According to NIH guidelines, norepinephrine is recommended as the first-choice vasopressor. For adults with COVID-19 and refractory shock, low-dose corticosteroid therapy ("shock reversal") is recommended above no corticosteroid use.
For adults with COVID-19 and acute hypoxemic respiratory failure despite conventional oxygen therapy, the NIH recommends HFNC oxygen over NIPPV. In the absence of an indication for endotracheal intubation, a closely monitored trial of NIPPV is recommended for adults with COVID-19 and acute hypoxemic respiratory failure for whom HFNC is not available.
The NIH recommends against using awake prone positioning as a rescue therapy for refractory hypoxemia to avoid intubation in patients who otherwise require intubation and mechanical ventilation.
For critically ill patients with COVID-19 who have acute kidney injury and who develop indications for renal replacement therapy, the NIH recommends continuous renal replacement therapy (CRRT), if available. If CRRT is not available or not possible owing to limited resources, the NIH recommends prolonged intermittent renal replacement therapy rather than intermittent hemodialysis.
Read more about the treatment of COVID-19.
This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases article Coronavirus Disease 2019 (COVID-19).
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Michael Stuart Bronze. Fast Five Quiz: COVID-19 Clinical Keys - Medscape - Oct 22, 2020.
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