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Review
. 2020 May 28;7(1):1761677.
doi: 10.1080/20018525.2020.1761677.

Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting

Klaus Nielsen Jeschke  1 , Barbara Bonnesen  2 , Ejvind Frausing Hansen  1 , Jens-Ulrik Stæhr Jensen  2 , Therese Sophie Lapperre  3 , Ulla Møller Weinreich  4 , Ole Hilberg  5
Affiliations
Review

Guideline for the management of COVID-19 patients during hospital admission in a non-intensive care setting

Klaus Nielsen Jeschke et al. Eur Clin Respir J. .

Abstract

Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has presented health-care systems worldwide with novel challenges and experiences and evidence is emerging during the pandemic. Patients requiring hospitalization frequently suffer from respiratory failure of different severities.

Aim: The aim of this guideline is the treatment of patients with SARS CoV-2 (COVID-19) in hospital; in particular, it addresses the treatment of respiratory failure treated in general Internal Medical- and Pulmonary Medical wards.

Results: Elderly patients and patients with chronic disease are particularly vulnerable to COVID-19. Target oxygen saturation should be between 92% and 96% in patients without chronic lung diseases. Treatment with >5 L oxygen/min should be in close collaboration with intensive care colleagues and >15 l/min preferably in intensive care units. High-flow nasal canula (HFNC) and long-term Continuous Positive Airway Pressure (CPAP) are recommended for patients not responding to conventional oxygen therapy. Non-invasive ventilation (NIV) is only recommended for selected patients, such as those with a ceiling of treatment or patients presenting with hypercapnic failure. With the use of humidification protective equipment as FFP2-3 masks should be used. Nebulized medication should be avoided, and spacers should be used instead.

Conclusion: Respiratory failure is frequently the cause of hospitalization in patients with COVID-19 and should be monitored closely.

Keywords: COVID-19; CPAP; Guideline; HFNC; NIV; SARS-CoV-2; corona virus; high Flow; hospital; oxygen.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Summary of Risk factors, symptoms, paraclinical findings, and complications in COVID-19; in red: Most frequent; in yellow: Less frequent.
Figure 2.
Figure 2.
Summary of diagnostic workup for hospitalized COVID-19 patients.
Figure 3.
Figure 3.
ROX-Score for evaluation of oxygen treatment of type 1 respiratory failure, treated with High-Flow treatment.
Figure 4.
Figure 4.
Closed system CPAP/NIV: Non-vented mask – filter – exhalation port – tube-filter ventilator.
None
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See this image and copyright information in PMC

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