Abstract
COVID-19, a new viral disease affecting primarily the respiratory system and the lung,
has caused a pandemic posing serious challenges to healthcare systems around the world.
In about 20% of patients, severe symptoms occur after a mean incubation period of
5 – 6 days; 5% of patients need intensive care therapy. Mortality is about 1 – 2%.
Protecting healthcare workers is of paramount importance in order to prevent hospital-acquired
infections. Therefore, during all procedures associated with aerosol production, personal
protective equipment consisting of a FFP2/FFP3 (N95) respiratory mask, gloves, safety
glasses and a waterproof overall should be used. Therapy is based on established recommendations
issued for patients with acute lung injury (ARDS). Lung protective ventilation, prone
position, restrictive fluid management and adequate management of organ failure are
the mainstays of therapy. In case of fulminant lung failure, veno-venous extracorporeal
membrane oxygenation may be used as a rescue in experienced centres. New, experimental
therapies are evolving with ever increasing frequency; currently, however, no evidence-based
recommendation is possible. If off-label and compassionate use of these drugs is considered,
an individual benefit-risk assessment is necessary, since serious side effects have
been reported.
Key words
SARS-CoV-2 - COVID-19 - critical care - adult respiratory distress syndrome - acute
lung injury - personal protection equipment - N95 respiratory masks
