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Review
. 2020;15(6):477-486.
doi: 10.1007/s11377-020-00478-z. Epub 2020 Oct 15.

[Treatment of severe COVID-19 courses in intensive care medicine]

[Article in German]
M Busch  1 , O Wiesner  2 , S David  3   4
Affiliations
Review

[Treatment of severe COVID-19 courses in intensive care medicine]

[Article in German]
M Busch et al. Gastroenterologe. 2020.

Abstract
in English, German

The pandemic triggered by coronavirus disease 2019 (COVID-19) has put intensive care medicine into the focus of public attention. The mortality of patients with the disease escalates, particularly at the moment when the treatment possibilities of intensive medical care end. In the routine intensive medical care practice, the challenges due to the special features of infections with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its treatment become obvious. These occur in the development and treatment of respiratory and multiorgan failure as well as the severe inflammatory syndrome. For these severe courses there is still only little evidence available as to which interventions are the most effective. In addition to the knowledge that can be gained from the rapid performance of clinical trials, the treatment is therefore based on analogies to other syndromes, such as sepsis and macrophage activation syndrome.

Die durch die „coronavirus disease 2019“ (COVID-19) ausgelöste Pandemie hat die Intensivmedizin in den Fokus der Öffentlichkeit gerückt. Die Sterblichkeit der Erkrankten eskaliert v. a. in dem Moment, in dem die intensivmedizinischen Versorgungsmöglichkeiten enden. In der täglichen intensivmedizinischen Praxis werden die Herausforderungen durch die Besonderheiten der Infektion mit dem „severe acute respiratory syndrome coronavirus 2“ (SARS-CoV-2) und ihrer Behandlung deutlich. Diese bestehen in der Entwicklung und Therapie von Lungen‑, Multiorganversagen sowie des schweren Inflammationssyndroms. Zu diesen schweren Verläufen ist noch wenig Evidenz darüber vorhanden, welche Interventionen am effektivsten sind. Neben Erkenntnissen, die aus der raschen Durchführung klinischer Studien gewonnen wurden, stützt sich die Behandlung daher auch auf Analogien zu anderen Syndromen wie der Sepsis und dem Makrophagenaktivierungssyndrom.

Keywords: Antiviral agents; Artificial respiration; Multiple organ failure; Respiratory failure; Systemic inflammatory response syndrome.

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