COVID-19 Treatment algorithm focused on early identification of risk factors
Main Article Content
Keywords
Algorithms, Coronavirus, Therapeutics, Risk Factors, Clinical Protocols, Algorithms
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the respiratory disease called COVID-19 and of the state of global health emergency. Currently, there is no specific treatment or sufficient scientific information to generate consensus or unique international guidelines on how to treat COVID-19. It is suggested that adapting the actions of evaluation, monitoring and treatment of patients with COVID-19, focused on the knowledge of the pathophysiology of the disease and on the known risk factors, could improve the presentation of adverse outcomes in patients. In this work, a flow chart of care and treatment for the patient with COVID-19 during hospitalization is presented, focused on the identification of the stage of the disease, constant reassessment with emphasis on the early identification of poor prognosis factors and treatment proposals according to current guidelines.
References
1. Helmy A, Fawzy M, Elaswad A, Sobieh A, Kenney S, Shehata A. The COVID-19 Pandemic:A Comprehensive Review of Taxonomy, Genetics, Epidemiology, Diagnosis, Treatment, and Control. J Clin Med. 2020;1225(9). doi:10.3390/jcm9041225
2. World Health Organization. Clinical management of COVID-19. Interim guidance. Última actualización 27 de mayo de2020. [Internet, consultado el 22 julio 2020]. Disponible en:https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance-publications
3. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health [Internet]. Última actualización 17 de julio de 2020 [consultado el 22 julio 2020]. Disponible en:https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/
4. Zheng C, Wang J, Guo H, Lu Z, Ma Y, Zhu Y, et al. Risk-adapted Treatment Strategy For COVID-19 Patients. Int J Infect Dis. 2020;94:74-77. doi:10.1016/j.ijid.2020.03.047
5. Galluccio F, Ergonenc T, Garcia A, Ei-Sayed A, Pérez M, Aguilar R. Treatment algorithm for COVID-19:a multidisciplinary point of view. Clin Rheumatol. 2020. doi:10.1007/s10067-020-05179-0
6. Gandhi R, Lynch J, Del Río C. Mild or Moderate Covid-19. N Engl J Med 2020;10.1056/NEJMcp2009249. doi:10.1056/NEJMcp2009249
7. Berlin D, Gulick R, Martinez F. Severe Covid-19. N Engl J Med 2020;10.1056/NEJMcp2009575. doi:10.1056/NEJMcp2009575
8. Instituto Mexicano del Seguro Social. Algoritmos internos para atención del COVID-19. Ciudad de México:IMSS;25 de junio de 2020 [consultado el 22 julio 2020]. Disponible en:http://educacionensalud.imss.gob.mx/es/coronavirus/algoritmos
9. Zhou F, Yu T, Ronghui D, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China:a retrospective cohort study. Lancet. 2020;395:1054-62.
10. Bikdeli B, Madhavan M, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al. COVID-19 and Thrombotic or Thromboembolic Disease:Implications for Prevention, Antithrombotic Therapy, an Follow-up. J Am Coll Cardiol. 2020;75(23):2950-73.
11. Boukhris M, Hillani A, Moroni F, Salah M, Addad F, Harada-Ribeiro M, et al. Cardiovascular implications of the COVID-19 pandemic:a global perspective. Can J Cardiol. 2020. DOI:10.1016/j.cjca.2020.05.018
12. Wang D, Yin Y, Hu C, Liu X, Zhang X, Zhou S, et al. Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China. Critical Care. 2020;24:188.
13. Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol 2020;S0091-6749(20)30495-4. doi:10.1016/j.jaci.2020.04.006
14. Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, et al. Association Between Hypoxemia and Mortality in Patients With COVID-19. Mayo Clin Proc. 2020;95(6):1138-1147. doi:10.1016/j.mayocp.2020.04.006
15. Chen J, Qi T, Liu L, Ling Y, Qian Z, Li T, et al. Clinical progression of patients with COVID-19 in Shanghai, China. Journal of Infection 2020;80:e1–e6. doi:10.1016/j.jinf.2020.03.004
16. Chen G, Zhao J, Ning Q. Clinical and immunologic features in severe and moderate Coronavirus Disease2019. J Clin Invest2020. doi:10.1172/JCI137244
17. Buckner F, McCulloch D, Atluri V, Blain M, McGuffin S, Nalla A, et al. Clinical Features and Outcomes of 105 Hospitalized patients with COVID-19 in Seattle, Washington. doi:10.1093/cid/ciaa632/5842263.
