There are currently no recommended specific treatments for the group with
severe COVID-19. Therefore , supportive treatment is essential. Expedient recognition
and decisions for aggressive measures such as permanent control of the airway and
positive-pressure ventilation, along with CST and t-PA administration, should be
evaluated using certain selection criteria. Prone position is mostly associated with more
favorable outcomes than supine position in the resuscitation of selected cases. Shock is
also a catastrophic event that should be recognized and managed as early as possible
for favorable outcomes. If the mean arterial pressure (MAP) cannot be kept above 65
mmHg with intravenous (IV) hydration and lactate cannot be maintained below 2
mmol/L, vasopressor support should definitely be initiated.
Extracorporeal membrane oxygenation (ECMO) therapy is used in ARDS to
temporarily maintain adequate O2
supply and CO2
elimination and / or provide
perfusion in patients with respiratory and / or heart failure who do not respond to
conventional interventions and whose physiological variables are abnormal despite
maximal support.
The development of coagulopathy is associated with high mortality in patients with
COVID-19. Therefore, low molecular weight heparin (LMWH) should be used for
prophylactic purposes. In order to reduce the incidence of VTE, it should be
administered to patients with severe conditions and who are dependent on mechanical
ventilation. Prophylactic LMWH will also benefit patients at high risk of VTE. The use
of LMWH and anticoagulant therapy has been shown to reduce mortality in COVID19.
The FDA has also recently approved the use of convalescent (immune) plasma therapy
(CPT) in the COVID-19 era. Sera of the persons recovering from COVID-19 infection
can be used in the prophylaxis or treatment of COVID-19 infection. CPT is one of the
most important treatment options that can be used in pandemic COVID-19 infection.
Antibody replacement by plasma infusion may be beneficial in the first 7-10 days of
the disease. CPT is an important option for the prevention and treatment of COVID-19
disease in the presence of a sufficient number of people who can donate Ig-containing
plasma. Patients treated with CP have a shorter hospital stay and lower mortality rates
than other patients.
Keywords: Convalescent plasma, CPR, COVID-19, Critical care, Emergency
cardiac care, Extracorporeal membrane oxygenation, Low molecular weight
heparin, Positive-pressure ventilation, Prone position, Shock, Treatment.
