Clinical management of COVID-19

• Published in: Indian journal of medical research (New Delhi, India : 1994) Vol. 151; no. 5; pp. 401 - 410
• Main Authors: Varghese, George, John, Rebecca, Manesh, Abi, Karthik, Rajiv, Abraham, O
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.05.2020; Medknow Publications and Media Pvt. Ltd; Scientific Scholar; Wolters Kluwer - Medknow
• Subjects: Adenosine Monophosphate - analogs & derivatives; Adenosine Monophosphate - therapeutic use; Adrenal Cortex Hormones - therapeutic use; Airway Management; Alanine - analogs & derivatives; Alanine - therapeutic use; Angiotensin II; Antibodies, Monoclonal, Humanized - therapeutic use; Antimalarials - therapeutic use; Antiviral Agents - therapeutic use; Bacterial infections; Betacoronavirus; Comorbidity; Coronavirus Infections - diagnosis; Coronavirus Infections - therapy; Coronaviruses; COVID-19; COVID-19 Serotherapy; Critical Illness; Cross infection; Diagnostic tests; Disease transmission; Fatalities; Health aspects; Hospitals; Humans; Hydroxychloroquine - therapeutic use; Illnesses; Immunization, Passive; Infection control; Infections; Intensive care; Laboratories; Pandemics; Patient Acuity; Patients; Pneumonia; Pneumonia, Viral - diagnosis; Pneumonia, Viral - therapy; Population; Review; RNA polymerase; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Shock - therapy; Specimen Handling; Symptom Assessment; Vulnerable Populations; China; Clinical management - corticosteroids - COVID-19 - hydroxychloroquine - lopinavir - remdesivir - risk groups - SARS-CoV-2
• ISSN: 0971-5916; 0975-9174
• DOI: 10.4103/ijmr.IJMR_957_20

The novel coronavirus disease 2019 (COVID-19) with its early origin from Wuhan city in China has evolved into a global pandemic. Maximal precautionary measures and resources have been put forward by most nations in war footing to mitigate transmission and decrease fatality rates. This article was aimed to review the evidence on clinical management and to deal with the identification of high-risk groups, warning signs, appropriate investigations, proper sample collection for confirmation, general and specific treatment measures, strategies as well as infection control in the healthcare settings. Advanced age, cardiovascular disease, diabetes, hypertension and cancer have been found to be the risk factors for severe disease. Fever lasting for >five days with tachypnoea, tachycardia or hypotension are indications for urgent attention and hospitalization in a patient with suspected COVID-19. At present, reverse transcription-polymerase chain reaction (RT-PCR) from the upper respiratory tract samples is the diagnostic test of choice. While many drugs have shown in vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there are insufficient clinical data to promote or dissuade their usage. Among the currently available drugs, hydroxychloroquine and lopinavir/ritonavir may be considered for patients with severe COVID-19 infection, awaiting further clinical trials. Stringent droplet and contact precautions will protect healthcare workers against most clinical exposures to COVID-19.