What have we learned about treatment of Covid-19 to date?

Treatments

A: New discoveries happen every day!

In addition to research taking place to develop a vaccine, many clinicians and researchers are learning more about how to treat Covid-19 infection. The new knowledge about treatment falls into three categories: 1) pathophysiology of Covid-19 infection, 2) decreasing disease severity, and 3) minimizing long-term complications.

Understanding the physiologic changes caused by Covid-19 in the body lay the foundation for identifying and testing treatments specific to the Covid -19 mechanisms of destruction. In the last six months, there has been increasing focus on the capacity of Covid-19 to impair blood clotting. Once believed to be primarily a respiratory virus, treatments focused on the lungs. The discovery of the blood clotting issues caused by Covid-19 in clinical care, laboratory tests, autopsies, and lab studies advance how we treat this disease. Drugs and therapies to reduce the risk of blood clots among individuals with Covid-19 infection are now becoming the standard of practice, with continued research on the best therapies.

Treatments that decrease disease severity are very important as they can reduce the mortality rate from the virus. Guidelines for the treatment of Covid-19 are evolving as new information becomes available. Based on the data available, the CDC is currently recommending the experimental use of Remdesivir for individuals hospitalized with Covid-19. There is insufficient data to recommend for or against the routine use of Remdesivir for individuals presenting with mild to moderate Covid-19 infection in the community. See NIH article.  Additionally, there is early evidence that the use of Dexamethasone decreases mortality in individuals with severe infection. This was not found to be as effective earlier in the disease course and among individuals who did not require oxygen support. In addition to medications, turning critically ill individuals on their stomachs, a procedure called proning, has shown a reduction in mortality in the short and long run when compared to remaining on their back (AKA supine).

As we move forward, continued attention should focus on interventions that decrease the need for hospitalization and therapies to minimize long-term complications. The Learning Agency Lab has compiled an incredibly helpful toolkit to support care of individuals with Covid-19 at home. https://www.the-learning-agency-lab.com/covid-19-at-home… In addition, studies are taking place among individuals who were discharged from the hospital following Covid-19 infection to understand how individuals recover over months.

Prevention of disease transmission remains our best weapon against the real and life threatening risks posed by Covid-19. Stay SMART.

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