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Review
. 2021 Dec;70(Suppl 1):1-10.
doi: 10.1007/s00101-020-00760-3.

Coronavirus disease 2019 (COVID-19): update for anesthesiologists and intensivists March 2020

D Thomas-Rüddel  1   2 , J Winning  1 , P Dickmann  1   2 , D Ouart  1   2 , A Kortgen  1 , U Janssens  3 , M Bauer  4   5
Affiliations
Review

Coronavirus disease 2019 (COVID-19): update for anesthesiologists and intensivists March 2020

D Thomas-Rüddel et al. Anaesthesist. 2021 Dec.

Abstract
in English, German

The current outbreak of coronavirus disease (COVID-19) has reached Germany. The majority of people infected present with mild disease, but there are severe cases that need intensive care. Unlike other acute infectious diseases progressing to sepsis, the severe courses of COVID19 seemingly show prolonged progression from onset of first symptoms to life-threatening deterioration of (primarily) lung function. Diagnosis relies on PCR using specimens from the respiratory tract. Severe ARDS reflects the hallmark of a critical course of the disease. Preventing nosocomial infections (primarily by correct use of personal protective equipment) and maintenance of hospitals' operational capability are of utmost importance. Departments of Anaesthesia, Intensive Care and emergency medicine will envisage major challenges.

Die neu aufgetretene Atemwegserkrankung „coronavirus disease 2019“ (COVID-19) hat Deutschland erreicht. Die Erkrankung verläuft in den meisten Fällen leicht, aber der kleinere Anteil an schwer Erkrankten wird stationär und auch intensivmedizinisch behandelt werden. Im Gegensatz zu anderen akuten Infektionskrankheiten zeigen die schweren Verläufe eine langsame Progredienz von den ersten Symptomen bis zur lebensbedrohlichen Verschlechterung. Die Diagnosestellung erfolgt mithilfe der Polymerase-Kettenreaktion (PCR) aus Proben des Respirationstrakts. Ein schweres „acute respiratory distress syndrome“ (ARDS) ist charakteristisch für die kritischen Verläufe. Der Vermeidung nosokomialer Infektionen, insbesondere durch korrekte Anwendung der Schutzausrüstung, und der Aufrechterhaltung des Krankenhausbetriebs kommen zentrale Bedeutung zu. Auch in der Anästhesie und Notfallmedizin ist mit erheblichen Herausforderungen zu rechnen.

Keywords: Anesthesiology; Emergency medicine; Infection control; Infectious disease outbreaks; Intensive care.

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Conflict of interest statement

D. Thomas-Rüddel, J. Winning, P. Dickmann, D. Ouart, A. Kortgen, U. Janssens and M. Bauer declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Mortality rate and contagiousness of selected viral infectious diseases compared to latest COVID-19 estimates. COVID-19 coronavirus disease 2019, MERS Middle East respiratory syndrome, SARS severe acute respiratory syndrome, R0 basic reproduction number (data from [–3])
Fig. 2
Fig. 2
Frequency of typical symptoms in patients (synopsis from [–11])
Fig. 3
Fig. 3
Frequency distribution of the degree of severity in the People’s Republic of China
Fig. 4
Fig. 4
Median chronological course of symptoms and interquartile range (IQR) estimated according to [–9, 11]. Hospital admission and dyspnea, acute respiratory distress syndrome (ARDS) and death on Intensive Care Unit (ICU) only in case of increasing severity
Fig. 5
Fig. 5
Typical changes in laboratory values and imaging findings (synopsis from [–12, 15])
Fig. 6
Fig. 6
Colleague in complete personal protection gear
Fig. 7
Fig. 7
Information sign for visitors and patients, distribution of mouth-nose protection to symptomatic persons
See this image and copyright information in PMC

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