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Treatment and management of COVID-19

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The treatment and management of COVID-19 combines both supportive care, which includes treatment to relieve symptoms, fluid therapy, oxygen support as needed,[1][2][3] and a growing list of approved medications. Highly effective vaccines have reduced mortality related to SARS-CoV-2; however, for those awaiting vaccination, as well as for the estimated millions of immunocompromised persons who are unlikely to respond robustly to vaccination, treatment remains important.[4] Some people may experience persistent symptoms or disability after recovery from the infection, known as long COVID, but there is still limited information on the best management and rehabilitation for this condition.[5]

Most cases of COVID-19 are mild. In these, supportive care includes medication such as paracetamol or NSAIDs to relieve symptoms (fever, body aches, cough), proper intake of fluids, rest, and nasal breathing.[6][7][8][9] Good personal hygiene and a healthy diet are also recommended.[10] As of April 2020 the U.S. Centers for Disease Control and Prevention (CDC) recommended that those who suspect they are carrying the virus isolate themselves at home and wear a face mask.[11] As of November 2020 use of the glucocorticoid dexamethasone had been strongly recommended in those severe cases treated in hospital with low oxygen levels, to reduce the risk of death.[12][13][14] Noninvasive ventilation and, ultimately, admission to an intensive care unit for mechanical ventilation may be required to support breathing.[5] Extracorporeal membrane oxygenation (ECMO) has been used to address respiratory failure, but its benefits are still under consideration.[15][16] Some of the cases of severe disease course are caused by systemic hyper-inflammation, the so-called cytokine storm.[17]

Although several medications have been approved in different countries as of April 2022, not all countries have these medications. Patients with mild to moderate symptoms who are in the risk groups[needs update] can take nirmatrelvir/ritonavir (marketed as Paxlovid) or remdesivir, either of which reduces the risk of serious illness or hospitalization.[18] In the US, the Biden Administration COVID-19 action plan includes the Test to Treat initiative, where people can go to a pharmacy, take a COVID test, and immediately receive free Paxlovid if they test positive.[19]

Several experimental treatments are being actively studied in clinical trials.[20] These include the antivirals molnupiravir (developed by Merck),[21] and nirmatrelvir/ritonavir (developed by Pfizer).[22][23] Others were thought to be promising early in the pandemic, such as hydroxychloroquine and lopinavir/ritonavir, but later research found them to be ineffective or even harmful,[20][24][25] like fluvoxamine, a cheap and widely available antidepressant;[26] As of December 2020, there was not enough high-quality evidence to recommend so-called early treatment.[24][25] In December 2020, two monoclonal antibody-based therapies were available in the United States, for early use in cases thought to be at high risk of progression to severe disease.[25] The antiviral remdesivir has been available in the U.S., Canada, Australia, and several other countries, with varying restrictions; however, it is not recommended for people needing mechanical ventilation, and has been discouraged altogether by the World Health Organization (WHO),[27] due to limited evidence of its efficacy.[20] In November 2021, the UK approved the use of molnupiravir as a COVID treatment for vulnerable patients recently diagnosed with the disease.[28]

The WHO, the Chinese National Health Commission, the UK National Institute for Health and Care Excellence, and the United States' National Institutes of Health, among other bodies and agencies worldwide, have all published recommendations and guidelines for taking care of people with COVID-19.[29][30][5][31] As of 2020 Intensivists and pulmonologists in the U.S. have compiled treatment recommendations from various agencies into a free resource, the IBCC.[32][33]

General support

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Taking over-the-counter drugs such as paracetamol or ibuprofen, drinking fluids, taking honey to ease a cough, and resting may help alleviate symptoms.[7][34][35][36]

Medications

[edit]
See also: COVID-19 drug repurposing research and COVID-19 drug development
An exhausted anesthesiologist physician in Pesaro, Italy, March 2020

In the early months of the pandemic, many ICU doctors faced with the virus ventured to prescribe conjectured treatments because of the unprecedented circumstances.[37] However, the standard of care for most intractable illnesses is that, as it develops over years, doctors build a body of research that tests various theories, compares and contrasts dosages, and measures one drug's power against another.[37]

Antiviral development for SARS-CoV-2 has been disappointing.[38] In January 2020, research into potential treatments started,[39] and several antiviral drugs were in clinical trials.[40][41] In February 2020 with 'no known effective' treatments, the WHO recommended volunteers take part in trials of the effectiveness and safety of potential treatments.[42] Antiviral medications were tried in people with severe disease.[1] As of March 2020 several medications were already approved for other uses or were already in advanced testing.[43] As of April 2020 trials were investigating whether existing medications could be used effectively against the body's immune reaction to SARS-CoV-2 infection.[44][45] As of May 2020 several antiviral drugs were under investigation for COVID-19, though none had been shown to be clearly effective on mortality in published randomized controlled trials.[44]

As of February 2021, in the European Union, the use of dexamethasone and remdesivir were authorized.[46] Corticosteroids like dexamethasone have shown clinical benefit in treating COVID-19.[47][48] As of February 2021, the monoclonal antibody therapies bamlanivimab/etesevimab and casirivimab/imdevimab were found to reduce the number of hospitalizations, emergency room visits, and deaths.[49][50] and both combination drugs received emergency use authorization by the US Food and Drug Administration (FDA).[49][50]

