COVID-19 Infection: Implications for Perioperative and Critical Care Physicians

Anesthesiology. 2020 Jun;132(6):1346-1361. doi: 10.1097/ALN.0000000000003303.

Abstract

Healthcare systems worldwide are responding to Coronavirus Disease 2019 (COVID-19), an emerging infectious syndrome caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus. Patients with COVID-19 can progress from asymptomatic or mild illness to hypoxemic respiratory failure or multisystem organ failure, necessitating intubation and intensive care management. Healthcare providers, and particularly anesthesiologists, are at the frontline of this epidemic, and they need to be aware of the best available evidence to guide therapeutic management of patients with COVID-19 and to keep themselves safe while doing so. Here, the authors review COVID-19 pathogenesis, presentation, diagnosis, and potential therapeutics, with a focus on management of COVID-19-associated respiratory failure. The authors draw on literature from other viral epidemics, treatment of acute respiratory distress syndrome, and recent publications on COVID-19, as well as guidelines from major health organizations. This review provides a comprehensive summary of the evidence currently available to guide management of critically ill patients with COVID-19.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Anesthesiology / standards*
  • Betacoronavirus / isolation & purification
  • Betacoronavirus / metabolism
  • Betacoronavirus / pathogenicity
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / therapy
  • Coronavirus Infections* / transmission
  • Critical Care / standards*
  • Critical Illness / therapy
  • Humans
  • Pandemics*
  • Perioperative Care / standards*
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / therapy
  • Pneumonia, Viral* / transmission
  • Pulmonary Medicine / standards*
  • Respiratory Insufficiency / therapy
  • Respiratory Insufficiency / virology

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2