EDITORIAL


COVID-19: A Therapeutic Approach Based on Pathophysiological Staging



Christian Domingo Ribas1, 2, *
1 Pulmonary Service, Corporació Sanitària Parc Taulí, Barcelona, Spain
2 Departament of Medicine, Universitat Autònoma de Barcelona (UAB) Barcelona, Spain


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Creative Commons License
© 2020 Christian Domingo.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Pulmonary Service, Corporació Sanitària Parc Tauli, Parc Taulí s/n, 08208 Sabadell Barcelona, Spain; Tel: +34 93 723 10 10; Ext; 29142; E-mail: cdomingo@tauli.cat


Editorial

The COVID-19 pandemic is a recently emerging problem. This has caused that the knowledge of the disease has been progressive and, therefore, the therapeutic decisions have been conditioned by this lack of knowledge on the one hand and by the therapeutic limitations on the other. Many published studies are methodologically weak and their conclusions, of limited value, have contributed to creating confusion on the therapeutic approach of the disease.

In the present paper, we propose a therapeutic approach based on a new disease staging. The therapeutic approach is divided into two big sections: the pharmacological treatment for the phase of viral replication, cytokine storm or late respiratory events (which includes the adult respiratory distress syndrome (ARDS)) and the treatment of the respiratory failure In every stage, we discuss the pathophysiology and comment (accept or rule out) the pharmacological options according to the present evidence. Moreover, we indicate how respiratory failure should be treated. Some characteristics are based on the evidence found in the literature. Others are the result of my experience in other situations.