As of February 2021 there were Emergency Use Authorizations for baricitinib, bamlanivimab, bamlanivimab/etesevimab, and casirivimab/imdevimab.[51]

As of July 2021, outpatient drugs budesonide and tocilizumab showed promising results in some patients but remained under investigation.[52][53][54] As of July 2021, a large number of drugs had been considered for treating COVID-19 patients.[55] As of November 2022, there was moderate-certainty evidence suggesting that dexamethasone, and systemic corticosteroids in general, probably cause a slight reduction in all-cause mortality (up to 30 days) in hospitalized patients with COVID‐19, the evidence was very uncertain at 120 days.[56]

In March 2022, the BBC wrote, "There are now many drugs that target the virus or our body in different ways: anti-inflammatory drugs that stop our immune system overreacting with deadly consequences, anti-viral drugs that make it harder for the coronavirus to replicate inside the body and antibody therapies that mimic our own immune system to attack the virus"[57]

The WHO recommendations on which medications should or should not be used to treat Covid-19 are continuously updated. As of July 2022, WHO strongly recommended for non-severe cases nirmatrelvir and ritonavir, and recommended conditionally Molnupiravir, Sotrovimab and Remdesivir. For severe cases WHO strongly recommended corticosteroids, IL-6 receptor blockers or Baricitinib and conditionally recommended casirivimab and imdevimab.[58]

For patients in a life-threatening stage of the illness and in the presence of poor prognostic predictors, early antiviral treatment is essential.[59]

Ineffective

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As of 2020, several treatments had been investigated and found to be ineffective or unsafe, and are thus were not recommended for use; these include baloxavir marboxil, lopinavir/ritonavir, ruxolitinib, chloroquine, hydroxychloroquine, interferon β-1a, and colchicine.[14] As of 2021, favipiravir and nafamostat had shown mixed results but were still in clinical trials in some countries.[60][61][62]

During the early part of 2020 convalescent plasma, plasma from persons who recovered from SARS-CoV-2 infection, was frequently used with anecdotal successes in reports and small case series.[63] However subsequent trials found no consistent evidence of benefit.[64][65] However, conflicting outcomes from trials could be understood by noting that they transfused insufficient therapeutic doses of CCP.[66]

As of February 2021, in the United States, only remdesivir had FDA approval for certain COVID-19 patients,[67] and while early research had suggested a benefit in preventing death and shortening illness duration, this was not borne out by subsequent trials.[68][needs update]

On 16 April 2021, the FDA revoked the emergency use authorization (EUA) for the investigational monoclonal antibody therapy bamlanivimab, when administered alone, to be used for the treatment of mild-to-moderate COVID-19 in adults and certain pediatric patients.[69]

As of July 2022, WHO strongly recommended against treating non-severe cases with convalescent plasma, hydroxychloroquine, lopinavir-ritonavir or colchicine and recommended conditionally against corticosteroids or ivermectin or fluvoxamine or nirmatrelvir and ritonavir WHO also strongly recommended against treating severe cases with hydroxychloroquine or lopinavir-ritonavir or Baricitinib and conditionally recommended against ruxolitinib or tofacitinib, ivermectin or convalescent plasma.[58]

As of September 2022, oral treatment of outpatients with metformin, ivermectin, and fluvoxamine were found to be ineffective in a large randomized, controlled trial.[70]

Adjuvant anticoagulation

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In general there is no good evidence that anticoagulants have any benefit in the treatment of COVID-19, other than poor quality evidence suggesting a possible effect on all-cause mortality.[71]

Respiratory support

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A critically ill patient receiving invasive ventilation in the intensive care unit of the Heart Institute, University of São Paulo, during the COVID-19 pandemic in Brazil. Due to a shortage of mechanical ventilators, a bridge ventilator is being used to automatically actuate a bag valve mask.

People seriously ill with COVID-19 may require respiratory support. Depending on the severity, oxygen therapy, mechanical ventilation, and intravenous fluids may be required.[72]

Mechanical ventilation

[edit]
See also: Shortages related to the COVID-19 pandemic § Mechanical ventilation

Most cases of COVID-19 are not severe enough to require mechanical ventilation or alternatives, but a percentage of cases are.[73][74] Some of the people acutely ill with COVID-19 experience deterioration of their lungs and acute respiratory distress syndrome (ARDS) and/or respiratory failure. Due to the high risk of death, urgent respiratory support including mechanical ventilation is often required in these people.[75] Mechanical ventilation becomes more complex as ARDS develops in COVID-19 and oxygenation becomes increasingly difficult.[76]

People who undergo mechanical ventilation are at risk of ventilator-associated lung injury or of worsening an existing lung injury, this damage is called ventilatory-induced lung injury (VILI).[75] The mechanism of this injury is thought to be due to trauma to the lungs caused by aerated regions of the lungs being over swollen (overdistension of the aerated alveoli) and atelectrauma (force on the alveolar that could lead to lung collapse).[75]

