OVID-19 Management experience What we learned from bedside experience in COVID-19 treatment Dr. Essam A. Salem, ICU Registrar, Meeqat GENERAL.HOSPITAL, Head OF ICU Unit Meeqat General Hospital

2. 1-When to start Antiviral
2-Antibiotics
3-Corticosteroids
4-Tocilizumab
5-Mechanical ventilation
6-The psychological state of the patient
7-Anticoagulants
8-Ivermectin and hydroxylchloroquine
9-Lasix

3. Once there is a radiological finding in CXR, we
must start antiviral treatment even if the swab
result have not yet come out. If the swab result
came out negative we continued to administrate
the Antiviral treatment and retested the patient
again for covid19
If fever persisted for more than two days Antiviral
treatment was initiated

5. We discovered early that we have to start broad spectrum
Antibiotics if there is CXR findings
1-Vancomycin or Linzolid
2-Meropenam, Imepenim or Tazocin
3-Moxifloxacin
4-Azithromycin

6. Arguing about wither or not we should follow treatment
guidelines of community acquired pneumonia made us
always late by one or two steps in COVID19
pneumonia due to secondary bacterial infection

8. We started administrating IV Methylprednisolone in all cases
admitted to the ICU since March 2020 and we think it's one of
the main reasons of good treatment outcome
Later dexamethasone and methylprednisolone was added to
MOH protocol

9. Methylprednisolone also continued for some patients by
a pulmonology consultant to prevent progression of
interstitial lung fibrosis in cases complicated by
interstitial lung fibrosis

11. This medication is not in the MOH protocol
Tocilizumab showed improvement in cases pre
intubation or just intubated
Improvement can be observed within few hours

12. Intubated cases have had very poor outcome
intubation should be delayed as much as possible..
High flow nasal cannula
*
.
* NIV

13. The psychological status of the patient plays a very
important role in patient's prognosis
Irritable and uncooperative patients are usually
intubated early due to their exhausted state caused by
unnecessary and purposeless movement and speech.

15. Anticoagulants play a huge role in
preventing and reducing morbidity and
mortality related to COVID-19

16. Hydroxylchloroquine is approved by WHO to be
effective in mild cases
Ivermectin is used to treat COVID-19 in Egypt,
Bangladesh, and Brazil.
The medication is not approved by the FDA for
COVID-19 cases yet.

17. Diuretics are very important in prevention of
intubation .
If we had the slightest doubt about the patient’s
cardiac function an ECHO was done to review
any indication for diuretics or other supportive
cardiac medications .

18. Don’t be late in starting :
-Antiviral
-Antibiotics
-Corticosteroids.
Hesitation in starting the treatment can only harm the
patient
COVID-19 is a professional killer that can only be
stopped by professional and efficient medical
practitioners.