Download PDF
intensiv 2021; 29(02): 80-89
DOI: 10.1055/a-1338-7847
Intensivpflege
COVID-19 – Diagnostik und Therapie

SARS-CoV-2/COVID-19 – aktualisierte Empfehlungen zu Diagnostik und Therapie

Berthold Bein
,
Martin Bachmann
,
Susanne Huggett
,
Petra Wegermann
› Further Information
Also available at
    Permissions and Reprints

Dieser Übersichtsartikel ist als praktische Handreichung für alle gedacht, die COVID-19-Patienten behandeln, und fasst das derzeit verfügbare Wissen zu Diagnostik und Therapie zusammen. Zusätzlich werden auch neue und experimentelle Therapien bewertet.



Publication History

Article published online:
04 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Johns Hopkins Coronavirus Resource Center. Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. Im Internet: bit.ly/3cb8Mbk; Stand: 23.01.2021
  • 2 Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 2020; 109: 102433
    CrossrefPubMedGoogle Scholar
  • 3 Andersen KG, Rambaut A, Lipkin WI. et al The proximal origin of SARS-CoV-2. Nat Med 2020; 26 (04) 450-2
    CrossrefPubMedGoogle Scholar
  • 4 Adhikari SP, Meng S, Wu Y-J. et al Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty 2020; 9: 29
    CrossrefPubMedGoogle Scholar
  • 5 Wang CJ, Ng CY, Brook RH. Response to COVID-19 in Taiwan. JAMA 2020; 323 (14) 1341-2
    CrossrefPubMedGoogle Scholar
  • 6 Robert Koch-Institut – RKI. Virus und Epidemiologie (Stand: 6.1.2021). Im Internet: bit.ly/3t0yLbl, Stand: 23.01.2021
  • 7 Robert Koch-Institut – RKI. Übersicht und Empfehlungen zu neuen SARS-CoV-2-Virusvarianten. Im Internet: bit.ly/3rbs8RZ, Stand: 23.01.2021
  • 8 WHO. SARS-CoV-2 Variant – United Kingdom of Great Britain and Northern Ireland. Im Internet: bit.ly/2M4zurw, Stand: 23.01.2021
  • 9 Makoni M. South Africa responds to new SARS-CoV-2 variant. Lancet 2021; 397 10271 267
    CrossrefPubMedGoogle Scholar
  • 10 Wu JT, Leung K, Bushman M. et al Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat Med 2020; 26: 506-10
    CrossrefPubMedGoogle Scholar
  • 11 Cruz A, Zeichner S. COVID-19 in children: initial characterization of the pediatric disease. Pediatrics 2020; 145 (06) e20200834
    CrossrefPubMedGoogle Scholar
  • 12 Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China. JAMA 2020; 323 (13) 1239-42
    CrossrefPubMedGoogle Scholar
  • 13 Center of Disease Control. Healthcare Professionals: frequently asked questions and answers. CDC. Im Internet: bit.ly/39fODPx; Stand: 23.01.2021
  • 14 Bao L, Deng W, Gao H. et al Reinfection could not occur in SARS-CoV-2 infected rhesus macaques. bioRxiv. Cold Spring Harbor Laboratory 2020
    PubMedGoogle Scholar
  • 15 Harvey RA, Rassen JA, Kabelac CA. et al Real-world data suggest antibody positivity to SARS-CoV-2 is associated with a decreased risk of future infection. medRxiv. Cold Spring Harbor Laboratory 2020
    PubMedGoogle Scholar
  • 16 Mustapha JO, Abdullahi IN, Ajagbe OOR. et al Heliyon. 2021; 7 (01) e05951
    PubMedGoogle Scholar
  • 17 Zou L, Ruan F, Huang M. et al SARS-CoV-2 Viral load in upper respiratory specimens of infected patients. N Engl J Med 2020; 382: 1177-9
    CrossrefPubMedGoogle Scholar
  • 18 Yang X, Yu Y, Xu J. et al Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8 (05) 475-81
    CrossrefPubMedGoogle Scholar
  • 19 Wang D, Hu B, Hu C. et al Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323: 1061
    CrossrefPubMedGoogle Scholar
  • 20 Huang C, Wang Y, Li X. et al Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506
    CrossrefPubMedGoogle Scholar
  • 21 Guan W, Ni Z, Hu Y. et al Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382 (18) 1708-20
    CrossrefPubMedGoogle Scholar
  • 22 Zhou F, Yu T, Du R. et al Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62
    CrossrefPubMedGoogle Scholar
  • 23 Wu Z, McGoogan J. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323 (13) 1239-42
    CrossrefPubMedGoogle Scholar