Ventilators capable of pressure control modes and optimal PEEP are needed to maximise oxygen delivery while minimising the risk of ventilator-associated lung injury and pneumothorax.[77][75][78] An approach to enable the person to breath spontaneously while being mechanically ventilated by adjusting the level of sedation and the respirator settings has been suggested, with the goal of reducing atrophy of the diaphragm.[79] There is no clear evidence to suggest that enabling spontaneous breathing early while being mechanically ventilated is either beneficial or detrimental for the person's recovery.[79]

Other approaches to mechanical ventilation including avoiding intubation using a high flow nasal cannula or bi-level positive airway pressure are under investigation, however, the effectiveness of these approaches compared to intubation are not clear.[80] Some doctors prefer staying with invasive mechanical ventilation when available because this technique limits the spread of aerosol particles compared to a high flow nasal cannula.[73]

The administration of inhaled nitric oxide to people being ventilated is not recommended, and evidence around this practice is weak.[81]

Extracorporeal membrane oxygenation

[edit]
Main article: Extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO) is an artificial lung technology that has been used since the 1980s to treat respiratory failure and acute respiratory distress syndrome when conventional mechanical ventilation fails. In this complex procedure, blood is removed from the body via large cannulae, moved through a membrane oxygenator that performs the lung functions of oxygen delivery and carbon dioxide removal, and then returned to the body. The Extracorporeal Life Support Organization (ELSO) maintains a registry of outcomes for this technology, and as of September 2020 it has been used in less than 120,000 patients over 435 ECMO centers worldwide with 40% mortality for adult respiratory patients.[82]

Initial use of ECMO in COVID-19 patients from China early in the pandemic suggested poor outcomes, with less than 90% mortality.[83] In March 2020, the ELSO registry began collecting data on the worldwide use of ECMO for patients with COVID-19 and reporting this data on the ELSO website in real time. In September 2020, the outcomes of 1,035 COVID-19 patients supported with ECMO from 213 experienced centers in 36 different countries were published in The Lancet, and demonstrated 38% mortality, which is similar to many other respiratory diseases treated with ECMO. The mortality is also similar to the 35% mortality seen in the EOLIA trial, the largest randomized controlled trial for ECMO in ARDS.[84] This registry based, multi-center, multi-country data provide provisional support for the use of ECMO for COVID-19 associated acute hypoxemic respiratory failure. Given that this is a complex technology that can be resource intense, guidelines exist for the use of ECMO during the COVID-19 pandemic.[85][86][87]

Psychological support

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See also: Mental health during the COVID-19 pandemic

Individuals may experience distress from quarantine, travel restrictions, side effects of treatment, or fear of the infection itself. To address these concerns, the National Health Commission of China published a national guideline for psychological crisis intervention on 27 January 2020.[88][89]

According to the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support, the pandemic produced long-term consequences. Deterioration of social networks and economies, survivor stigma, anger and aggression, and mistrust of official information are long-term consequences.[90]

In April 2020 The Lancet published a 14-page call for action focusing on the UK and stated conditions were such that a range of mental health issues was likely to become more common. BBC quoted Rory O'Connor in saying, "Increased social isolation, loneliness, health anxiety, stress, and an economic downturn are a perfect storm to harm people's mental health and wellbeing."[91][92]

Special populations

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Concurrent treatment of other conditions

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Early in the pandemic, theoretical concerns were raised about ACE inhibitors and angiotensin receptor blockers. However, later research in March 2020 found no evidence to justify stopping these medications in people who take them for conditions such as high blood pressure.[5][93][94][95] One study from April 2020 found that people with COVID-19 and hypertension had lower all-cause mortality when on these medications.[96] Similar concerns were raised about non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen; these were likewise not borne out, and NSAIDs may both be used to relieve symptoms of COVID-19 and continue to be used by people who take them for other conditions.[97]

People who use topical or systemic corticosteroids for respiratory conditions such as asthma or chronic obstructive pulmonary disease should continue taking them as prescribed even if they contract COVID-19.[47]

The principal for obstetric management of COVID-19 include rapid detection, isolation, and testing, profound preventive measures, regular monitoring of fetus as well as of uterine contractions, peculiar case-to-case delivery planning based on severity of symptoms, and appropriate post-natal measures for preventing infection.[98]

Patients with simultaneous Influenza infection

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Patients with simultaneous SARS CoV2 and Influenza infection are more than twice as likely to die and more than four times as likely to need ventilation as patients with only COVID. It is recommended that patients admitted to hospital with COVID should be routinely tested to see if they also have Influenza. The public are advised to get vaccinated against both Influenza and COVID.[99]

Epidemiology

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Severe cases are most common in older adults (those older than 60 years,[73] and especially those older than 80 years).[100] Many developed countries do not have enough hospital beds per capita, which limits a health system's capacity to handle a sudden spike in the number of COVID-19 cases severe enough to require hospitalisation.[101] This limited capacity is a significant driver behind calls to flatten the curve.[101] One study in China found 5% were admitted to intensive care units, 2.3% needed mechanical support of ventilation, and 1.4% died.[15] In China, approximately 30% of people in hospital with COVID-19 are eventually admitted to ICU.[102]

