Subject(s)
COVID-19 Drug Treatment , Adrenal Cortex Hormones/therapeutic use , Dexamethasone , Humans , SARS-CoV-2ABSTRACT
The diagnosis of pneumonia is both simple and complex. Recent research is challenging our concept of pneumonia and radiological gold standards that have underpinned research for decades. In particular, the accuracy of chest radiographs in diagnosing pneumonia is now highly questionable when compared with computed tomography scans. Depending on the question being asked, pneumonia can be defined in clinical, pathological, radiological, or microbiological contexts, or frequently a combination of all of these. However, while the field is changing, until we have new studies defining pneumonia in new ways, clinicians can be reassured that existing guidelines based on "old" standards remain as valid as they have always been.
Subject(s)
Anti-Bacterial Agents , COVID-19 , Anti-Bacterial Agents/therapeutic use , Bacteria , Humans , SARS-CoV-2ABSTRACT
Community-acquired pneumonia (CAP) remains one of the most frequent causes of death worldwide, and the most common infection requiring hospitalization. Worldwide CAP is the leading infectious disease cause of death and the fourth leading cause of death overall and the leading cause of death in children. While most of the literature on CAP is on patients who become ill enough to require admission to hospital, less severe disease that is treated in the outpatient setting is also exceptionally common.
Subject(s)
COVID-19/prevention & control , Communicable Disease Control , Community-Acquired Infections/prevention & control , Health Behavior , Influenza, Human/prevention & control , Masks , Picornaviridae Infections/prevention & control , Pneumonia, Viral/prevention & control , Respiratory Tract Infections/prevention & control , Disease Progression , Hand Disinfection , Humans , Physical Distancing , Pulmonary Disease, Chronic Obstructive , Rhinovirus , SARS-CoV-2ABSTRACT
The 2020 International Web Scientific Event in COVID-19 pandemic in critically ill patients aimed at updating the information and knowledge on the COVID-19 pandemic in the intensive care unit. Experts reviewed the latest literature relating to the COVID-19 pandemic in critically ill patients, such as epidemiology, pathophysiology, phenotypes of infection, COVID-19 as a systematic infection, molecular diagnosis, mechanical ventilation, thromboprophylaxis, COVID-19 associated co-infections, immunotherapy, plasma treatment, catheter-related bloodstream infections, artificial intelligence for COVID-19, and vaccination. Antiviral therapy and co-infections are out of the scope of this review. In this review, each of these issues is discussed with key messages regarding management and further research being presented after a brief review of available evidence.
Subject(s)
COVID-19 , Congresses as Topic , Intensive Care Units , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19/therapy , COVID-19 Nucleic Acid Testing/methods , COVID-19 Vaccines , Global Health/statistics & numerical data , Humans , Immunization, Passive/methods , Immunotherapy/methods , Pandemics , Phenotype , Symptom Assessment , Thromboembolism/prevention & control , Videoconferencing , Virus Internalization , COVID-19 SerotherapyABSTRACT
PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID-19) has produced an extraordinary amount of literature in a short time period. This review focuses on what the new literature has provided in terms of more general information about the management of community-acquired pneumonia (CAP). RECENT FINDINGS: Measures taken to reduce the spread of COVID-19 have caused a significant drop in influenza worldwide. Improvements in imaging, especially ultrasound, and especially in the application of rapid molecular diagnosis are likely to have significant impact on the management of CAP. Therapeutic advances are so far limited. SUMMARY: COVID-19 has taught us that we can do far more to prevent seasonal influenza and its associated mortality, morbidity and economic cost. Improvements in imaging and pathogen diagnosis are welcome, as is the potential for secondary benefits of anti-COVID-19 therapies that may have reach effect on respiratory viruses other than severe acute respiratory syndrome coronavirus 2. As community-transmission is likely to persist for many years, recognition and treatment of severe acute respiratory syndrome coronavirus 2 will need to be incorporated into CAP guidelines moving forward.
Subject(s)
COVID-19/diagnosis , COVID-19/prevention & control , COVID-19/epidemiology , COVID-19/therapy , Clinical Laboratory Techniques , Community-Acquired Infections/diagnosis , Community-Acquired Infections/prevention & control , Community-Acquired Infections/therapy , Diagnostic Imaging , Humans , Infection Control , Pneumonia/diagnosis , Pneumonia/prevention & control , Pneumonia/therapy , SARS-CoV-2Subject(s)
Adrenal Cortex Hormones/therapeutic use , COVID-19 Drug Treatment , Immunologic Factors/therapeutic use , SARS-CoV-2 , Steroids/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Community-Acquired Infections/drug therapy , Dexamethasone/therapeutic use , Humans , Hydrocortisone/therapeutic use , Interleukin-6/antagonists & inhibitors , Randomized Controlled Trials as Topic , Respiratory Distress Syndrome/drug therapyABSTRACT
COVID-19 is a new infectious disease causing severe respiratory failure and death for which optimal treatment is currently unclear. Many therapies have been proven to be ineffective; however, promising findings related to corticosteroid therapy have been published. Analysis of published data including in this issue suggests that therapy with corticosteroids in the range of 6 mg of dexamethasone (or equivalent) per day likely has a positive effect in patients requiring mechanical ventilation but there remains considerable doubt in patients over the age of 70, in patients with diabetes and patients with milder disease. Clinicians must consider the individual potential risks and benefits of corticosteroid in patients with COVID-19 rather than routinely using them until more data is available.