Recommendations on Inpatient Treatment of Patients With COVID-19
Recommendations on Inpatient Treatment of Patients With COVID-19
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DOI：
10.3238/arztebl.m2021.0110
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发表时间：
2021-01-11
影响因子：
7.7
通讯作者：
Karagiannidis, Christian
中科院分区：
文献类型：
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作者：
Kluge, Stefan;Janssens, Uwe;Karagiannidis, Christian
Background: Since the first known cases in December 2019, the disease COVID-19, caused by the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has spread to become a worldwide pandemic.Methods: The literature in PubMed was surveyed using search terms defined by the authors. Topics important for the management of patients with COVID-19 were identified and discussed. In a structured consensus framework, recommendations and statements on these topics were formulated.Results: Whether hospital admission is indicated for patients with COVID-19 should be decided on the basis of age, comorbidities, respiratory rate, and oxygen saturation. For every patient admitted to the hospital, a polymerase chain reaction (PCR) test shortly beforehand or immediately thereafter is mandatory. Admission to the intensive care unit is recommended for COVID-19 patients with hypoxemia (oxygen saturation < 90%) despite administration of oxygen, dyspnea, or a high respiratory rate. A treatment trial of high-flow oxygen or non-invasive ventilation is suggested in hypoxemic respiratory insufficiency, while intubation and invasive ventilation is proposed for patients with more severe hypoxemia/high respiratory rate. If additional risk factors (such as obesity, known thrombophilia, intensive care treatment, or elevated D-dimers) are present, measures to prevent thromboembolism can be intensified. Treatment with dexamethasone reduces the mortality in patients with severe COVID-19. The important protection measures are observation of hygiene and the correct wearing of personal protective equipment.Conclusion: The most important elements of treatment in severe cases of COVID-19 are adequate oxygenation, pharmaceutical prevention of thrombosis, and administration of dexamethasone.
