Table 1.

Recommendations for the management of patients with suspected or confirmed coronavirus infection (SARS-CoV-2).

Place patients preferably in a negative pressure isolation room that meets established standards.

Limit the number of people caring for the patient and the time spent in the room to the absolute minimum.

The protection of medical personnel is a priority, and they must be given adequate personal protective equipment and be trained in donning and doffing techniques.

Use PPEs that protect staff from inhalation and contact with aerosols and droplets that can be generated during therapeutic procedures. PPEs must consist of: N95 respirator or preferably FFP3 mask, close-fitting goggles or full face shield, fluid resistant gown, double gloves, waterproof head and shoe covers.

Perform hand hygiene before and after contact with the patient, particularly before donning and after doffing PPE.

Minimise the need for aerosol-generating procedures, and if unavoidable, always use the recommended protective measures.

If tracheal intubation is needed, it should be performed by the most experienced clinician available. Perform rapid sequence induction, avoid bag-mask ventilation, use a video laryngoscope and preferably a subglottic secretion drainage endotracheal tube.

Start supportive treatment as soon as possible in patients with respiratory involvement (tachypnoea, hypoxaemia) or septic shock.

Avoid high-flow nasal oxygen and non-invasive mechanical ventilation as far as possible – they are aerosol-generating devices and should only be used in certain patients.

Avoid administering antimicrobials unless there is suspicion of associated sepsis or bacterial superinfection. Superinfection with pathogens such as Acinetobacter baumanii and Apergillus fumigatus have been described.

Do not routinely administer systemic steroids.

PPE: personal protective equipment.