CC BY-NC-ND 4.0 · Journal of Cardiac Critical Care TSS 2022; 06(03): 210-215
DOI: 10.1055/s-0042-1759862
Review Article

COVID 19: Airway Management and Pharmacological Strategies

Sonal Chandra
1   Anaesthesia and Critical care VMMC and Safdarjung Hospital, New Delhi, India
,
Aditi Narang
1   Anaesthesia and Critical care VMMC and Safdarjung Hospital, New Delhi, India
,
Pratiti Choudhuri
1   Anaesthesia and Critical care VMMC and Safdarjung Hospital, New Delhi, India
,
Kapil Gupta
1   Anaesthesia and Critical care VMMC and Safdarjung Hospital, New Delhi, India
› Author Affiliations

Abstract

Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 has since resulted in more than 250 million cases worldwide and over 50 million deaths. Although treatment is mainly supportive, with oxygen therapy being the mainstay, various pharmacological treatment modalities have also been explored. In this review, we have evaluated the available evidence on airway management as well as medical management and highlighted the possible interventions that may be effective in care of critically ill patients.



Publication History

Article published online:
03 December 2022

© 2022. Official Publication of The Simulation Society (TSS), accredited by International Society of Cardiovascular Ultrasound (ISCU). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Sungnak W, Huang N, Bécavin C. et al; HCA Lung Biological Network. SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med 2020; 26 (05) 681-687
  • 2 Letko M, Marzi A, Munster V. Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses. Nat Microbiol 2020; 5 (04) 562-569
  • 3 Kim KD, Zhao J, Auh S. et al. Adaptive immune cells temper initial innate responses. Nat Med 2007; 13 (10) 1248-1252
  • 4 Guan WJ, Ni ZY, Hu Y. et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382 (18) 1708-1720
  • 5 Zhou F, Yu T, Du R. 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 (10229): 1054-1062
  • 6 Kanne JP. Chest CT findings in 2019 novel coronavirus (2019-nCoV) infections from Wuhan, China: key points for the radiologist. Radiology 2020; 295 (01) 16-17
  • 7 Puelles VG, Lütgehetmann M, Lindenmeyer MT. et al. Multiorgan and renal tropism of SARS-CoV-2. N Engl J Med 2020; 383 (06) 590-592
  • 8 Cheng Y, Luo R, Wang K. et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020; 97 (05) 829-838
  • 9 Pei G, Zhang Z, Peng J. et al. Renal involvement and early prognosis in patients with COVID-19 pneumonia. J Am Soc Nephrol 2020; 31 (06) 1157-1165
  • 10 Clerkin KJ, Fried JA, Raikhelkar J. et al. Coronavirus disease 2019 (COVID-19) and cardiovascular disease. Circulation 2020; 141 (20) 1648-1655
  • 11 Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood 2020; 135 (23) 2033-2040
  • 12 Mao R, Qiu Y, He JS. et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2020; 5 (07) 667-678
  • 13 Lechien JR, Chiesa-Estomba CM, De Siati DR. et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol 2020; 277 (08) 2251-2261
  • 14 Li L, Li R, Wu Z. et al. Therapeutic strategies for critically ill patients with COVID-19. Ann Intensive Care 2020; 10 (01) 45
  • 15 Rochwerg B, Brochard L, Elliott MW. et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J 2017; 50 (02) 1602426
  • 16 Hui DS. Severe acute respiratory syndrome (SARS): lessons learnt in Hong Kong. J Thorac Dis 2013; 5 (Suppl. 02) S122-S126
  • 17 Hui DS, Chow BK, Chu L. et al. Exhaled air dispersion during coughing with and without wearing a surgical or N95 mask. PLoS One 2012; 7 (12) e50845
  • 18 Leung CCH, Joynt GM, Gomersall CD. et al. Comparison of high-flow nasal cannula versus oxygen face mask for environmental bacterial contamination in critically ill pneumonia patients: a randomized controlled crossover trial. J Hosp Infect 2019; 101 (01) 84-87
  • 19 Ip M, Tang JW, Hui DSC. et al. Airflow and droplet spreading around oxygen masks: a simulation model for infection control research. Am J Infect Control 2007; 35 (10) 684-689
  • 20 Zhong X, Tao X, Tang Y, Chen R. The outcomes of hyperbaric oxygen therapy to retrieve hypoxemia of severe novel coronavirus pneumonia: first case report. Zhonghua Hanghai Yixue yu Gaoqiya Yixue Zazhi 2020; 48: 10-300060520939824
