Zusammenfassung
Der Übersichtsartikel ist als praktische Handreichung für alle gedacht, die COVID-19-Patienten
behandeln bzw. in nächster Zeit behandeln werden, und fasst das derzeit verfügbare
Wissen zu Diagnostik und Therapie zusammen. Zusätzlich werden auch neue und experimentelle
Therapien bewertet, soweit dazu zumindest Einzelfallberichte vorliegen.
Abstract
COVID-19, a new viral disease affecting primarily the respiratory system and the lung,
has caused a pandemic with serious challenges to health systems around the world.
In about 20% of patients, severe symptoms occur after a mean incubation period of
5 – 6 days; 5% of patients need intensive care therapy. Morbidity is about 1 – 2%.
Protecting health care workers is of paramount importance in order to prevent hospital
acquired infections. Therefore, during all procedures associated with aerosol production,
a personal safety equipment consisting of a FFP2/FFP3 (N95) respiratory mask, gloves,
safety glasses and a waterproof overall should be used. Therapy is based on established
recommendations issued for patients with acute lung injury (ARDS). Lung protective
ventilation, prone position, restrictive fluid management and an adequate management
of organ failures are the mainstays of therapy. In case of fulminant lung failure,
veno-venous extracorporeal membrane oxygenation may be used as a rescue in experienced
centres. New, experimental therapies evolve with ever increasing frequency; currently,
however, there is no evidence based recommendation possible. If off-label and compassionate
use of these drugs is considered, an individual benefit-risk assessment is necessary,
since serious side effects have been reported.
Schlüsselwörter
SARS CoV-2 - COVID-19 - Intensivtherapie - ARDS - akutes Lungenversagen - persönliche
Schutzausrüstung - FFP3
Key words
SARS CoV-2 - COVID-19 - critical care - adult respiratory distress syndrome - acute
lung injury - personal protection equipment - N95 respiratory masks