References

[edit]
  1. ^ a b Fisher D, Heymann D (February 2020). "Q&A: The novel coronavirus outbreak causing COVID-19". BMC Medicine. 18 (1): 57. doi:10.1186/s12916-020-01533-w. PMC 7047369. PMID 32106852.
  2. ^ Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. (May 2020). "Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province". Chinese Medical Journal. 133 (9): 1025–1031. doi:10.1097/CM9.0000000000000744. PMC 7147277. PMID 32044814.
  3. ^ Wang T, Du Z, Zhu F, Cao Z, An Y, Gao Y, et al. (March 2020). "Comorbidities and multi-organ injuries in the treatment of COVID-19". Lancet. 395 (10228). Elsevier BV: e52. doi:10.1016/s0140-6736(20)30558-4. PMC 7270177. PMID 32171074.
  4. ^ Tao K, Tzou PL, Nouhin J, Bonilla H, Jagannathan P, Shafer RW (July 2021). "SARS-CoV-2 Antiviral Therapy". Clinical Microbiology Reviews. 34 (4): e0010921. doi:10.1128/CMR.00109-21. PMC 8404831. PMID 34319150. S2CID 236472654.
  5. ^ a b c d Motseki TP (7 June 2022). "COVID-19 Vaccination Guidelines". www.nih.gov. National Institutes of Health. Archived from the original on 19 January 2021. Retrieved 18 January 2021.
  6. ^ Wang Y, Wang Y, Chen Y, Qin Q (March 2020). "Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures". Journal of Medical Virology. 92 (6): 568–576. doi:10.1002/jmv.25748. PMC 7228347. PMID 32134116.
  7. ^ a b "Coronavirus". WebMD. Archived from the original on 1 February 2020. Retrieved 1 February 2020.
  8. ^ Martel J, Ko YF, Young JD, Ojcius DM (May 2020). "Could nasal breathing help to mitigate the severity of COVID-19". Microbes and Infection. 22 (4–5): 168–171. doi:10.1016/j.micinf.2020.05.002. PMC 7200356. PMID 32387333.
  9. ^ "Coronavirus recovery: breathing exercises". www.hopkinsmedicine.org. Johns Hopkins Medicine. Archived from the original on 11 October 2020. Retrieved 30 July 2020.
  10. ^ Wang L, Wang Y, Ye D, Liu Q (March 2020). "Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence". International Journal of Antimicrobial Agents. 55 (6): 105948. doi:10.1016/j.ijantimicag.2020.105948. PMC 7156162. PMID 32201353.
  11. ^ U.S. Centers for Disease Control and Prevention (5 April 2020). "What to Do if You Are Sick". U.S. Centers for Disease Control and Prevention (CDC). Archived from the original on 14 February 2020. Retrieved 24 April 2020.
  12. ^ "Update to living WHO guideline on drugs for covid-19". BMJ (Clinical Research Ed.). 371: m4475. November 2020. doi:10.1136/bmj.m4475. ISSN 1756-1833. PMID 33214213. S2CID 227059995.
  13. ^ "Q&A: Dexamethasone and COVID-19". World Health Organization (WHO). Archived from the original on 11 October 2020. Retrieved 11 July 2020.
  14. ^ a b "Home". National COVID-19 Clinical Evidence Taskforce. Archived from the original on 11 October 2020. Retrieved 11 July 2020.
  15. ^ a b Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. (April 2020). "Clinical Characteristics of Coronavirus Disease 2019 in China". The New England Journal of Medicine. 382 (18). Massachusetts Medical Society: 1708–1720. doi:10.1056/nejmoa2002032. PMC 7092819. PMID 32109013.
  16. ^ Henry BM (April 2020). "COVID-19, ECMO, and lymphopenia: a word of caution". The Lancet. Respiratory Medicine. 8 (4). Elsevier BV: e24. doi:10.1016/s2213-2600(20)30119-3. PMC 7118650. PMID 32178774.
  17. ^ Kim JS, Lee JY, Yang JW, Lee KH, Effenberger M, Szpirt W, et al. (2021). "Immunopathogenesis and treatment of cytokine storm in COVID-19". Theranostics. 11 (1): 316–329. doi:10.7150/thno.49713. PMC 7681075. PMID 33391477.
  18. ^ "COVID Treatment Guidelines: Clinical Management Summary". NIH Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. 8 April 2022. Archived from the original on 5 November 2021. Retrieved 19 April 2022.
  19. ^ Wise J (17 April 2022). "What Happened to Paxlovid, the COVID Wonder Drug?". Intelligencer. Archived from the original on 19 April 2022. Retrieved 19 April 2022.
  20. ^ a b c "Drug treatments for covid-19: living systematic review and network meta-analysis". BMJ. 373: n967. April 2021. doi:10.1136/bmj.n967. hdl:11375/26524. PMID 33849936.
  21. ^ Aripaka P (5 November 2021). "Britain approves Merck's COVID-19 pill in world first". Reuters. Archived from the original on 8 November 2021. Retrieved 8 November 2021.
  22. ^ Beasley D (5 November 2021). "Pfizer says its antiviral pill slashes risk of severe COVID-19 by 89%". Reuters. Archived from the original on 7 November 2021. Retrieved 8 November 2021.
  23. ^ Reis S, Metzendorf MI, Kuehn R, Popp M, Gagyor I, Kranke P, et al. (November 2023). "Nirmatrelvir combined with ritonavir for preventing and treating COVID-19". The Cochrane Database of Systematic Reviews. 2023 (11): CD015395. doi:10.1002/14651858.CD015395.pub3. PMC 10688265. PMID 38032024.
