[HTML][HTML] Severe covid-19

DA Berlin, RM Gulick, FJ Martinez - New England Journal of …, 2020 - Mass Medical Soc
DA Berlin, RM Gulick, FJ Martinez
New England Journal of Medicine, 2020Mass Medical Soc
Key Clinical Points Evaluation and Management of Severe Covid-19 Patients with severe
coronavirus disease 2019 (Covid-19) may become critically ill with acute respiratory distress
syndrome that typically begins approximately 1 week after the onset of symptoms. Deciding
when a patient with severe Covid-19 should receive endotracheal intubation is an essential
component of care. After intubation, patients should receive lung-protective ventilation with
plateau pressure less than or equal to 30 cm of water and with tidal volumes based on the …
Key Clinical Points
Evaluation and Management of Severe Covid-19
  • Patients with severe coronavirus disease 2019 (Covid-19) may become critically ill with acute respiratory distress syndrome that typically begins approximately 1 week after the onset of symptoms.
  • Deciding when a patient with severe Covid-19 should receive endotracheal intubation is an essential component of care.
  • After intubation, patients should receive lung-protective ventilation with plateau pressure less than or equal to 30 cm of water and with tidal volumes based on the patient’s height.
  • Prone positioning is a potential treatment strategy for refractory hypoxemia.
  • Thrombosis and renal failure are well-recognized complications of severe Covid-19.
  • Dexamethasone has been shown to reduce mortality among hospitalized patients with Covid-19 who require oxygen, particularly those receiving mechanical ventilation.
  • Remdesivir was recently approved by the Food and Drug Administration for the treatment of Covid-19 in hospitalized patients, on the basis of randomized trials showing that the drug reduces time to clinical recovery; however, more data are needed to inform its role in treating severe Covid-19.
The New England Journal Of Medicine