Describe the supportive care.
Intravenous fluid therapy as needed
Antipyretics and analgesia
Antitussives
Describe the oxygen therapy.
Goal: Maintain SpO2 levels between 92–96% (≥ 95% in pregnant individuals).
High flow nasal cannula (HFNC)
hypoxemic respiratory failure despite the use of basic oxygen delivery systems
Persistent hypoxemia despite HFNC (and no indications for invasive mechanical ventilation): Consider a trial of awake prone positioning to improve oxygenation.
Mechanical ventilation
See “Indications for invasive mechanical ventilation.”
Recommended ventilator settings for patients with COVID-19 and ARDS:
Tidal volume 4–8 mL/kg of predicted body weight
Plateau pressure < 30 cm H2O
Ventilation in the prone position for 12–16 hours/day
High PEEP
Pharmacotherapy regimens (table).
Medication classes (table).
When is a antithrombotic therapy indicated?
Antithrombotic therapy is recommended in all hospitalized patients with COVID-19 unless there are contraindications for anticoagulation.
Describe the postdischarge management.
All patients
Stop antithrombotic therapy at the time of discharge unless the patient has a VTE.
Supplemental O2 no longer required: Discontinue remdesivir, corticosteroids, and JAK inhibitors at the time of discharge.
Continued requirement of supplemental O2 at discharge: Arrange for home oxygen monitoring.
List complications.
Thromboembolic events (e.g., ischemic stroke, pulmonary embolism)
Hypoxemic respiratory failure
ARDS
Septic shock
Cardiac disease (e.g., ischemic heart disease, heart failure)
Arrhythmias
Acute kidney injury
Multisystem inflammatory syndrome in children
Postacute COVID-19 syndrome (“long COVID”) [66]
Refers to symptoms persisting > 4 weeks after confirmed or suspected COVID-19
Last changed2 years ago
