COVID-19 have clinical symptoms such as fever, cough, fatigue, sore throat, headache, muscle aches, runny nose, loss of taste, smell, diarrhea...

+ Respiratory: no symptoms of pneumonia or shortness of breath, no hypoxemia

Consciousness: awake.

Patients can self-service.

- Subclinical: Chest X-ray is normal or has little damage.

* Moderate degree (Pneumonia):

- Clinical

+ General condition: The patient has clinical symptoms that are mild.

+ Respiration: rapid breathing 22–30 times/minute, moderate dyspnea (when doing housework, going up the stairs one floor), SpO2 >= 94% when breathing room air.

Circulatory: Tachycardia, normal blood pressure.

Consciousness: awake.

The patient showed no signs of severe respiratory failure.

- Subclinical

+ Chest X-ray and chest CT: with lesions, less than 50% of lesions.

+ Ultrasound: B wave image.

* Severity (severe pneumonia):

- Clinical

+ Respiratory: signs of severe respiratory failure such as: shortness of breath even at rest, breathing rate > 30 times/minute; contractile breathing of the accessory respiratory muscles; SpO2 < 94% when breathing room air.

+ Circulatory: tachycardia or possibly bradycardia, BP normal or elevated.
+ Nervous: nervous or tired, okay.

- Subclinical

+ Chest X-ray and/or CT chest: there is more than 50% lung damage.

+ Ultrasound: many B-wave images.

+ PaO2/FiO2 < 300 (or SpO2/FiO2 < 315 when there is no KMD).

* Critical level:

Acute respiratory distress syndrome (ARDS), septic shock, cardiogenic shock, acute embolism, cytokine storm, exacerbation of severe chronic illness, multi-organ failure.

- Clinical

+ Respiratory: there are signs of acute respiratory failure with severe breathing effort, severe contraction of accessory respiratory muscles; an abnormal breathing pattern; a need for oxygen supply > 6 l/min to maintain SpO2 > 92% or a rapidly increasing oxygen demand; a requirement for respiratory support with high-flow oxygen (HFNC), CPAP, or invasive mechanical ventilation.

+ Nervous: decreased consciousness or coma.

Circulatory: fast or slow heart rate, low blood pressure.

+ Kidney: little urine or anuria.

- Subclinical

+ Chest X-ray and/or CT chest: there is more than 50% lung damage.

+ Ultrasound: many B-wave images.

+ PaO2/FiO2 < 200 (or SpO2/FiO2 < 235 when there is no KDM)

+ PH < 7.3; PaCO2 > 50 mmHg,

Blood lactate > 2 mmol/L.

More details can be found in Decision 2671/QĐ-BYT, effective from June 26, 2023.

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