SARS-CoV-2 (COVID-19) and intravascular volume management strategies in the critically ill

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread across the globe, and millions of people may be affected. While knowledge regarding epidemiologic features and diagnostic tools of coronavirus disease 2019 (COVID-19) is rapidly evolving, uncertainties surrounding various aspects of its optimal management strategies persist. A subset of these patients develop a more severe form of the disease characterized by expanding pulmonary lesions, sepsis, acute respiratory distress syndrome, and respiratory failure. Due to lack of data on treatment strategies specific to this subset of patients, currently available evidence on management of the critically ill needs to be extrapolated and customized to their clinical needs. The article calls attention to fluid stewardship in the critically ill with COVID-19 by judiciously applying the evidence-based resuscitation principles to their specific clinical features such as high rates of cardiac injury. As we await more data from treating these patients, this strategy is likely to help reduce potential complications.

COVID-19 cardiovascular epidemiology, cellular pathogenesis, clinical manifestations and management

“…Arrhythmias in COVID-19 are managed based on etiology including repletion of electrolytes, discontinuation of medications causing arrhythmia, managing volume status, or suppressing catecholamine surge in COVID-19 [44] , [66] , [67] , [68] . Brugada syndrome can be treated by alleviating the underlying triggers including fever, or pneumonia, or ICD placement in cases of Brugada-1 [69] , [70] , [71] .…”

Sequential use of hemadsorption using Cytosorb® and Biosky® filter- technology in a COVID-19 patient suffering from severe ARDS

“…Initially, our attempts were to stabilize pulmonary function through adjusting parameters of ventilation, according to current recommendations [1,10,11]. In addition, a restrictive uid management strategy was chosen since this is currently recommended in ARDS [11][12][13][14] and bene cial effects have been described with respect to COVID-19 [15].…”

Challenging Issues in the Management of Cardiovascular Risk Factors in Diabetes During the COVID-19 Pandemic: A Review of Current Literature

“…As noted above, this can cause a downregulation of ACE2 receptors and decrease SARS-COV-2 entry into the pulmonary cells [74]. In a study performed on 12,500 individuals who were tested for COVID-19 in New York City, people who were taking beta-blockers had a lower likelihood for a positive test for the virus [75]. Further studies are necessary to determine the efficacy of beta blockers in patients with COVID-19.…”