COVID-19 is an unpredictable infectious disease caused by SARS-CoV-2. The development of effective anti-COVID-19 vaccines has enormously minimized the risk of severe illness in most immunocompetent patients. However, unvaccinated patients and non-re-sponders to the COVID-19 vaccine are at risk of short-and long-term consequences. In these patients, the outcome of COVID-19 relies on an interplay of multiple factors including age, immunocompetence, comorbid-ities, inflammatory response triggered by the virus as well as the virulence of SARS-CoV-2 variants. General-ly, COVID-19 is asymptomatic or mildly symptomatic in young people, but it may manifest with respiratory insufficiency requiring mechanical ventilation in cer-tain susceptible groups of patients. Furthermore, severe SARS-CoV-2 infection induces multiorgan failure syndrome by affecting liver, kidney heart and nervous system. Since December 2019, multiple drugs have been test-ed to treat COVID-19, but only a few have been prov-en effective to mitigate the course of the disease that continues to cause death and comorbidity worldwide. Current treatment of COVID-19 patients is essential-ly based on the administration of supportive oxygen therapy and the use of specific drugs such as steroids, anticoagulants, antivirals, anti-SARS-CoV-2 antibodies and immunomodulators. However, the rapid spread of new variants and the release of new data coming from the numerous ongoing clinical trials have cre-ated the conditions for maintaining a continuous up-dating of the therapeutic management of COVID-19 patients. Furthermore, we believe that a well-estab-lished therapeutic strategy along with the continu-um of medical care for all patients with COVID-19 is pivotal to improving disease outcomes and restoring healthcare care fragmentation caused by the pandem-ic. This narrative review, focusing on the therapeutic management of COVID-19 patients, aimed to provide an overview of current therapies for (i) asymptomatic or mildly/moderate symptomatic patients, (ii) hospitalized patients requiring low-flow oxygen, (iii) high-flow oxygen and (iv) mechanical ventilation.

Awaiting a cure for COVID-19: therapeutic approach in patients with different severity levels of COVID-19 / Alfano, G.; Morisi, N.; Frisina, M.; Ferrari, A.; Fontana, F.; Tonelli, R.; Franceschini, E.; Meschiari, M.; Donati, G.; Guaraldi, G.. - In: LE INFEZIONI IN MEDICINA. - ISSN 1124-9390. - 30:1(2022), pp. 11-21. [10.53854/liim-3001-2]

Awaiting a cure for COVID-19: therapeutic approach in patients with different severity levels of COVID-19

Alfano G.;Morisi N.;Frisina M.;Ferrari A.;Fontana F.;Tonelli R.;Franceschini E.;Meschiari M.;Donati G.;Guaraldi G.
2022

Abstract

COVID-19 is an unpredictable infectious disease caused by SARS-CoV-2. The development of effective anti-COVID-19 vaccines has enormously minimized the risk of severe illness in most immunocompetent patients. However, unvaccinated patients and non-re-sponders to the COVID-19 vaccine are at risk of short-and long-term consequences. In these patients, the outcome of COVID-19 relies on an interplay of multiple factors including age, immunocompetence, comorbid-ities, inflammatory response triggered by the virus as well as the virulence of SARS-CoV-2 variants. General-ly, COVID-19 is asymptomatic or mildly symptomatic in young people, but it may manifest with respiratory insufficiency requiring mechanical ventilation in cer-tain susceptible groups of patients. Furthermore, severe SARS-CoV-2 infection induces multiorgan failure syndrome by affecting liver, kidney heart and nervous system. Since December 2019, multiple drugs have been test-ed to treat COVID-19, but only a few have been prov-en effective to mitigate the course of the disease that continues to cause death and comorbidity worldwide. Current treatment of COVID-19 patients is essential-ly based on the administration of supportive oxygen therapy and the use of specific drugs such as steroids, anticoagulants, antivirals, anti-SARS-CoV-2 antibodies and immunomodulators. However, the rapid spread of new variants and the release of new data coming from the numerous ongoing clinical trials have cre-ated the conditions for maintaining a continuous up-dating of the therapeutic management of COVID-19 patients. Furthermore, we believe that a well-estab-lished therapeutic strategy along with the continu-um of medical care for all patients with COVID-19 is pivotal to improving disease outcomes and restoring healthcare care fragmentation caused by the pandem-ic. This narrative review, focusing on the therapeutic management of COVID-19 patients, aimed to provide an overview of current therapies for (i) asymptomatic or mildly/moderate symptomatic patients, (ii) hospitalized patients requiring low-flow oxygen, (iii) high-flow oxygen and (iv) mechanical ventilation.
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11
21
Awaiting a cure for COVID-19: therapeutic approach in patients with different severity levels of COVID-19 / Alfano, G.; Morisi, N.; Frisina, M.; Ferrari, A.; Fontana, F.; Tonelli, R.; Franceschini, E.; Meschiari, M.; Donati, G.; Guaraldi, G.. - In: LE INFEZIONI IN MEDICINA. - ISSN 1124-9390. - 30:1(2022), pp. 11-21. [10.53854/liim-3001-2]
Alfano, G.; Morisi, N.; Frisina, M.; Ferrari, A.; Fontana, F.; Tonelli, R.; Franceschini, E.; Meschiari, M.; Donati, G.; Guaraldi, G.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/1277100
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