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How We Have Treated Severe to Critically Ill Patients With Coronavirus Disease 2019 in Korea
Do Hyeon Park1, Chang Kyung Kang1, Pyoeng Gyun Choe1
1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Insights
COVID-19 treatment guidelines in South Korea evolved significantly, focusing on severe cases. Dexamethasone is the primary treatment, with other antivirals and therapies used as needed for critical patients.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Public Health Policy
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, necessitated rapid development of effective treatment strategies.
- Severe to critical COVID-19 cases present high mortality risks, demanding specialized therapeutic approaches.
- Treatment guidelines have undergone continuous evolution, adapting to new research and regional healthcare conditions.
Purpose of the Study:
- To review and summarize the evolution of COVID-19 treatment guidelines in the Republic of Korea over three years.
- To reflect on the clinical experiences in managing severe to critically ill COVID-19 patients.
- To highlight the current established treatment protocols based on international and national updates.
Main Methods:
- Analysis of updated Korean COVID-19 treatment guidelines, reflecting changes in National Institutes of Health (NIH) recommendations.
- Review of clinical practices for severe and critical COVID-19 patients.
- Synthesis of evidence-based treatment strategies implemented in the Republic of Korea.
Main Results:
- Dexamethasone is established as the cornerstone therapy for severe to critical COVID-19.
- Antiviral agents like remdesivir, baricitinib, and tocilizumab are utilized as add-on therapies based on patient status.
- Venous thromboembolism prophylaxis is recognized as a crucial adjunctive treatment for severe COVID-19.
Conclusions:
- Korean COVID-19 treatment guidelines have been dynamically updated, aligning with global advancements.
- Current guidelines provide a robust framework for managing severe to critical COVID-19 patients.
- Standardized treatment protocols ensure consistent and effective care delivery by healthcare professionals.
Abstract:
Since 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, and the coronavirus disease 2019 (COVID-19) pandemic currently continues. In response to this unprecedented pandemic, several researchers and medical staff have struggled to find appropriate treatments for COVID-19. Patients with mild symptoms can recuperate with symptomatic care, however establishing treatment for severe to critically ill patients who can have a high mortality has been essential. Accordingly, the guidelines for COVID-19 treatment have evolved through numerous trials and errors and have been relatively well established to date. In the Republic of Korea, several evidence-based guidelines for COVID-19 treatment were released and revised, reflecting various research and regional medical conditions. To date, approximately 3 years after the beginning of the COVID-19 pandemic, we are reflecting on the changes in the guidelines thus far and have summarized the treatment experience of severe to critically ill patients with COVID-19. The Korean guidelines for COVID-19 treatment have been updated continuously as the National Institutes of Health (NIH) guidelines have changed. Dexamethasone is currently used as the backbone for the treatment of severe to critically ill patients with COVID-19, and remdesivir, baricitinib, and tocilizumab can be added depending on a patient's situation. In addition, venous thromboembolism prophylaxis is one of the important adjunctive therapies for patients with severe COVID-19. In the clinical field, treatment of severely ill patients with COVID-19 based on guidelines is widely practiced by medical staff and established currently.
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