  24. ^ a b Kim PS, Read SW, Fauci AS (December 2020). "Therapy for Early COVID-19: A Critical Need". JAMA. 324 (21). American Medical Association (AMA): 2149–2150. doi:10.1001/jama.2020.22813. PMID 33175121.
  25. ^ a b c "COVID-19 Treatment Guidelines". www.nih.gov. National Institutes of Health. Archived from the original on 19 January 2021. Retrieved 18 January 2021./
  26. ^ Saima MS (2 November 2021). "Common Antidepressant Slashes Risk of COVID Death". Nature. Archived from the original on 8 November 2021. Retrieved 8 November 2021.
  27. ^ Hsu J (November 2020). "Covid-19: What now for remdesivir?". BMJ. 371: m4457. doi:10.1136/bmj.m4457. PMID 33214186.
  28. ^ Reed J (4 November 2021). "Molnupiravir: First pill to treat Covid gets approval in UK". www.bbc.co.uk. Archived from the original on 4 November 2021. Retrieved 23 November 2021.
  29. ^ "Clinical management of COVID-19". World Health Organization (WHO). 27 May 2020. Archived from the original on 15 January 2021. Retrieved 18 January 2021.
  30. ^ "Coronavirus (COVID-19) | NICE". National Institute for Health and Care Excellence. Archived from the original on 20 January 2021. Retrieved 18 January 2021.
  31. ^ Cheng ZJ, Shan J (April 2020). "2019 Novel coronavirus: where we are and what we know". Infection. 48 (2): 155–163. doi:10.1007/s15010-020-01401-y. PMC 7095345. PMID 32072569.
  32. ^ Farkas J (March 2020). COVID-19—The Internet Book of Critical Care (digital) (Reference manual). USA: EMCrit. Archived from the original on 11 March 2020. Retrieved 13 March 2020.
  33. ^ "COVID19—Resources for Health Care Professionals". Penn Libraries. 11 March 2020. Archived from the original on 14 March 2020. Retrieved 13 March 2020.
  34. ^ "Home care for patients with suspected or confirmed COVID-19 and management of their contacts" (PDF). World Health Organization (WHO). 13 August 2020. Archived from the original on 21 January 2021. Retrieved 18 January 2021.
  35. ^ "Prevention & Treatment". U.S. Centers for Disease Control and Prevention (CDC). 15 February 2020. Archived from the original on 15 December 2019. Retrieved 21 January 2020. Public Domain This article incorporates text from this source, which is in the public domain.
  36. ^ "How to look after yourself at home if you have coronavirus (COVID-19) or symptoms of COVID-19". NHS. 6 May 2022. Archived from the original on 23 May 2022. Retrieved 22 May 2022.
  37. ^ a b Dominus S (5 August 2020). "The Covid Drug Wars That Pitted Doctor vs. Doctor". The New York Times. Archived from the original on 1 July 2021. Retrieved 1 July 2021.
  38. ^ Tao K, Tzou PL, Nouhin J, Bonilla H, Jagannathan P, Shafer RW (December 2021). "SARS-CoV-2 Antiviral Therapy". Clinical Microbiology Reviews. 34 (4): e0010921. doi:10.1128/CMR.00109-21. PMC 8404831. PMID 34319150.
  39. ^ "Chinese doctors using plasma therapy on coronavirus, WHO says 'very valid' approach". Reuters. 17 February 2020. Archived from the original on 4 March 2020. Retrieved 19 March 2020.
  40. ^ Steenhuysen J, Kelland K (24 January 2020). "With Wuhan virus genetic code in hand, scientists begin work on a vaccine". Reuters. Archived from the original on 25 January 2020. Retrieved 25 January 2020.
  41. ^ Duddu P (19 February 2020). "Coronavirus outbreak: Vaccines/drugs in the pipeline for Covid-19". clinicaltrialsarena.com. Archived from the original on 19 February 2020.
  42. ^ Nebehay S, Kelland K, Liu R (5 February 2020). "WHO: 'no known effective' treatments for new coronavirus". Thomson Reuters. Archived from the original on 5 February 2020. Retrieved 5 February 2020.
  43. ^ Li G, De Clercq E (March 2020). "Therapeutic options for the 2019 novel coronavirus (2019-nCoV)". Nature Reviews. Drug Discovery. 19 (3): 149–150. doi:10.1038/d41573-020-00016-0. PMID 32127666.
  44. ^ a b Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB (May 2020). "Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review". JAMA. 323 (18): 1824–1836. doi:10.1001/jama.2020.6019. PMID 32282022. S2CID 215752785.
  45. ^ McCreary EK, Pogue JM (April 2020). "Coronavirus Disease 2019 Treatment: A Review of Early and Emerging Options". Open Forum Infectious Diseases. 7 (4): ofaa105. doi:10.1093/ofid/ofaa105. PMC 7144823. PMID 32284951.
  46. ^ "Treatments and vaccines for COVID-19: authorised medicines". European Medicines Agency. 11 January 2021. Archived from the original on 19 February 2021. Retrieved 20 February 2021.
  47. ^ a b "Australian guidelines for the clinical care of people with COVID-19". National COVID-19 Clinical Evidence Taskforce. Archived from the original on 25 September 2020. Retrieved 11 July 2020.
