Co-Morbidity Based Questions: Difference between revisions

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====Should ACE Inhibitors and ARBs be discontinued in patients on admission for COVID-19?====
====Should ACE Inhibitors and ARBs be discontinued in patients on admission for COVID-19?====
Based on current studies, it is advisable to continue the current treatment of chronic disease conditions including hypertension with either ACEI or ARB during the COVID-19 pandemic,
 
* Based on current studies, it is advisable to continue the current treatment of chronic disease conditions including hypertension with either ACEI or ARB during the COVID-19 pandemic,


=== <u>Patients with Asthma</u> ===
=== <u>Patients with Asthma</u> ===
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====Should an Asthma exacerbation be managed any differently to reduce the risk of COVID-19?====
====Should an Asthma exacerbation be managed any differently to reduce the risk of COVID-19?====


The selection of therapeutic options through the guideline-recommended treatment of asthma exacerbations has not been affected by what we currently know about COVID-19.
The selection of therapeutic options through the guideline-recommended treatment of asthma exacerbation has not been affected by what we currently know about COVID-19.
Systemic corticosteroids should be used to treat an asthma exacerbation per national asthma guidelines and current standards of care, even if it is caused by COVID-19. Short-term use of systemic corticosteroids to treat asthma exacerbations should be continued. There is currently no evidence to suggest that short-term use of systemic corticosteroids to treat asthma exacerbations increases the risk of developing severe COVID-19, whereas there is an abundance of data to support use of systemic steroids for moderate or severe asthma exacerbations.
Systemic corticosteroids should be used to treat an asthma exacerbation per national asthma guidelines and current standards of care, even if it is caused by COVID-19. Short-term use of systemic corticosteroids to treat asthma exacerbation should be continued. There is currently no evidence to suggest that short-term use of systemic corticosteroids to treat asthma exacerbation increases the risk of developing severe COVID-19, whereas there is an abundance of data to support use of systemic steroids for moderate or severe asthma exacerbation. Patients with asthma but without symptoms or a diagnosis of COVID-19 should continue any required nebulizer for treatments, as recommended by national professional organizations. If healthcare providers need to be present during nebulizer use among patients who have either symptoms or a diagnosis of COVID-19, they should use recommended precautions when performing aerosol-generating procedures (AGPs). If clinicians are concerned that an asthma exacerbation is related to an underlying infection with COVID-19, clinicians can access laboratory testing for COVID-19 through a network of state and local public health laboratories across the country.
Patients with asthma but without symptoms or a diagnosis of COVID-19 should continue any required nebulizer for treatments, as recommended by national professional organizations. If healthcare providers need to be present during nebulizer use among patients who have either symptoms or a diagnosis of COVID-19, they should use recommended precautions when performing aerosol-generating procedures (AGPs).
If clinicians are concerned that an asthma exacerbation is related to an underlying infection with COVID-19, clinicians can access laboratory testing for COVID-19 through a network of state and local public health laboratories across the country.


==== Are any changes recommended to the treatment plan of an asthma patient with  COVID 19? ====
==== Are any changes recommended to the treatment plan of an asthma patient with  COVID 19? ====
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If nebulizer use in a healthcare setting is necessary for patients who have either symptoms or a diagnosis of COVID-19, they must use recommended precautions when performing aerosol-generating procedures (AGPs).
If nebulizer use in a healthcare setting is necessary for patients who have either symptoms or a diagnosis of COVID-19, they must use recommended precautions when performing aerosol-generating procedures (AGPs).


=== <u>Patients currently Undergoing Hemodialysis</u> ===
=== <u>Patients currently Undergoing Hemo-dialysis</u> ===


===Can patients continue receiving Hemodialysis in a hospital where other COVID-19 patients are treated?===
===Can patients continue receiving Hemo-dialysis in a hospital where other COVID-19 patients are treated?===


=== <u>Cancer Patients</u> ===
=== <u>Cancer Patients</u> ===
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==== Can/Should Cancer surgery be delayed? What about radiation therapy? ====
==== Can/Should Cancer surgery be delayed? What about radiation therapy? ====


==== Should immuno-suppresive treatments be discontinued or delayed? ====
==== Should immune-suppressive treatments be discontinued or delayed? ====


==== Are support groups or activites still available in the hospital? ====
==== Are support groups or activities still available in the hospital? ====


==== Should patients take an antiviral medication such as Tami flu for protection? ====
==== Should patients take an antiviral medication such as Tami flu for protection? ====


== Sources ==
== Sources ==

Revision as of 13:16, 15 June 2020

Frequently Asked Inpatient Questions Microchapter

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD

Co-Morbidity Based Questions

Patients with Hypertension

Should ACE Inhibitors and ARBs be discontinued in patients on admission for COVID-19?

  • Based on current studies, it is advisable to continue the current treatment of chronic disease conditions including hypertension with either ACEI or ARB during the COVID-19 pandemic,

Patients with Asthma

Should an Asthma exacerbation be managed any differently to reduce the risk of COVID-19?

The selection of therapeutic options through the guideline-recommended treatment of asthma exacerbation has not been affected by what we currently know about COVID-19. Systemic corticosteroids should be used to treat an asthma exacerbation per national asthma guidelines and current standards of care, even if it is caused by COVID-19. Short-term use of systemic corticosteroids to treat asthma exacerbation should be continued. There is currently no evidence to suggest that short-term use of systemic corticosteroids to treat asthma exacerbation increases the risk of developing severe COVID-19, whereas there is an abundance of data to support use of systemic steroids for moderate or severe asthma exacerbation. Patients with asthma but without symptoms or a diagnosis of COVID-19 should continue any required nebulizer for treatments, as recommended by national professional organizations. If healthcare providers need to be present during nebulizer use among patients who have either symptoms or a diagnosis of COVID-19, they should use recommended precautions when performing aerosol-generating procedures (AGPs). If clinicians are concerned that an asthma exacerbation is related to an underlying infection with COVID-19, clinicians can access laboratory testing for COVID-19 through a network of state and local public health laboratories across the country.

Are any changes recommended to the treatment plan of an asthma patient with COVID 19?

If patients with asthma who have symptoms or a diagnosis of COVID-19 need to use nebulizer at home, it is recommended by national professional organizations that they should use the nebulizer in a location that minimizes and preferably avoids exposure to any other members of the household, and preferably a location where the air is not recirculated into the home (like a porch, patio, or garage). Limiting the number of people in the room or location where the nebulizer is used is also recommended. Nebulizers should be used and cleaned according to the manufacturer’s instructions. If nebulizer use in a healthcare setting is necessary for patients who have either symptoms or a diagnosis of COVID-19, they must use recommended precautions when performing aerosol-generating procedures (AGPs).

Patients currently Undergoing Hemo-dialysis

Can patients continue receiving Hemo-dialysis in a hospital where other COVID-19 patients are treated?

Cancer Patients

Can/Should Cancer surgery be delayed? What about radiation therapy?

Should immune-suppressive treatments be discontinued or delayed?

Are support groups or activities still available in the hospital?

Should patients take an antiviral medication such as Tami flu for protection?

Sources