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Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
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COVID-19: Opportunities to Improve Prognosis
S N Avdeev1,2
1Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Herald of the Russian Academy of Sciences
|September 12, 2022
Summary
Severe COVID-19 requires intensive care. Noninvasive ventilation (NIV) and prone positioning are effective respiratory support methods, reducing mechanical ventilation needs and improving outcomes for critical patients.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Infectious Diseases
Background:
- Severe COVID-19 impacts 5-10% of patients, often requiring intensive care and mechanical ventilation, carrying a high mortality risk.
- Noninvasive ventilation (NIV) is a widely adopted respiratory support method for severe COVID-19 patients in clinical practice.
- The COVID-19 pandemic accelerated the use of prone positioning for non-intubated patients with acute respiratory failure.
Purpose of the Study:
- To review the effectiveness of noninvasive ventilation (NIV) and prone positioning in managing severe COVID-19 patients.
- To summarize current therapeutic strategies for severe COVID-19, including established and emerging drug therapies.
- To highlight the role of respiratory support in reducing mortality and the need for mechanical ventilation.
Main Methods:
- Literature review of studies on noninvasive ventilation (NIV) for hypoxemic acute respiratory failure in COVID-19.
- Analysis of research on the impact of prone positioning on mechanical ventilation rates and mortality.
- Summary of evidence for pharmacological interventions in severe COVID-19.
Main Results:
- Studies indicate NIV use in COVID-19 acute respiratory failure shows a 20-30% average need for tracheal intubation and hospital mortality, suggesting significant efficacy.
- Prone positioning has demonstrated potential in reducing mechanical ventilation requirements and hospital mortality among non-intubated COVID-19 patients.
- Effective medications for severe COVID-19 include remdesivir, systemic glucocorticoids, tocilizumab, baricitinib, and anticoagulants, with N-acetylcysteine, inhaled surfactant, and prostacyclin analogues showing promise.
Conclusions:
- Noninvasive ventilation (NIV) and prone positioning are valuable strategies for managing severe COVID-19 respiratory failure.
- Established and novel pharmacological agents play a crucial role in treating severe COVID-19.
- These interventions collectively contribute to improved patient prognosis and reduced mortality in severe COVID-19 cases.
Keywords:
COVID-19N-acetylcysteineiloprostnoninvasive ventilationprognosisprone positionprostacyclinsurfactantMore Related Videos
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