SARS-CoV-2 (COVID-19) and intravascular volume management strategies in the critically ill

Amir Kazory; Claudio Ronco; Peter A McCullough

doi:10.1080/08998280.2020.1754700

SARS-CoV-2 (COVID-19) and intravascular volume management strategies in the critically ill

Proc (Bayl Univ Med Cent). 2020 Apr 16;0(0):1-6. doi: 10.1080/08998280.2020.1754700. eCollection 2020.

Authors

Amir Kazory¹, Claudio Ronco^{2

3}, Peter A McCullough⁴

Affiliations

¹ Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, Gainesville, Florida.
² Department of Nephrology, San Bortolo Hospital and International Renal Research Institute of Vicenza, Vicenza, Italy.
³ Department of Medicine, University of Padova, Padova, Italy.
⁴ Division of Cardiology, Baylor University Medical Center, Baylor Heart and Vascular Institute, and Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, Texas.

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread across the globe, and millions of people may be affected. While knowledge regarding epidemiologic features and diagnostic tools of coronavirus disease 2019 (COVID-19) is rapidly evolving, uncertainties surrounding various aspects of its optimal management strategies persist. A subset of these patients develop a more severe form of the disease characterized by expanding pulmonary lesions, sepsis, acute respiratory distress syndrome, and respiratory failure. Due to lack of data on treatment strategies specific to this subset of patients, currently available evidence on management of the critically ill needs to be extrapolated and customized to their clinical needs. The article calls attention to fluid stewardship in the critically ill with COVID-19 by judiciously applying the evidence-based resuscitation principles to their specific clinical features such as high rates of cardiac injury. As we await more data from treating these patients, this strategy is likely to help reduce potential complications.

Keywords: COVID-19; Congestion; SARS-CoV-2; critically ill; resuscitation.

Publication types

Review