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- Titel:
Clinical Practice Guideline: Recommendations on Inpatient Treatment of Patients with COVID-19.
- Dokumenttyp:
- Journal Article
- Autor(en):
- Kluge, Stefan; Janssens, Uwe; Spinner, Christoph D; Pfeifer, Michael; Marx, Gernot; Karagiannidis, Christian
- Abstract:
- 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.
- Zeitschriftentitel:
- Dtsch Arztebl Int
- Jahr:
- 2021
- Band / Volume:
- 118
- Heft / Issue:
- Forthcoming
- Volltext / DOI:
- doi:10.3238/arztebl.m2021.0110
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/33531113
- Print-ISSN:
- 1866-0452
- TUM Einrichtung:
- II. Medizinische Klinik und Poliklinik (Gastroenterologie)
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