  • 24 Gattinoni L, Chiumello D, Caironi P. et al COVID-19 pneumonia: different respiratory treatments for different phenotypes?. Intensive Care Med 2020; 46 (06) 1099-102
    CrossrefPubMedGoogle Scholar
  • 25 Brochard L, Slutsky A, Pesenti A. Mechanical Ventilation to Minimize Progression of Lung Injury in Acute Respiratory Failure. Am J Respir Crit Care Med 2017; 195 (04) 438-42
    CrossrefPubMedGoogle Scholar
  • 26 Pfeifer M, Ewig S, Voshaar T. et al Positionspapier zur praktischen Umsetzung der apparativen Differenzialtherapie der akuten respiratorischen Insuffizienz bei COVID-19: Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin e. V. (DGP). Pneumologie 2020; 74 (06) 337-57
    Article in Thieme ConnectPubMedGoogle Scholar
  • 27 Wu C, Chen X, Cai Y. et al Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 2020; 180 (07) 934-43
    CrossrefPubMedGoogle Scholar
  • 28 Mehta P, McAuley DF, Brown M. et al COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395: 1033-4
    CrossrefPubMedGoogle Scholar
  • 29 Chen N, Zhou M, Dong X. et al Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13
    CrossrefPubMedGoogle Scholar
  • 30 Kluge S, Janssens U, Welte T. et al S2k-Leitlinie – Empfehlungen zur stationären Therapie von Patienten mit COVID-19. Pneumologie 2021; 75 (02) 88-112
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Gross O, Moerer O, Weber M. et al COVID-19-associated nephritis: early warning for disease severity and complications?. Lancet 2020; 395 10236 e87-8
    CrossrefPubMedGoogle Scholar
  • 32 Reusken CBEM, Broberg EK, Haagmans B. et al Laboratory readiness and response for novel coronavirus (2019-nCoV) in expert laboratories in 30 EU/EEA countries, January 2020. Eurosurveillance 2020; 25 (06) 2000082
    PubMedGoogle Scholar
  • 33 Robert Koch-Institut – RKI. Coronavirus SARS-CoV-2 – Hinweise zur Testung von Patienten auf Infektion mit dem neuartigen Coronavirus SARS-CoV-2. Im Internet: bit.ly/34c8DiX; Stand: 23.01.2021
  • 34 Robert Koch-Institut – RKI. Coronavirus SARS-CoV-2 – Optionen zum Management von Kontaktpersonen unter medizinischem Personal bei Personalmangel. Im Internet: bit.ly/2NrugGo; Stand: 23.01.2021
  • 35 Anonymous. COVID-19: protecting health-care workers. Lancet 2020; 395: 922
    CrossrefPubMedGoogle Scholar
  • 36 AWMF online. Empfehlungen Krankenhaushygiene: Hygieneanforderungen bei ausgewählten respiratorisch übertragbaren Infektions-Erkrankungen (aerogen und Tröpfchen); 31.01.2016. Im Internet: bit.ly/3u3CcOX; Stand: 25.01.2021
  • 37 Robert Koch-Institut – RKI. Infektionsprävention im Rahmen der Pflege und Behandlung von Patienten mit übertragbaren Krankheiten. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz. 2015; 58: 1151-70
    PubMedGoogle Scholar
  • 38 Smith JD, MacDougall CC, Johnstone J. et al Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis. CMAJ 2016; 188 (08) 567-74
    CrossrefPubMedGoogle Scholar
  • 39 Radonovich LJ, Simberkoff MS, Bessesen MT. et al N95 Respirators vs. Medical Masks for Preventing Influenza Among Health Care Personnel. JAMA 2019; 322: 824
    CrossrefPubMedGoogle Scholar
  • 40 Sektion 2 Endoskopie der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin. Empfehlung. Im Internet: bit.ly/3a1Qt5B; Stand: 23.01.2021
  • 41 Fan E, Brodie D, Slutsky AS. Acuterespiratorydistress syndrome. JAMA 2018; 319: 698
    CrossrefPubMedGoogle Scholar
  • 42 Alhazzani W, Evans L, Alshamsi F. et al Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU: First Update Crit Care Med; 2021. online ahead of print.
    Google Scholar
  • 43 Wichmann D, Sperhake JP, Lütgehetmann M. et al Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Ann Intern Med 2020; 173: 268-77
    CrossrefPubMedGoogle Scholar
  • 44 LeTourneau JL, Pinney J, Phillips CR. Extravascular lung water predicts progression to acute lung injury in patients with increased risk. Crit Care Med 2012; 40: 847-854
    CrossrefPubMedGoogle Scholar