  48. ^ Rizk JG, Kalantar-Zadeh K, Mehra MR, Lavie CJ, Rizk Y, Forthal DN (September 2020). "Pharmaco-Immunomodulatory Therapy in COVID-19". Drugs. 80 (13). Springer: 1267–1292. doi:10.1007/s40265-020-01367-z. PMC 7372203. PMID 32696108.
  49. ^ a b "FDA Authorizes Monoclonal Antibodies for Treatment of COVID-19". U.S. Food and Drug Administration (FDA) (Press release). 10 February 2021. Archived from the original on 10 February 2021. Retrieved 9 February 2021. Public Domain This article incorporates text from this source, which is in the public domain.
  50. ^ a b "Coronavirus (COVID-19) Update: FDA Authorizes Monoclonal Antibodies for Treatment of COVID-19". U.S. Food and Drug Administration (FDA). 23 November 2020. Archived from the original on 25 January 2021. Retrieved 17 April 2021. Public Domain This article incorporates text from this source, which is in the public domain.
  51. ^ "COVID-19 Frequently Asked Questions: Drugs (Medicines)". U.S. Food and Drug Administration. 19 February 2021. Archived from the original on 19 February 2021. Retrieved 20 February 2021.
  52. ^ Frohman EM, Villemarette-Pittman NR, Rodriguez A, Glanzman R, Rugheimer S, Komogortsev O, et al. (July 2021). "Application of an evidence-based, out-patient treatment strategy for COVID-19: Multidisciplinary medical practice principles to prevent severe disease". Journal of the Neurological Sciences. 426: 117463. doi:10.1016/j.jns.2021.117463. PMC 8055502. PMID 33971376.
  53. ^ Viswanatha GL, Anjana Male CK, Shylaja H (2022). "Efficacy and safety of tocilizumab in the management of COVID-19: a systematic review and meta-analysis of observational studies". Clinical and Experimental Rheumatology. 40 (3): 634–646. doi:10.55563/clinexprheumatol/4dg0or. PMID 34251307. S2CID 247725977.
  54. ^ Shang L, Lye DC, Cao B (August 2021). "Contemporary narrative review of treatment options for COVID-19". Respirology. 26 (8): 745–767. doi:10.1111/resp.14106. PMC 8446994. PMID 34240518.
  55. ^ Guo W, Pan B, Sakkiah S, Ji Z, Yavas G, Lu Y, et al. (July 2021). "Informing selection of drugs for COVID-19 treatment through adverse events analysis". Scientific Reports. 11 (1): 14022. Bibcode:2021NatSR..1114022G. doi:10.1038/s41598-021-93500-5. PMC 8263777. PMID 34234253.
  56. ^ Wagner C, Griesel M, Mikolajewska A, Metzendorf MI, Fischer AL, Stegemann M, et al. (November 2022). "Systemic corticosteroids for the treatment of COVID-19: Equity-related analyses and update on evidence". The Cochrane Database of Systematic Reviews. 2022 (11): CD014963. doi:10.1002/14651858.CD014963.pub2. PMC 9670242. PMID 36385229.
  57. ^ Coronavirus treatments: What progress is being made? Archived 19 March 2022 at the Wayback Machine BBC
  58. ^ a b Abdool Karim SS, Devnarain N (August 2022). "Time to Stop Using Ineffective Covid-19 Drugs". The New England Journal of Medicine. 387 (7): 654–655. doi:10.1056/NEJMe2209017. PMID 36070715. S2CID 251658284.
  59. ^ Zhao F, Ma Q, Yue Q, Chen H (April 2022). "SARS-CoV-2 Infection and Lung Regeneration". Clinical Microbiology Reviews. 35 (2): e0018821. doi:10.1128/cmr.00188-21. PMC 8809385. PMID 35107300.
  60. ^ Janik E, Niemcewicz M, Podogrocki M, Saluk-Bijak J, Bijak M (May 2021). "Existing Drugs Considered as Promising in COVID-19 Therapy". International Journal of Molecular Sciences. 22 (11): 5434. doi:10.3390/ijms22115434. PMC 8196765. PMID 34063964.
  61. ^ Hall K, Mfone F, Shallcross M, Pathak V (June 2021). "Review of Pharmacotherapy Trialed for Management of the Coronavirus Disease-19". The Eurasian Journal of Medicine. 53 (2): 137–143. doi:10.5152/eurasianjmed.2021.20384. PMC 8184028. PMID 34177298.
  62. ^ Heustess AM, Allard MA, Thompson DK, Fasinu PS (May 2021). "Clinical Management of COVID-19: A Review of Pharmacological Treatment Options". Pharmaceuticals. 14 (6): 520. doi:10.3390/ph14060520. PMC 8229327. PMID 34071185.
  63. ^ Janiaud P, Axfors C, Schmitt AM, Gloy V, Ebrahimi F, Hepprich M, et al. (March 2021). "Association of Convalescent Plasma Treatment With Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis". JAMA. 325 (12): 1185–1195. doi:10.1001/jama.2021.2747. PMC 7911095. PMID 33635310.
  64. ^ Focosi D, Franchini M, Pirofski LA, Burnouf T, Paneth N, Joyner MJ, et al. (September 2022). "COVID-19 Convalescent Plasma and Clinical Trials: Understanding Conflicting Outcomes". Clinical Microbiology Reviews (Review). 35 (3): e0020021. doi:10.1128/cmr.00200-21. PMC 9491201. PMID 35262370.
  65. ^ Qian Z, Zhang Z, Ma H, Shao S, Kang H, Tong Z (2022). "The efficiency of convalescent plasma in COVID-19 patients: A systematic review and meta-analysis of randomized controlled clinical trials". Frontiers in Immunology (Systematic review). 13: 964398. doi:10.3389/fimmu.2022.964398. PMC 9366612. PMID 35967398.
