Treatment of COVID-19 is critically phase specific
A number of beneficial (corticosteroids and remdesivir), and potentially beneficial therapies, exist for the treatment of COVID-19. What is not widely appreciated is that patients with COVID-19 progress though several distinct phases, with each stage having a different treatment strategy (Figure 1). This fact is of critical importance in achieving the best possible outcomes of this disease. The symptomatic phase is marked by enormous viral replication reaching viral loads in the upper respiratory tract in excess of a billion virions per milliliter, with a very limited host inflammatory response. While patients may remain SARS-CoV-2 PCR positive for weeks (and in...
On becoming a COVIDologist: An intensivist tale
In late December 2019, I was made aware of a novel coronavirus, which had been identified as the cause of a cluster of pneumonia and acute hypoxemic respiratory failure in Wuhan, China. As we are now aware, this coronavirus disease 2019 (COVID-19) outbreak became a global pandemic. Over the next several months, I read everything I could about this illness, from basic epidemiology to advance diagnostic and therapeutic methods.
By the end of February of 2020, a series of cases were reported in the United States, and large mass gathering events were cancelled. At that time, I knew I was going to be called upon to take care of these patients in a very short period of time.