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