How do I manage patients with different clinical phenotypes of COVID-19? Does every patient need to be admitted to the hospital?

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  • How do I manage patients with different clinical phenotypes of COVID-19? Does every patient need to be admitted to the hospital?
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  • Phenotype 1: Fever, without  respiratory Symptoms: Test for SARS-CoV-2, symptomatic therapy, hospital admission not necessary
  • Phenotype 2: Fever and pneumonic infiltrate or silent hypoxemia: Hospital admission, symptomatic therapy, antiretroviral therapy
  • Phenotype 3: Fever and clinically overt hypoxemia: Hospital admission and cardiorespiratory monitoring, Oxygen-insufflation. Reevaluation after 30 min (Goal SpO2: 92-96%, less in COPD), symptomatic and antiretroviral therapy. 
  • Phenotype 4: Pre-ARDS: Hospital admission, Non-invasive ventilation, PEEP at least 10mmHg

Phenotype 5: ARDS: ICU admission, intubation, 24h after diagnosis of ARDS: 20mg of dexamethasone for 5 days, then 10mg for another 5 days.