  • 21 Ding L, Wang L, Ma W, He H. Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study. Crit Care 2020; 24 (01) 28
  • 22 Bamford P, Bentley A, Dean J, Whitmore D, Wilson-Baig N. ICS Guidance for Prone Positioning of the Conscious COVID Patient. London, UK: Intensive Care Society; 2020
  • 23 Guérin C, Reignier J, Richard J-C. et al; PROSEVA Study Group. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 2013; 368 (23) 2159-2168
  • 24 Amato MB, Meade MO, Slutsky AS. et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015; 372 (08) 747-755
  • 25 Munshi L, Walkey A, Goligher E, Pham T, Uleryk EM, Fan E. Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis. Lancet Respir Med 2019; 7 (02) 163-172
  • 26 Brodie D, Slutsky AS, Combes A. Extracorporeal life support for adults with respiratory failure and related indications: a review. JAMA 2019; 322 (06) 557-568
  • 27 Pravda NS, Pravda MS, Kornowski R, Orvin K. Extracorporeal membrane oxygenation therapy in the COVID-19 pandemic. Future Cardiol 2020; 16 (06) 543-546
  • 28 Savarimuthu S, BinSaeid J, Harky A. The role of ECMO in COVID-19: can it provide rescue therapy in those who are critically ill?. J Card Surg 2020; 35 (06) 1298-1301
  • 29 Yang X, Yu Y, Xu J. et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8 (05) 475-481
  • 30 Li X, Guo Z, Li B. et al. Extracorporeal membrane oxygenation for coronavirus disease 2019 in Shanghai, China. ASAIO J 2020; 66 (05) 475-481
  • 31 Henry BM, Lippi G. Poor survival with extracorporeal membrane oxygenation in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19): pooled analysis of early reports. J Crit Care 2020; 58: 27-28
  • 32 Zeng Y, Cai Z, Xianyu Y, Yang BX, Song T, Yan Q. Prognosis when using extracorporeal membrane oxygenation (ECMO) for critically ill COVID-19 patients in China: a retrospective case series. Crit Care 2020; 24 (01) 148
  • 33 Khan IH, Zahra SA, Zaim S, Harky A. At the heart of COVID-19. J Card Surg 2020; 35 (06) 1287-1294
  • 34 Agarwal A, Mukherjee A, Kumar G, Chatterjee P, Bhatnagar T, Malhotra P. PLACID Trial Collaborators. Convalescent plasma in the management of moderate covid-19 in adults in India: open label phase II multicentre randomised controlled trial (PLACID Trial). BMJ 2020; 371: m3939
  • 35 Grein J, Ohmagari N, Shin D. et al. Compassionate use of remdesivir for patients with severe Covid-19. N Engl J Med 2020; 382 (24) 2327-2336
  • 36 Rezagholizadeh A, Khiali S, Sarbakhsh P, Entezari-Maleki T. Remdesivir for treatment of COVID-19; an updated systematic review and meta-analysis. Eur J Pharmacol 2021; 897: 173926
  • 37 Wang Y, Zhang D, Du G. et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 2020; 395 (10236): 1569-1578
  • 38 Furuta Y, Komeno T, Nakamura T. Favipiravir (T-705), a broad spectrum inhibitor of viral RNA polymerase. Proc Jpn Acad, Ser B, Phys Biol Sci 2017; 93 (07) 449-463
  • 39 Cai Q, Yang M, Liu D. et al. Experimental treatment with favipiravir for COVID-19: an open-label control study. Engineering (Beijing) 2020; 6 (10) 1192-1198
  • 40 Shrestha DB, Budhathoki P, Khadka S, Shah PB, Pokharel N, Rashmi P. Favipiravir versus other antiviral or standard of care for COVID-19 treatment: a rapid systematic review and meta-analysis. Virol J 2020; 17 (01) 141
  • 41 Rajter JC, Sherman MS, Fatteh N, Vogel F, Sacks J, Rajter JJ. Use of ivermectin is associated with lower mortality in hospitalized patients with coronavirus disease 2019: the ivermectin in COVID nineteen study. Chest 2021; 159 (01) 85-92
  • 42 Bryant A, Lawrie TA, Dowswell T. et al. Ivermectin for prevention and treatment of COVID-19 infection: a systematic review, meta-analysis, and trial sequential analysis to inform clinical guidelines. Am J Ther 2021; 28 (04) e434-e460
  • 43 Popp M, Stegemann M, Metzendorf MI. et al. Ivermectin for preventing and treating COVID-19. Cochrane Database Syst Rev 2021; 7 (07) CD015017
  • 44 Jovic TH, Ali SR, Ibrahim N. et al. Could vitamins help in the fight against COVID-19?. Nutrients 2020; 12 (09) 2550