4.5 Review

How We Have Treated Severe to Critically Ill Patients With Coronavirus Disease 2019 in Korea

Journal

JOURNAL OF KOREAN MEDICAL SCIENCE
Volume 37, Issue 49, Pages -

Publisher

KOREAN ACAD MEDICAL SCIENCES
DOI: 10.3346/jkms.2022.37.e353

Keywords

Coronavirus disease 2019; Antiviral; Dexamethasone; Anticoagulation

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Since 2019, the Republic of Korea has released and revised evidence-based guidelines for the treatment of severe to critically ill patients with COVID-19, which have been widely practiced by medical staff. Dexamethasone is currently used as the main treatment drug, with additional medicines such as remdesivir, baricitinib, and tocilizumab depending on the patient's condition. Venous thromboembolism prophylaxis is also an important adjunctive therapy for severe COVID-19 patients.
Since 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, and the coronavirus disease 2019 (COVID-19) pandemic currently continues. In response to this unprecedented pandemic, several researchers and medical staff have struggled to find appropriate treatments for COVID-19. Patients with mild symptoms can recuperate with symptomatic care, however establishing treatment for severe to critically ill patients who can have a high mortality has been essential. Accordingly, the guidelines for COVID-19 treatment have evolved through numerous trials and errors and have been relatively well established to date. In the Republic of Korea, several evidence-based guidelines for COVID-19 treatment were released and revised, reflecting various research and regional medical conditions. To date, approximately 3 years after the beginning of the COVID-19 pandemic, we are reflecting on the changes in the guidelines thus far and have summarized the treatment experience of severe to critically ill patients with COVID-19. The Korean guidelines for COVID-19 treatment have been updated continuously as the National Institutes of Health (NIH) guidelines have changed. Dexamethasone is currently used as the backbone for the treatment of severe to critically ill patients with COVID-19, and remdesivir, baricitinib, and tocilizumab can be added depending on a patient's situation. In addition, venous thromboembolism prophylaxis is one of the important adjunctive therapies for patients with severe COVID-19. In the clinical field, treatment of severely ill patients with COVID-19 based on guidelines is widely practiced by medical staff and established currently.

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