Early and effective treatment of mild cases is critical
The overall mortality rate is about 0.9% in Shanghai. However, we have found that once the disease course progressed to the critical illness state (requiring mechanical ventilation), the prognosis of the patients would become significantly worse. From this perspective, treatments that can prevent mild state from progressing to the severe or critical state will significantly improve the overall prognosis of the clinical courses. Such effective treatments include intermittent short-term haemofiltration (ISVVH), low-dose short-course glucocorticoids therapy, among other approaches. The use of glucocorticoids is rather controversial and there is no general agreement by now. Based on our experiences, stably mild patients could self-manage the infection effectively and corticosteroid would not be recommended for them considering its potential risks. For patients who have an overly exuberant inflammatory response or are at high risk of developing ARDS, early-start of corticosteroids could be helpful. The benefit of corticosteroids as rescue treatment remains doubtful.