  66. ^ Focosi D, Franchini M, Pirofski LA, Burnouf T, Paneth N, Joyner MJ, et al. (September 2022). "COVID-19 Convalescent Plasma and Clinical Trials: Understanding Conflicting Outcomes". Clinical Microbiology Reviews. 35 (3): e0020021. doi:10.1128/cmr.00200-21. PMC 9491201. PMID 35262370.
  67. ^ Zimmer C, Wu KJ, Corum J (16 July 2020). "Coronavirus Drug and Treatment Tracker". The New York Times. Archived from the original on 20 January 2021. Retrieved 3 November 2021.
  68. ^ Siemieniuk RA, Bartoszko JJ, Ge L, Zeraatkar D, Izcovich A, Kum E, et al. (July 2020). "Drug treatments for covid-19: living systematic review and network meta-analysis". BMJ. 370: m2980. doi:10.1136/bmj.m2980. PMC 7390912. PMID 32732190.
  69. ^ "Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Monoclonal Antibody Bamlanivimab". U.S. Food and Drug Administration (FDA) (Press release). 16 April 2021. Archived from the original on 16 April 2021. Retrieved 16 April 2021. Public Domain This article incorporates text from this source, which is in the public domain.
  70. ^ Abdool Karim SS, Devnarain N (August 2022). "Time to Stop Using Ineffective Covid-19 Drugs". The New England Journal of Medicine. 387 (7): 654–655. doi:10.1056/NEJMe2209017. PMID 36070715. S2CID 251658284.
  71. ^ Flumignan RL, Civile VT, Tinôco JD, Pascoal PI, Areias LL, Matar CF, et al. (March 2022). "Anticoagulants for people hospitalised with COVID-19". The Cochrane Database of Systematic Reviews. 2022 (3): CD013739. doi:10.1002/14651858.CD013739.pub2. PMC 8895460. PMID 35244208.
  72. ^ "Overview of novel coronavirus (2019-nCoV)—Summary of relevant conditions". The BMJ. Archived from the original on 31 January 2020. Retrieved 1 February 2020.
  73. ^ a b c Murthy S, Gomersall CD, Fowler RA (April 2020). "Care for Critically Ill Patients With COVID-19". JAMA. 323 (15): 1499–1500. doi:10.1001/jama.2020.3633. PMID 32159735. Archived from the original on 18 March 2020. Retrieved 18 March 2020.
  74. ^ "Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected" (PDF). World Health Organization (WHO). 28 January 2020. Archived (PDF) from the original on 26 February 2020. Retrieved 18 March 2020.
  75. ^ a b c d Santa Cruz R, Villarejo F, Irrazabal C, Ciapponi A (March 2021). "High versus low positive end-expiratory pressure (PEEP) levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome". The Cochrane Database of Systematic Reviews. 2021 (3): CD009098. doi:10.1002/14651858.CD009098.pub3. PMC 8094163. PMID 33784416.
  76. ^ Matthay MA, Aldrich JM, Gotts JE (May 2020). "Treatment for severe acute respiratory distress syndrome from COVID-19". The Lancet. Respiratory Medicine. 8 (5): 433–434. doi:10.1016/S2213-2600(20)30127-2. PMC 7118607. PMID 32203709.
  77. ^ Diaz R, Heller D (2020). "Barotrauma And Mechanical Ventilation". StatPearls. StatPearls Publishing. PMID 31424810. Archived from the original on 11 October 2020. Retrieved 1 June 2020.
  78. ^ Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. (March 2010). "Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis". JAMA. 303 (9): 865–873. doi:10.1001/jama.2010.218. PMID 20197533.
  79. ^ a b Hohmann F, Wedekind L, Grundeis F, Dickel S, Frank J, Golinski M, et al. (June 2022). "Early spontaneous breathing for acute respiratory distress syndrome in individuals with COVID-19". The Cochrane Database of Systematic Reviews. 2022 (6): CD015077. doi:10.1002/14651858.CD015077. PMC 9242537. PMID 35767435.
  80. ^ McEnery T, Gough C, Costello RW (April 2020). "COVID-19: Respiratory support outside the intensive care unit". The Lancet. Respiratory Medicine. 8 (6): 538–539. doi:10.1016/S2213-2600(20)30176-4. PMC 7146718. PMID 32278367.
  81. ^ Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. (May 2020). "Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)". Intensive Care Med (Clinical practice guideline). 46 (5): 854–887. doi:10.1007/s00134-020-06022-5. PMC 7101866. PMID 32222812.
  82. ^ "Extracorporeal Life Support Organization - ECMO and ECLS > Registry > Statistics > International Summary". www.elso.org. Archived from the original on 23 September 2020. Retrieved 28 September 2020.
  83. ^ Henry BM, Lippi G (August 2020). "Poor survival with extracorporeal membrane oxygenation in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19): Pooled analysis of early reports". Journal of Critical Care. 58: 27–8. doi:10.1016/j.jcrc.2020.03.011. PMC 7118619. PMID 32279018.
