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. 2020 May 14;14(2):232–248. doi: 10.1007/s11684-020-0774-9

Organ function support in patients with coronavirus disease 2019: Tongji experience

Yong Li 1, Fan He 2, Ning Zhou 3,4, Jia Wei 5, Zeyang Ding 6,7, Luyun Wang 3,4, Peng Chen 3,4, Shuiming Guo 2, Binhao Zhang 6,7, Xiaoning Wan 3,4, Wei Zhu 8,✉; Multidisciplinary Team for COVID-199
PMCID: PMC7220847  PMID: 32405974

Abstract

Coronavirus disease 2019 (COVID-19) is a highly contagious disease and a serious threat to human health. COVID-19 can cause multiple organ dysfunction, such as respiratory and circulatory failure, liver and kidney injury, disseminated intravascular coagulation, and thromboembolism, and even death. The World Health Organization reports that the mortality rate of severe-type COVID-19 is over 50%. Currently, the number of severe cases worldwide has increased rapidly, but the experience in the treatment of infected patients is still limited. Given the lack of specific antiviral drugs, multi-organ function support treatment is important for patients with COVID-19. To improve the cure rate and reduce the mortality of patients with severe- and critical-type COVID-19, this paper summarizes the experience of organ function support in patients with severe- and critical-type COVID-19 in Optical Valley Branch of Tongji Hospital, Wuhan, China. This paper systematically summarizes the procedures of functional support therapies for multiple organs and systems, including respiratory, circulatory, renal, hepatic, and hematological systems, among patients with severe- and critical-type COVID-19. This paper provides a clinical reference and a new strategy for the optimal treatment of COVID-19 worldwide.

Keywords: COVID-19, severe and critical type, organ function support

Compliance with ethics guidelines

The authors declare that they have no conflicts of interest. This manuscript does not involve a research protocol requiring approval by the relevant institutional review board or ethics committee.

References

  • 1.Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, Huang H, Zhang L, Zhou X, Du C, Zhang Y, Song J, Wang S, Chao Y, Yang Z, Xu J, Zhou X, Chen D, Xiong W, Xu L, Zhou F, Jiang J, Bai C, Zheng J, Song Y. JAMA Intern Med. 2020. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-Infected pneumonia in wuhan, china. JAMA. 2020;323(11):1061–1069. doi: 10.1001/jama.2020.1585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.National Health Commission of China . Diagnosis and treatment protocol for novel coronavirus pneumonia. 7th interim edition 2020. [Google Scholar]
  • 4.Chen L, Liu HG, Liu W, Liu J, Liu K, Shang J, Deng Y, Wei S. Chin J Tuberc Respir Dis (Zhonghua Jie He He Hu Xi Za Zhi) 2020. Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia. [DOI] [PubMed] [Google Scholar]
  • 5.Liu J, Liu Y, Xiang P, Pu L, Xiong HF, Li CS, Zhang M, Tan JB, Xu YL, Song R, Song MH, Wang L, Zhang W, Bing H, Yang L, Wang XJ, Zhou GQ, Zhang T, Li B, Wang YB, Chen ZH, Wang XB. Medrxiv. 2020. Neutrophil-to-lymphocyte ratio predicts severe illness patients with 2019 novel coronavirus in the early stage. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Sun TW, Shang Y. Chin Crit Care Med (Zhonghua Wei Zhong Bing Ji Jiu Yi Xue) 2020. Chinese experts consensus on diagnosis and treatment of severe and critical new coronavirus pneumonia; p. 32. [DOI] [PubMed] [Google Scholar]
  • 7.Guan XD, Qiu HB, Du B. Chin J Crit Care Intensive Care Med (Zhonghua Zhong Zheng Yi Xue Dian Zi Za Zhi) 2020. Expert recommendations on severe type coronavirus disease 2019; p. 6. [Google Scholar]
  • 8.Zhao JP, Hu Y, Du RH, Cheng ZS, Jin Y, Zhou M, Zhang J, Qu JM, Cao B. Chin J Tuberc Respir Dis (Zhonghua Jie He He Hu Xi Za Zhi) 2020. Expert consensus on the use of corticosteroid in patients with 2019-nCoV pneumonia. [DOI] [PubMed] [Google Scholar]
  • 9.Critical care committee of Chinese Association of Chest Physician. Respiratory and critical care group of Chinese Thoracic Society. Respiratory care group of Chinese Thoracic Society . Chin J Tuberc Respir Dis (Zhonghua Jie He He Hu Xi Za Zhi) 2020. Conventional respiratory support therapy for severe acute respiratory infections (SARI): clinical indications and nosocomial infection prevention and control. [DOI] [PubMed] [Google Scholar]
  • 10.Wang D, Jiang JG, Li S, Yan JT, Zhao CX, Wang Y, Ma YX, Zeng HS, Guo XM, Wang H, Tang JR, Zuo HJ, Lin L, Cui GL, Editorial Board of Chinese Journal of Cardiology. Working Group of Adult Fulminant Myocarditis Chinese society of cardiology expert consensus statement on the diagnosis and treatment of adult fulminant myocarditis. Sci China Life Sci. 2019;62(2):187–202. doi: 10.1007/s11427-018-9385-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, Tan KS, Wang DY, Yan Y. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak—an update on the status. Mil Med Res. 2020;7(1):11. doi: 10.1186/s40779-020-00240-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Joannidis M, Forni LG. Clinical review: timing of renal replacement therapy. Crit Care. 2011;15(3):223. doi: 10.1186/cc10109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Miao H, Shi J, Wang C, Lu G, Zhu X, Wang Y, Cui Y, Zhang Y. Continuous renal replacement therapy in pediatric severe sepsis: a propensity score-matched prospective multicenter cohort study in the PICU. Crit Care Med. 2019;47(10):e806–e813. doi: 10.1097/CCM.0000000000003901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Putzu A, Fang MX, Boscolo Berto M, Belletti A, Cabrini L, Cassina T, Landoni G. Blood purification with continuous veno-venous hemofiltration in patients with sepsis or ARDS: a systematic review and meta-analysis. Minerva Anestesiol. 2017;83(8):867–877. doi: 10.23736/S0375-9393.17.11946-2. [DOI] [PubMed] [Google Scholar]
  • 15.Han F, Sun R, Ni Y, Hu X, Chen X, Jiang L, Wu A, Ma L, Chen M, Xv Y, Tu Y. Early initiation of continuous renal replacement therapy improves clinical outcomes in patients with acute respiratory distress syndrome. Am J Med Sci. 2015;349(3):199–205. doi: 10.1097/MAJ.0000000000000379. [DOI] [PubMed] [Google Scholar]
  • 16.Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–513. doi: 10.1016/S0140-6736(20)30211-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, Spitters C, Ericson K, Wilkerson S, Tural A, Diaz G, Cohn A, Fox L, Patel A, Gerber SI, Kim L, Tong S, Lu X, Lindstrom S, Pallansch MA, Weldon WC, Biggs HM, Uyeki TM, Pillai SK, Washington State 2019-nCoV Case Investigation Team First case of 2019 novel coronavirus in the United States. N Engl J Med. 2020;382(10):929–936. doi: 10.1056/NEJMoa2001191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5. [DOI] [PMC free article] [PubMed] [Google Scholar]

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