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. 2020 May;80(5):491-498.
doi: 10.1055/a-1156-3991. Epub 2020 May 18.

SARS-CoV-2/COVID-19: Evidence-Based Recommendations on Diagnosis and Therapy

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Free PMC article

SARS-CoV-2/COVID-19: Evidence-Based Recommendations on Diagnosis and Therapy

Berthold Bein et al. Geburtshilfe Frauenheilkd. .
Free PMC article

Abstract

COVID-19, a new viral disease affecting primarily the respiratory system and the lung, has caused a pandemic posing serious challenges to healthcare systems around the world. In about 20% of patients, severe symptoms occur after a mean incubation period of 5 - 6 days; 5% of patients need intensive care therapy. Mortality is about 1 - 2%. Protecting healthcare workers is of paramount importance in order to prevent hospital-acquired infections. Therefore, during all procedures associated with aerosol production, personal protective equipment consisting of a FFP2/FFP3 (N95) respiratory mask, gloves, safety glasses and a waterproof overall should be used. Therapy is based on established recommendations issued for patients with acute lung injury (ARDS). Lung protective ventilation, prone position, restrictive fluid management and adequate management of organ failure are the mainstays of therapy. In case of fulminant lung failure, veno-venous extracorporeal membrane oxygenation may be used as a rescue in experienced centres. New, experimental therapies are evolving with ever increasing frequency; currently, however, no evidence-based recommendation is possible. If off-label and compassionate use of these drugs is considered, an individual benefit-risk assessment is necessary, since serious side effects have been reported.

Keywords: COVID-19; N95 respiratory masks; SARS-CoV-2; acute lung injury; adult respiratory distress syndrome; critical care; personal protection equipment.

Conflict of interest statement

Conflict of Interest/Interessenkonflikt Prof. Bein received honoraria for consulting and giving lectures from Pulsion/Maquet, Edwards Life Sciences and Cytosorbents. The other authors state that they have no conflict of interest./ Prof. Bein hat Honorare für Vorträge und Beratertätigkeit von Pulsion/Maquet, Edwards Life Sciences und Cytosorbents erhalten. Die anderen Autorinnen/Autoren geben an, dass keine Interessenkonflikte bestehen.

Figures

Fig. 1
Fig. 1
Summary of clinical recommendations to treat COVID-19 patients [data from: Alhazzani W, Moller MH, Arabi YM et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) (in press). doi:10.1007/s00134-020-06022-5 ].
Fig. 2
Fig. 2
Treatment algorithm for patients with acute hypoxemic respiratory insufficiency caused by COVID-19 [data from: Alhazzani W, Moller MH, Arabi YM et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) (in press). doi:10.1007/s00134-020-06022-5 ].
Abb. 1
Abb. 1
Zusammenfassung der klinischen Handlungsempfehlungen für COVID-19-Patienten [Daten aus: Alhazzani W, Moller MH, Arabi YM et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) (in press). doi:10.1007/s00134-020-06022-5 ].
Abb. 2
Abb. 2
Therapiealgorithmus für Patienten mit akuter hypoxämischer respiratorischer Insuffizienz als Folge von COVID-19 [Daten aus: Alhazzani W, Moller MH, Arabi YM et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) (in press). doi:10.1007/s00134-020-06022-5 ].

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