O'Keefe James B, Newsom Lydia C, Taylor Thomas H
Division of General Internal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Department of Pharmacy Practice, Mercer University College of Pharmacy, Atlanta, GA, USA.
Infect Dis Ther. 2021 Jun;10(2):839-851. doi: 10.1007/s40121-021-00432-8. Epub 2021 Mar 22.
Many patients with mild coronavirus disease 2019 (COVID-19) have symptoms requiring acute and follow-up care. The aims of this study were to assess (1) provider-reported use of medications and their perceived effectiveness and (2) degree of difficulty managing specific symptoms at episodic COVID-19 care sites and in a longitudinal monitoring program.
We sent an online survey to physicians, advanced practice providers, and registered nurses redeployed to COVID-19 care sites at an academic medical center from March to May 2020. We asked about the use of medications and perceived effectiveness of medications to treat symptoms of COVID-19 and the perceived challenge of symptom management. Comparison was made by provider type (episodic or longitudinal site of care).
Responses from 64 providers were included. The most frequently used medications were acetaminophen (87.1% of respondents), benzonatate (83.9%), and albuterol metered dose inhalers (MDI) (80.6%). Therapies for lower respiratory tract symptoms were reported as more commonly used by longitudinal follow-up providers compared to episodic providers including guaifenesin (90.6% vs 60.0%, p = 0.007), benzonatate (93.8% vs 73.3%, p = 0.04), nebulized albuterol for patients with asthma (75.0% vs 43.3%, p = 0.019), and albuterol MDIs for patients without asthma (90.6% vs 66.7%, p = 0.029). Medications found to have the highest perceived efficacy by respondents using the therapy (> 80% reporting "very efficacious") included albuterol, acetaminophen for fever, non-sedating antihistamines, nasal steroid spray, and non-steroidal anti-inflammatory drugs (NSAIDs) for myalgia, arthralgia, or headache. Lower respiratory symptoms and anxiety were rated as the most challenging symptoms to manage.
Providers reported that clinical care of mild COVID-19 with medications in common use for other respiratory infections is effective, both at episodic care and longitudinal sites of care, but that specific symptoms are still challenging to manage.
许多轻度2019冠状病毒病（COVID-19）患者有需要急性治疗和后续护理的症状。本研究的目的是评估：（1）医疗服务提供者报告的药物使用情况及其感知到的有效性；（2）在COVID-19门诊护理场所和纵向监测项目中管理特定症状的难度程度。
我们于2020年3月至5月向一家学术医疗中心重新部署到COVID-19护理场所的医生、高级执业提供者和注册护士发送了一项在线调查。我们询问了治疗COVID-19症状的药物使用情况、药物的感知有效性以及症状管理的感知挑战。按医疗服务提供者类型（门诊或纵向护理场所）进行比较。
纳入了64名医疗服务提供者的回复。最常用的药物是对乙酰氨基酚（87.1%的受访者）、苯佐那酯（83.9%）和沙丁胺醇定量吸入器（MDI）（80.6%）。与门诊提供者相比，纵向随访提供者报告更常用治疗下呼吸道症状的疗法，包括愈创甘油醚（90.6%对60.0%，p = 0.007）、苯佐那酯（93.8%对73.3%，p = 0.04）、用于哮喘患者的雾化沙丁胺醇（75.0%对43.3%，p = 0.019）以及用于非哮喘患者的沙丁胺醇MDI（90.6%对66.7%，p = 0.029）。受访者使用这些疗法后认为疗效最高（>80%报告“非常有效”）的药物包括沙丁胺醇、用于退热的对乙酰氨基酚、非镇静性抗组胺药、鼻用类固醇喷雾剂以及用于肌痛、关节痛或头痛的非甾体抗炎药（NSAIDs）。下呼吸道症状和焦虑被评为最难管理的症状。
医疗服务提供者报告称，在门诊护理和纵向护理场所，使用常用于其他呼吸道感染的药物对轻度COVID-19进行临床护理是有效的，但特定症状的管理仍然具有挑战性。
