Mwandishi:
Mhariri:
Imeboreshwa:
6 Juni 2026, 03:54:45
Management of Severe COVID-19
Management of SEVERE COVID-19 DISEASE (SEVERE PNEUMONIA)
Clinical definition
Pneumonia with hypoxia → risk ofAcute Respiratory Distress Syndrome
Admission required
Place in oxygen-equipped isolation room
1. Oxygenation strategy
Method | Flow Rate |
Nasal cannula | 1–5 L/min |
Face mask | 6–10 L/min |
Non-rebreather | 10–15 L/min |
CPAP/NIV | If oxygen inadequate |
Encourage awake prone positioning
2. Corticosteroids
Drug | Regimen |
Methylprednisolone | 80 mg stat → 40 mg BD × 7 days |
Hydrocortisone | 200 mg BD × 7 days |
Dexamethasone | 8 mg TDS × 7 days |
3. Anticoagulation
COVID-19 causes micro-thrombosis and may progress toSepsis
Preferred
Enoxaparin 1 mg/kg SC BD
Alternatives
Rivaroxaban 10 mg OD
Aspirin 75 mg OD
Clopidogrel 75 mg OD
4. Antibiotics
Azithromycin OR ClarithromycinPLUS
Piperacillin-tazobactam OR Ceftriaxone-Sulbactam
(Change based on culture results)
5. Additional supportive care
Careful IV fluids
Proton pump inhibitor
Nutrition therapy
Chest physiotherapy
Psychosocial support
6. Adjunct therapies
Therapy | Note |
Magnesium | Prevent cytokine storm/QTc prolongation |
Ivermectin | Not recommended by major guidelines |
Vitamins | Continue supplementation |
Key clinical principle
Main treatment is correction of hypoxia and organ support
CORE PRINCIPLE OF COVID-19 MANAGEMENT
Mild → symptomatic care
Moderate → anti-inflammatory therapy
Severe → oxygen + steroids + anticoagulation
Critical → organ support + ICU care
Imeandikwa:
26 Mei 2026, 07:49:04