COVID-19 and Intensive Care

Abstract

COVID-19 caused by SARS-CoV2 has spread rapidly across the world, resulting in many patients in need of intensive care support. Severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis/septic shock, and multi-organ failure may occur during the disease course among many other complications. There still is not a definite cure, but supportive care is important to minimize complications. Patients in need of respiratory support and interventions should preferably be placed in negative pressure isolation rooms, with utmost care to decrease viral spread. Points to consider during oxygen therapy, non-invasive and invasive mechanical ventilation, and shock management of COVID-19 patients are discussed. Patients with mild hypoxia may be managed with conventional oxygen therapy, while others will benefit from high flow nasal oxygen therapy and mechanical ventilation. Although corticosteroids are not recommended for other viral pneumonia, there are recent reports suggesting that steroids may have a place in the treatment of COVID-19 patients with hypoxia. Shock may complicate the course of the disease and a search for the etiology of shock should be carefully planned. Thromboembolic events are common; prophylaxis and/or treatment of thromboembolic events should be managed according to the guidelines. Meanwhile, the results of ongoing randomized, controlled trials on antiviral and immunomodulatory agents are expected to offer better treatment options for COVID-19 patients in the near future.