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Vol. 45. Issue 2.
Pages 104-121 (March 2021)
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Vol. 45. Issue 2.
Pages 104-121 (March 2021)
Special article
DOI: 10.1016/j.medine.2020.06.007
Pharmacological treatment of COVID-19: Narrative review of the Working Group in Infectious Diseases and Sepsis (GTEIS) and the Working Groups in Transfusions and Blood Products (GTTH)
Tratamiento farmacológico de la COVID-19: revisión narrativa de los Grupos de Trabajo de Enfermedades Infecciosas y Sepsis (GTEIS) y del Grupo de Trabajo de Transfusiones y Hemoderivados (GTTH)
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E. Díaza,
Corresponding author
emilio.diaz.santos@gmail.com

Corresponding author.
, R. Amézaga Menéndezb, P. Vidal Cortésc, M.G. Escapad, B. Suberviolae, A. Serrano Lázarof, P. Marcos Neirag, M. Quintana Díazh, M. Catalán Gonzálezi
a Área de Críticos, Corporación Sanitaria i Universitaria Parc Taulí, Univ. Autonoma de Barcelona, CIBER de Enfermedades Respiratorias, Sabadell, Barcelona, Spain
b Hospital Universitari Son Espases, Palma, Spain
c Complexo Hospitalario Universitario Ourense, Ourense, Spain
d Hospital Universitario de Burgos, Burgos, Spain
e Hospital Universitario Marqués de Valdecilla, Santander, Spain
f Hospital Clínico Universitario de Valencia, Valencia, Spain
g Hospital Germans Trias y Pujol, Badalona, Spain
h Hospital Universitario La Paz, Madrid, Spain
i Hospital Universitario 12 de Octubre, Madrid, Spain
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Figures (1)
Tables (9)
Table 1. Studies with lopinavir/ritonavir.
Table 2. Studies with remdesivir.
Table 3. Studies with hydroxychloroquine and azithromycin.
Table 4. Studies with corticoids.
Table 5. Studies with immunomodulators.
Table 6. Studies on thrombosis in patients with COVID-19.
Table 7. Studies on anticoagulation and thromboprophylaxis in patients with COVID-19.
Table 8. Antithrombotic prophylaxis dosing.
Table 9. Anticoagulation doses and recommendations.
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Abstract

Infection by the SARS-CoV-2 virus, known as COVID-19 (COronaVIrus Disease-19) was initially detected in China in December 2019, and has subsequently spread rapidly throughout the world, to the point that on March 11 the World Health Organization (WHO) reported that the outbreak could be defined as a pandemic. COVID-19 disease ranges from mild flu-like episodes to other serious and even life-threatening conditions, mainly due to acute respiratory failure. These patients are frequently admitted to our Intensive Care Units in relation to acute respiratory distress syndrome (ARDS). The lack of a treatment based on scientific evidence has led to the use of different management guidelines, in many cases with rapid changes in the applied protocols. Recent reviews in reputed journals have underscored the lack of proven therapies and the need for clinical trials to establish clear and objective treatment guidelines. The present study provides an update on the currently applied treatment, and intends to offer help in relation to daily care, without seeking to replace the protocols adopted in each individual center.

Keywords:
COVID-19
ARDS-CoV-2
Treatment
ICU
Resumen

La infección por el virus SARS-CoV-2, denominada COVID-19 (COronaVIrus Disease 19), fue detectada inicialmente en China en diciembre 2019, y posteriormente se ha diseminado rápidamente por todo el mundo, hasta el punto de que el 11 de marzo la OMS declaró que el brote podría definirse como pandemia. La COVID-19 presenta un cuadro que oscila desde episodios leves pseudogripales a otros graves e incluso potencialmente mortales debido, sobre todo, a insuficiencia respiratoria aguda. Es frecuente el ingreso de estos pacientes en nuestros Servicios de Medicina Intensiva en relación con un Síndrome de Distrés Respiratorio Agudo (SDRA). La falta de un tratamiento con evidencia científica ha llevado al empleo de diferentes pautas terapéuticas, en muchas ocasiones, con modificaciones rápidas de los protocolos. Recientes revisiones en revistas de prestigio han destacado la falta de terapias probadas y la necesidad de ensayo clínicos que permitan establecer pautas de tratamiento claras y objetivas. Este documento tiene por objeto ofrecer una actualización de la terapia que se está aplicando en la actualidad, y una ayuda en la asistencia diaria, sin pretender sustituir los protocolos adoptados en cada centro.

Palabras clave:
COVID-19
SARS-CoV-2
Tratamiento
UCI

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