A Collaborative Multidisciplinary Approach to the Management of Coronavirus Disease 2019 in the Hospital Setting
Autor: | Raymund R. Razonable, John W. Wilson, Abinash Virk, Adam T. Froemming, Anne M. Meehan, Kelly Pennington, Ariela L. Marshall, Eva M. Carmona, Courtney Bennett |
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Rok vydání: | 2020 |
Předmět: |
Emergency Use Authorization
ARDS COVID-19 coronavirus disease-19 030204 cardiovascular system & hematology RT-PCR reverse transcriptase polymerase chain reaction law.invention 0302 clinical medicine PCR polymerase chain reaction law 030212 general & internal medicine medicine.diagnostic_test General Medicine Intensive care unit ICU intensive care unit CT computed tomography CXR chest x-ray Hospitalization GM-CSF granulocyte macrophage colony stimulating factor CRP C-reactive protein BAL bronchoalveolar lavage SARS-CoV-2 severe acute respiratory syndrome-coronavirus 2 Coronavirus Infections GP aerosol-generating procedures PPE personal protective equipment Telemedicine medicine.medical_specialty Pneumonia Viral PAPR powered air-purifying respirator AKI acute kidney injury Article 03 medical and health sciences Betacoronavirus IL6 interleukin-6 Coagulopathy medicine Humans Intensive care medicine Pandemics ARDS acute respiratory distress syndrome Patient Care Team business.industry SARS-CoV-2 COVID-19 medicine.disease FDA Food and Drug Administration Clinical trial GGO ground-glass opacity Respiratory failure ECG electrocardiogram business Liver function tests G6PD glucose-6-phosphase dehydrogenase |
Zdroj: | Mayo Clinic Proceedings |
ISSN: | 1942-5546 |
Popis: | The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which presents an unprecedented challenge to medical providers worldwide. Although most SARS-CoV-2-infected individuals manifest with a self-limited mild disease that resolves with supportive care in the outpatient setting, patients with moderate to severe COVID-19 will require a multidisciplinary collaborative management approach for optimal care in the hospital setting. Laboratory and radiologic studies provide critical information on disease severity, management options, and overall prognosis. Medical management is mostly supportive with antipyretics, hydration, oxygen supplementation, and other measures as dictated by clinical need. Among its medical complications is a characteristic proinflammatory cytokine storm often associated with end-organ dysfunction, including respiratory failure, liver and renal insufficiency, cardiac injury, and coagulopathy. Specific recommendations for the management of these medical complications are discussed. Despite the issuance of emergency use authorization for remdesivir, there are still no proven effective antiviral and immunomodulatory therapies, and their use in COVID-19 management should be guided by clinical trial protocols or treatment registries. The medical care of patients with COVID-19 extends beyond their hospitalization. Postdischarge follow-up and monitoring should be performed, preferably using telemedicine, until the patients have fully recovered from their illness and are released from home quarantine protocols. |
Databáze: | OpenAIRE |
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