  84. ^ Combes A, Hajage D, Capellier G, Demoule A, Lavoué S, Guervilly C, et al. (May 2018). "Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome". New England Journal of Medicine. 378 (21): 1965–75. doi:10.1056/NEJMoa1800385. PMID 29791822. S2CID 44106489.
  85. ^ Bartlett RH, Ogino MT, Brodie D, McMullan DM, Lorusso R, MacLaren G, et al. (May 2020). "Initial ELSO Guidance Document: ECMO for COVID-19 Patients with Severe Cardiopulmonary Failure". ASAIO Journal. 66 (5): 472–4. doi:10.1097/MAT.0000000000001173. PMC 7273858. PMID 32243267.
  86. ^ Shekar K, Badulak J, Peek G, Boeken U, Dalton HJ, Arora L, et al. (July 2020). "Extracorporeal Life Support Organization Coronavirus Disease 2019 Interim Guidelines: A Consensus Document from an International Group of Interdisciplinary Extracorporeal Membrane Oxygenation Providers". ASAIO Journal. 66 (7): 707–21. doi:10.1097/MAT.0000000000001193. PMC 7228451. PMID 32358233.
  87. ^ Ramanathan K, Antognini D, Combes A, Paden M, Zakhary B, Ogino M, et al. (May 2020). "Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases". The Lancet Respiratory Medicine. 8 (5): 518–26. doi:10.1016/s2213-2600(20)30121-1. PMC 7102637. PMID 32203711.
  88. ^ Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. (March 2020). "Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed". The Lancet. Psychiatry. 7 (3): 228–229. doi:10.1016/S2215-0366(20)30046-8. PMC 7128153. PMID 32032543.
  89. ^ Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. (March 2020). "The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus". The Lancet. Psychiatry. 7 (3): e14. doi:10.1016/S2215-0366(20)30047-X. PMC 7129673. PMID 32035030.
  90. ^ "Inter-Agency Standing Committee Guidelines on Mental Health and Psychosocial support" (PDF). MH Innovation. Archived (PDF) from the original on 31 March 2020. Retrieved 28 March 2020.
  91. ^ Roxby P (16 April 2020). "Coronavirus: 'Profound' mental health impact prompts calls for urgent research". BBC. Archived from the original on 11 October 2020.
  92. ^ Holmes EA, O'Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, et al. (June 2020). "Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science". The Lancet. Psychiatry. 7 (6): 547–560. doi:10.1016/S2215-0366(20)30168-1. PMC 7159850. PMID 32304649. "A fragmented research response, characterised by small-scale and localised initiatives, will not yield the clear insights necessary to guide policymakers or the public
  93. ^ "Patients taking ACE-i and ARBs who contract COVID-19 should continue treatment, unless otherwise advised by their physician". Archived from the original on 21 March 2020. Retrieved 21 March 2020.
  94. ^ "Patients taking ACE-i and ARBs who contract COVID-19 should continue treatment, unless otherwise advised by their physician". American Heart Association (Press release). 17 March 2020. Archived from the original on 24 March 2020. Retrieved 25 March 2020.
  95. ^ de Simone G. "Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers". Council on Hypertension of the European Society of Cardiology. Archived from the original on 24 March 2020. Retrieved 24 March 2020.
  96. ^ "New Evidence Concerning Safety of ACE Inhibitors, ARBs in COVID-19". Pharmacy Times. 28 April 2020. Archived from the original on 11 October 2020. Retrieved 2 May 2020.
  97. ^ "FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19". U.S. Food and Drug Administration (FDA). 19 March 2020. Archived from the original on 27 March 2020. Retrieved 27 March 2020.
  98. ^ Tripathi S, Gogia A, Kakar A (September 2020). "COVID-19 in pregnancy: A review". Journal of Family Medicine and Primary Care. 9 (9): 4536–4540. doi:10.4103/jfmpc.jfmpc_714_20. PMC 7652131. PMID 33209759.
  99. ^ McKie R (27 March 2022). "Patients with Covid and flu double the risk of dying, say scientists". The Guardian. Archived from the original on 27 March 2022.
  100. ^ Ferguson NM, Laydon D, Nedjati-Gilani G, Imai N, Ainslie K, Baguelin M (16 March 2020). Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand (Report). Imperial College London. Table 1. doi:10.25561/77482. hdl:20.1000/100.
  101. ^ a b Scott D (16 March 2020). "Coronavirus is exposing all of the weaknesses in the US health system High health care costs and low medical capacity made the US uniquely vulnerable to the coronavirus". Vox. Archived from the original on 18 March 2020. Retrieved 18 March 2020.
  102. ^ "Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19)". U.S. Centers for Disease Control and Prevention (CDC). 6 April 2020. Archived from the original on 2 March 2020. Retrieved 19 April 2020.
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Treatment guidelines

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