The clinical presentation of SARS CoV-2 ranges from a mild common cold-like illness, to a severe viral pneumonia leading to acute respiratory distress syndrome that is potentially fatal. Large, retrospective case series from China have shown that the elderly, those with co-morbidities, and those with pneumonia, are most at risk (3-6). Treatment is largely supportive, although in-vitro and early retrospective data regarding the off-label use of several compounds, such as remdesivir (RD/GS-5734), chloroquine (CQ), hydroxychloroquine (HCQ), lopinavir-ritonavir (LPV/r) and tocilizumab (TCZ) show promise.
This interim management guidelines (version 2.1) is written with the intention to guide clinicians managing COVID-19 cases. It is based on early scientific evidence that is also rapidly evolving, as more is discovered about the pathophysiology of SARS CoV-2 and the pathogenesis of the disease. As such, the recommendations in this guideline are based on limited, often low-quality evidence, and need to be carefully balanced with clinical judgment. The use of investigational drugs should be discussed with the patient or a legally authorized representative carefully outlining the potential adverse reactions and the potential clinical benefits of these investigational drugs. A signed informed consent should be obtained by the clinician.