18. Sun X, Wang T, Cai D, Hu Z, Chen J, Liao H, et al. Cytokine storm intervention in the early stages of COVID-19 pneumonia. Cytokine and Growth Factor Reviews. 09 abril2020. doi:10.1016/j.cytogfr.2020.04.002
19. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in whuan, China. JAMA Intern Med. 2020;e200994.
20. Kermali M, Kaur R, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19 –A systematic review. Life Sciences. 2020. doi:10.1016/j.lfs.2020.117788.20
21. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020:ciaa248. doi:10.1093/cid/ciaa248
22. Lagunas F. Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19):A meta-analysis. J Med Virol. 2020;1-2. doi:10.1002/jmv.25819
23. Liu Y, Du X, Chen J, Jin Y, Peng L, Wang H, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. Journal of Infection. 2020;17:28. doi:10.1016/j.jinf.2020.04.002
24. Liu J, Li S, Liu J, Liang B, Wang X, Wang H, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. EBioMedicine. 2020;55:102763. doi:10.1016/j.ebiom.2020.102763
25. Mehta P, McAuley D, Brown M, Sanchez E, Tattersall R, et al. COVID-19:Consider Cytokine Storm Syndromes and Immunosuppression. Lancet. 2020;395(10229):1033-4. doi:10.1016/S0140-6736(20)30628-0
26. Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The Clinical and Chest CT Features Associated With Severe and Critical COVID-19 Pneumonia. Invest Radiol. 2020;55:00–00). doi:10.1097/RLI.0000000000000672
27. Ji D, Zhang D, Xu J, Chen Z, Yang T, Zhao P, et al. Prediction for Progression Risk in Patients with COVID-19 Pneumonia:The CALL Score. Clinical Infectious Diseases. 2020;71(6):1393-99. doi:10.1093/cid/ciaa414
28. Mejia-Vilet JM, Cordova-Sanchez BM, Fernández-Camargo D, Medez-Perez RA, Morales-Buenrostro LE, Hernandez-Gilsoul T. A Risk Score to Predict Admission to Intensive Care Unit in Patients With COVID-19:The ABC-GOALS Score. medRxiv. 2020. doi:10.1101/2020.05.12.20099416
29. Bhimraj A, Morgan R, Hirsch A, Lavergne V, Baden L, Chi-Chung V, et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Version 1.0.4 [consultado el 22 de julio de 2020]. Disponible en https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management
30. The RECOVERY Collaborative Group. Dexamethasone in Hospitalized Patients with COVID-19 –Preliminary Report. N Engl J Med. 2020. doi:10.1056/NEJMoa2021436.
31. Beigel J, Tomashek K, Dodd L, Mehta A, Zingman B, Kalil A, et al. Remdesivir for the treatment of Covid-19 —preliminary report. N Engl J Med2020. doi:10.1056/NEJMoa2007764
32. Piantoni S, Patroni A, Toniati P, Furloni R, Franceschini F, Andreoli L, et al. Why not to use colchicine in COVID-19?An old anti-inflammatory drug for a novel auto-inflammatory disease. Rheumatology (Oxford). 2020;keaa217. doi:10.1093/rheumatology/keaa217
33. Montealegre-Gomez G, Garavito E, Gómez A, Rojas A, Parra R. Colchicina:una herramienta terapeutica potencial frente a COVID-19. Experiencia en 5 pacientes. Reumatología Clínica2020. doi:10.1016/j.reuma.2020.05.001
34. Deftereos S, Giannopoulos G, Vrachatis D, Siasos G, Giotaki S, et al. Effect of Colchicine vs Standard Care on Cardiac and Inflammatory Biomarkers and Clinical Outcomes in Patients Hospitalized With Coronavirus Disease2019. The GRECCO-19 Randomized Clinical Trial. Jama Netw Open 2020;3(6):e2013136. doi:10.101/jamanetworkopen.2020.13136.
35. European Centre for Disease Prevention and Control. Technical Report. Novel coronavirus (SARS-CoV-2). Discharge criteria for confirmed COVID-19 cases –When is it safe to discharge COVID-19 cases from the hospital or end home isolation?
Article Sidebar
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.