Domingo Ribas Christian
Pulmonary Service, Corporació Sanitària Parc Taulí, Barcelona, Spain.
Departament of Medicine, Universitat Autònoma de Barcelona (UAB) Barcelona, Spain.
Open Respir Med J. 2020 Oct 13;14:32-37. doi: 10.2174/1874306402014010032. eCollection 2020.
The COVID-19 pandemic is a recently emerging problem. This has caused that the knowledge of the disease has been progressive and, therefore, the therapeutic decisions have been conditioned by this lack of knowledge on the one hand and by the therapeutic limitations on the other. Many published studies are methodologically weak and their conclusions, of limited value, have contributed to creating confusion on the therapeutic approach of the disease. In the present paper, we propose a therapeutic approach based on a new disease staging. The therapeutic approach is divided into two big sections: the pharmacological treatment for the phase of viral replication, cytokine storm or late respiratory events (which includes the adult respiratory distress syndrome (ARDS)) and the treatment of the respiratory failure In every stage, we discuss the pathophysiology and comment (accept or rule out) the pharmacological options according to the present evidence. Moreover, we indicate how respiratory failure should be treated. Some characteristics are based on the evidence found in the literature. Others are the result of my experience in other situations.
新冠疫情是一个最近出现的问题。这导致对该疾病的认识是渐进性的，因此，治疗决策一方面受到这种知识缺乏的制约，另一方面受到治疗局限性的制约。许多已发表的研究在方法上存在缺陷，其结论价值有限，这加剧了对该疾病治疗方法的困惑。在本文中，我们基于一种新的疾病分期提出一种治疗方法。该治疗方法分为两大板块：针对病毒复制期、细胞因子风暴或晚期呼吸事件（包括成人呼吸窘迫综合征（ARDS））的药物治疗，以及呼吸衰竭的治疗。在每个阶段，我们都会讨论病理生理学，并根据现有证据对药物治疗选项进行评论（认可或排除）。此外，我们还指出了应如何治疗呼吸衰竭。有些特点基于文献中的证据，其他则是我在其他情况中的经验总结。