  • 45 Bein B, Renner J. Best practice & research clinical anaesthesiology: Advances in haemodynamic monitoring for the perioperative patient. Best Pract Res Clin Anaesthesiol 2019; 33: 139-153
    CrossrefPubMedGoogle Scholar
  • 46 Müller C. DAZ online. WHO rät doch nicht von Ibuprofen ab: Ibuprofen und COVID-19: WHO rudert zurück. Im Internet: bit.ly/3qQPbkA; Stand: 23.01.2021
    Google Scholar
  • 47 Cao B, Wang Y, Wen D. et al A Trial of lopinavir-ritonavir in adults hospitalized with severe Covid-19. N Engl J Med 2020; 382 (19) 1787-99
    CrossrefPubMedGoogle Scholar
  • 48 Zhang L, Liu Y. Potential interventions for novel coronavirus in China: A systematic review. J Med Virol 2020; 92: 479-490
    CrossrefPubMedGoogle Scholar
  • 49 Sheahan TP, Sims AC, Leist SR. et al Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun 2020; 11 (01) 222
    CrossrefPubMedGoogle Scholar
  • 50 Beigel JH, Tomashek KM, Dodd LE. et al Remdesivir for the Treatment of Covid-19 – Final Report. N Engl J Med 2020; 383: 1813-26
    CrossrefPubMedGoogle Scholar
  • 51 WHO Solidarity Trial Consortium Pan H, Peto R. et al Repurposed Antiviral Drugs for Covid-19 – Interim WHO Solidarity Trial Results. N Engl J Med 2021; 384 (06) 497-511
    CrossrefPubMedGoogle Scholar
  • 52 Siemieniuk R, Rochwerg B, Agoritsas T. et al A living WHO guideline on drugs for covid-19. BMJ 2020; 370: m3379
    CrossrefPubMedGoogle Scholar
  • 53 Touret F, de Lamballerie X. Of chloroquine and COVID-19. Antiviral Res 2020; 177: 104762
    CrossrefPubMedGoogle Scholar
  • 54 Gottlieb RL, Nirula A, Chen P. et al Effect of Bamlanivimab as Monotherapy or in Combination With Etesevimab on Viral Load in Patients With Mild to Moderate COVID-19. JAMA 2021 Jan 21. Im Internet: bit.ly/3cjlO6I, Stand: 23.01.2021
    Google Scholar
  • 55 Weinreich DM, Sivapalasingam S, Norton T. et al REGN-COV2, a Neutralizing Antibody Cocktail, in Outpatients with Covid-19. N Engl J Med 2021; 384 (03) 238-51
    CrossrefPubMedGoogle Scholar
  • 56 Group TRC. Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report. N Engl J Med 2020 July 17. Im Internet: bit.ly/3psFhFt, Stand: 23.01.2021
  • 57 Robert Koch-Institut – RKI. Coronavirus SARS-CoV-2 – Therapieübersicht bei COVID-19. Im Internet: bit.ly/3pli8E5; Stand: 16.02.2021
  • 58 Ramanathan K, Antognini D, Combes A. et al Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases. Lancet Respir Med 2020; 8 (05) 518-26
    CrossrefPubMedGoogle Scholar
  • 59 Peek GJ, Mugford M, Tiruvoipati R. et al Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009; 374: 1351-63
    CrossrefPubMedGoogle Scholar
  • 60 Combes A, Hajage D, Capellier G. et al Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome. N Engl J Med 2018; 378: 1965-75
    CrossrefPubMedGoogle Scholar
  • 61 Shekar K, Badulak J, Peek G. et al Extracorporeal Life Support Organization Coronavirus Disease 2019 Interim Guidelines: A Consensus Document from an International Group of Interdisciplinary Extracorporeal Membrane Oxygenation Providers. ASAIO J 2020; 66 (07) 707-21
    CrossrefPubMedGoogle Scholar
  • 62 Barbaro RP, MacLaren G, Boonstra PS. et al Extracorporeal membrane oxygenation support in COVID-19: an international cohort study of the Extracorporeal Life Support Organization registry. Lancet 2020; 396 10257 1071-8
    CrossrefPubMedGoogle Scholar
  • 63 S3-Leitlinie Invasive Beatmung und Einsatz extrakorporaler Verfahren bei akuter respiratorischer Insuffizienz. 1. Aufl. Langversion, Stand: 04.12.2017. Im Internet: bit.ly/2YWLcaK; Stand: 16.02.2021
  • 64 Ruan Q, Yang K, Wang W. et al Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med 2020; 46 (05) 846-8
    CrossrefPubMedGoogle Scholar
  • 65 Kogelmann K, Jarczak D, Scheller M. et al Hemoadsorption by CytoSorb in septic patients: a case series. Crit Care 2017; 21: 74
    CrossrefPubMedGoogle Scholar
  • 66 Olson SW, Oliver JD, Collen J. et al Treatment for Severe Coronavirus Disease 2019 With the Seraph-100 Microbind Affinity Blood Filter. Crit Care Explor 2020; 2 (08) e0180
    CrossrefPubMedGoogle Scholar