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A fast-tracked update: what we know about the active pandemic of the novel coronavirus (SARS-CoV-2) and its resulting respiratory syndrome, COVID-19.
Takeaway lessons
- Treat like viral pneumonia/ARDS. High PEEP. Prone early. Keep fluid balance dry.
- Probably avoid CPAP/BiPAP except perhaps for very short trials. Unclear role for HFNC.
- Watch out for myocarditis-type picture with cardiogenic shock and arrhythmias.
- Take isolation extremely seriously.
- Think about innovative ways to optimize patient flow.
- Take care of yourself and each other, and try to stay sane.
Resources
References
- NTEC PPE donning/doffing video: One of the better ones online.
- Pulmcrit COVID-10 chapter: Summary at the IBCC on the disease. Probably the best single summary. Kept fairly current by Josh Farkas.
- Summary of potential disease-specific therapies
- Letter to the editor on remdesivir and chloroquine
- Sampling of informal online reports:
- From Washington
- From Italy
- U of Washington residency
- Viral survival on surfaces , van Doremalen et al: 3 hours post aerosolization, up to 4 hours on copper, up to 24 hours on cardboard and up to 2-3 days on plastic and stainless steel.