Clinical Practice Guideline: Recommendations on Inpatient Treatment of Patients With COVID-19

TY - JOUR

T1 - Clinical Practice Guideline: Recommendations on Inpatient Treatment of Patients With COVID-19

AU - Kluge, Stefan

AU - Janssens, Uwe

AU - Spinner, Christoph D

AU - Pfeifer, M

AU - Marx, G

AU - Karagiannidis, Christian

PY - 2021/1

Y1 - 2021/1

N2 - BACKGROUND: Since identification of the first cases in December 2019, COVID-19, caused by the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) has spread across the world, giving rise to a global pandemic.METHODS: A literature search was carried out in PubMed, using search terms defined by the authors. Questions important for the management of patients with COVID-19 were identified and discussed, and recommendations or statements on these topics were formulated in a structured consensus process.RESULTS: Determination of the indication for the admission of COVID-19 patients to the hospital should involve consideration of age, comorbidities, respiratory rate, and oxygen saturation. Every patient admitted without a recent PCR test should be tested immediately. It is recommended that any COVID-19 patient with hypoxemia (SpO2 <90%) despite being given oxygen, dyspnea, or a high respiratory rate be admitted to intensive care. In the case of hypoxemic respiratory insufficiency, an attempt at treatment with high-flow oxygen or non-invasive ventilation is suggested, while patients with severe hypoxemia/high respiratory rate should undergo intubation and invasive ventilation. In the presence of additional risk factors (such as obesity, known thrombophilia, intensive care treatment, or elevated D-dimers), intensified prophylaxis against thromboembolism may be indicated. Treatment with dexamethasone decreases the mortality among patients with severe or critical COVID-19. The important personal protection measures are attention to hygiene and the correct wearing of personal protective equipment.CONCLUSION: The principal treatment measures are maintenance of adequate oxygenation, pharmacological prevention of thrombosis, and, in severe cases, administration of dexamethasone.

AB - BACKGROUND: Since identification of the first cases in December 2019, COVID-19, caused by the novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2) has spread across the world, giving rise to a global pandemic.METHODS: A literature search was carried out in PubMed, using search terms defined by the authors. Questions important for the management of patients with COVID-19 were identified and discussed, and recommendations or statements on these topics were formulated in a structured consensus process.RESULTS: Determination of the indication for the admission of COVID-19 patients to the hospital should involve consideration of age, comorbidities, respiratory rate, and oxygen saturation. Every patient admitted without a recent PCR test should be tested immediately. It is recommended that any COVID-19 patient with hypoxemia (SpO2 <90%) despite being given oxygen, dyspnea, or a high respiratory rate be admitted to intensive care. In the case of hypoxemic respiratory insufficiency, an attempt at treatment with high-flow oxygen or non-invasive ventilation is suggested, while patients with severe hypoxemia/high respiratory rate should undergo intubation and invasive ventilation. In the presence of additional risk factors (such as obesity, known thrombophilia, intensive care treatment, or elevated D-dimers), intensified prophylaxis against thromboembolism may be indicated. Treatment with dexamethasone decreases the mortality among patients with severe or critical COVID-19. The important personal protection measures are attention to hygiene and the correct wearing of personal protective equipment.CONCLUSION: The principal treatment measures are maintenance of adequate oxygenation, pharmacological prevention of thrombosis, and, in severe cases, administration of dexamethasone.

U2 - 10.3238/arztebl.m2021.0110

DO - 10.3238/arztebl.m2021.0110

M3 - SCORING: Journal article

C2 - 33531113

VL - 118

SP - 1

EP - 7

JO - DTSCH ARZTEBL INT

JF - DTSCH ARZTEBL INT

SN - 1866-0452

ER -