Recommendations on the In-Hospital Treatment of Patients With COVID-19

Posted: 2021-11-18 20:00:00
Background: The mortality of COVID-19 patients who are admitted to a hospital because of the disease remains high. The implementation of evidence-based treatments can improve the quality of care. Methods: The new clinical practice guideline is based on publications retrieved by a systematic search in the Medline databases via PubMed and in the Cochrane COVID-19 trial registry, followed by a structured consensus process leading to the adoption of graded recommendations. Results: Therapeutic anticoagulation can be considered in patients who do not require intensive care and have an elevated risk of thromboembolism (for example, those with D-dimer levels ≥ 2 mg/L). For patients in intensive care, therapeutic anticoagulation has no benefit. For patients with hypoxemic respiratory insufficiency, prone positioning and an early therapy attempt with CPAP/noninvasive ventilation (CPAP, continuous positive airway pressure) or high-flow oxygen therapy is recommended. Patients with IgG-seronegativity and, at most, low-flow oxygen should be treated with SARS-CoV-2- specific monoclonal antibodies (at present, casirivimab and imdevimab). Patients needing no more than low-flow oxygen should additionally be treated with janus kinase (JAK) inhibitors. All patients who need oxygen (low-flow, high-flow, noninvasive ventilation/CPAP, invasive ventilation) should be given systemic corticosteroids. Tocilizumab should be given to patients with a high oxygen requirement and progressively severe COVID-19 disease, but not in combination with JAK inhibitors. Conclusion: Noninvasive ventilation, high-flow oxygen therapy, prone positioning, and invasive ventilation are important elements of the treatment of hypoxemic patients with COVID-19. A reduction of mortality has been demonstrated for the administration of monoclonal antibodies, JAK inhibitors, corticosteroids, tocilizumab, and therapeutic anticoagulation to specific groups of patients.

参考サイト PubMed: covid-19


10月 12, 2020 バイオアソシエイツ


テルアビブ大学の研究者らによると、遺伝子変異PiZまたはPiSの保因者は、重度の病気や COVID-19 による死亡のリスクが高いことを示唆している。 これらの変異は、重度の感染症の場合に肺組織を損傷から保護するα1-アンチトリプシンタンパク質の欠損に繋がっているという。他の研究では、このタンパク質の欠乏が他の疾患の肺機能への炎症性損傷と関連していることがすでに知られている。 この研究は、テルアビブ大学サックラー医学部のDavid Gurwitz教授、Noam Shomron教授および修士課程候補のGuy…

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