CRITICAL: Whether your chest results have come or not if you have respiratory problems get yourself CT scanned to rule out chest pneumonia. Pneumonia means your condition is very serious and you will require oxygen therapy sooner than later
If your infection takes a critical turn you will have to be admitted to the hospital. The main symptom which signals that you should get yourself hospitalised is the fact that your oxygen saturation level has fallen below 85. At the hospital if you are having serious respiratory problems you will be put on oxygen therapy. Medicines like Remdesivir are only for serious patients and have to be doctor prescribed or it can have serious consequences. If the oxygen given through the nasal passage is not effective you will have to be put on a ventilator, which will take over the function of the lungs. Please remember you will be in total isolation when you are admitted to a hospital and cannot have an attendant or even be in contact with your family!
COVID-19 is the disease caused by the novel coronavirus, SARS-CoV-2. Symptoms include fever, cough, fatigue, shortness of breath, lack of appetite, loss of taste or smell, and diarrhea. Most people who develop COVID-19 have mild symptoms that can (and should) be managed at home. However, some people with COVID-19 develop serious illness and require hospital care. About 25 to 33% of those who are hospitalized need intensive care. Most people who are hospitalized for COVID-19 recover.
Unfortunately, there is no known cure for COVID-19. Scientists and physicians are still searching for effective treatments, but there are some promising therapies currently in use for severely ill COVID-19 patients.
Hospital Care for Coronavirus
A person who is persistently short of breath may need hospital care. Shortness of breath indicates the lungs are not delivering enough oxygen to the rest of the body; without treatment, oxygen levels may fall and cause organ failure.
Because there is no cure for COVID-19 at this time, hospital care for coronavirus is focused on what’s called supportive care, or treatment to support the body’s vital organs. Doctors, nurses and others will monitor oxygen levels and provide treatment to maintain a healthy supply of oxygen to the rest of the body. Some patients need only a nasal cannula, a tube that’s placed in the nostrils to deliver oxygen. Other patients require an oxygen mask, which can deliver high concentrations of oxygen.
Hospital staff monitor patients’ vital signs (heart rate, blood pressure, number of breaths per minute) to watch for any developing problems. A patient whose heart rate increases as their blood pressure decreases could be experiencing heart trouble; staff will likely run tests and administer IV (intravenous) fluids and medicine to support the heart’s function.
Some patients will be able to eat and drink normally; others are too sick to do so. If needed, hospital staff can deliver nutrition directly into patients’ veins via an IV.
Looking for a Coronavirus Cure
Up until November 2020, there were no FDA-approved treatments specifically for COVID-19. Since then, the FDA has authorized monoclonal antibody drugs—bamlanivimab; combination bamlanivimab and etesevimab; and combination casirivimab and imdevimab—that target the virus’s spike protein. Clinical studies show the antibodies can reduce emergency room visits and hospitalizations in patients with mild to moderate COVID-19. Emergency use authorization (EUA) of the antibodies is for patients with mild-to-moderate COVID-19 at high risk for developing severe COVID-19.
Some existing drugs may help hospitalized patients with COVID-19, so doctors are using a variety of treatments. Patients may receive the following drugs:
Antibiotics. COVID-19 is caused by a virus, so antibiotics—which kill bacteria, not viruses—cannot cure the disease. Interestingly, some antibiotics like azithromycin (Zithromax) exhibit antiviral properties. Equally important, some patients with COVID-19 also develop bacteria-caused infections. Treating these infections with antibiotics can ease the overall strain on the body.
Antiviral drugs. Remdesivir (Veklury), an antiviral drug that can kill SARS-CoV-2 in a petri dish under experimental conditions, was given EUA by the FDA in May and normal FDA approval in October. The EUA is for hospitalized patients 12 and older, even if they are not enrolled in clinical trials. A clinical trial of another antiviral drug, EIDD-2801, began in late April 2020.
Steroids. Oxford University found that treating patients on ventilators with the steroid dexamethasone improved outcomes—reducing deaths by up to a third. Dexamethasone—an inexpensive and readily available drug—also reduced the death rate for patients receiving supplemental oxygen (one-fifth fewer deaths), but had no effect on hospitalized patients who did not need either of these therapies. The World Health Organization’s guideline is to administer a 7 to 10 course of dexamethasone to patients with severe or critical COVID-19.
Convalescent plasma. In 2020, the FDA began allowing doctors to collect “convalescent plasma” from the blood of recovered patients; this plasma was then administered to sick patients via IV infusion. U.S. clinical trials have thus far not provided conclusive evidence that convalescent therapy is more effective than the standard of care for patients with moderate, severe or critical COVID-19. Under its EUA, doctors can administer antibody-rich convalescent plasma to hospitalized patients early in the course of the disease, in an attempt to prevent progression of the disease and the need for mechanical ventilation.
DMARDS (disease-modifying antirheumatic drugs). Clinical trials are underway to test the effect of drugs currently prescribed to suppress the immune system, in the hopes of tamping down widespread inflammation that occurs in severely ill patients. Guidelines include administering a combination of tocilizumab (Actemra) with dexamethasone to patients whose oxygen levels are rapidly declining.
Early research from China suggested the malaria drugs, hydroxychloroquine (HCQ) and chloroquine (CQ), might be effective in treating COVID-19. In some cases, they seemed to help; in others, there was no positive effect. The FDA recently withdrew emergency use approval (EUA) for these drugs because they “are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA.” HCQ and CQ have serious side effects, including irregular heart rhythms and death.
For information about all COVID-19 clinical trials, visit clinicaltrials.gov and enter ‘COVID’ in the condition field.
Intensive Care and Ventilator Treatment
If a patient’s condition worsens despite supportive hospital care, the patient may be transferred to the intensive care unit (ICU). Patients in the ICU are monitored even more closely than other hospitalized patients; usually, an ICU nurse only cares for 1 to 2 patients per shift.
If the patient cannot breathe effectively, doctors may recommend intubation—placing a breathing tube in the patient’s airway—and ventilator treatment. A ventilator forces air and oxygen into the lungs. Critical care providers administer drugs so the patient remains sleepy and comfortable. If the patient’s condition improves, the healthcare team will gradually wean the patient off the ventilator.
Hospitalization for coronavirus may be a week or longer. According to the CDC (U.S. Centers for Disease Control and Prevention), the average length of hospitalization for survivors is 10 to 13 days. It is difficult to predict what will happen during coronavirus hospitalization. The healthcare team will do their best to keep you informed at all times.