Treatments at Home and Hospital
The majority of people with COVID-19 experience a mild or moderate illness that does not require going to hospital. The NHS website suggests that there are things you can do to help treat mild symptoms of COVID-19 while you’re staying at home and self-isolating. These include getting rest and fluids for a high temperature, lying on your side and honey for a cough and keeping a cool room, sitting upright, relaxing shoulders and breathing in slowly though nose and out through the mouth and to seek medical advice.
Those suffering with more severe symptoms who need help breathing or other organ support are admitted to hospital where they can receive supportive care to maintain the function of the body's vital organs while they fight the disease.
Below are some of the treatments received by some patients:
Damaged lungs are not very effective in allowing oxygen to pass into the blood so these patients will be given supplemental oxygen. This can be administered in a number of ways, including into the nose using plastic tubing, or via a loose-fitting face mask.
Continuous Positive Airway Pressure (CPAP)
If oxygen therapy isn’t enough, oxygen under pressure can be used to help the movement of gases in and out of the lungs. A mask connected to a machine via plastic tubing is tightly fitted to the patient who remains awake, and doctors can control the pressure and amount of oxygen delivered by the machine.
This treatment requires large quantities of oxygen and may also create virus aerosols so staff require high levels of personal protective equipment (PPE) with suitable masks.
Invasive Mechanical Ventilation (IMV)
A small proportion of the most unwell patients with COVID-19 will be put on a ventilator by a treatment called invasive mechanical ventilation (IMV). Here the patient is sedated and a breathing tube put into their windpipe (intubation) and the machine does the breathing.
Some ventilated patients benefit from being positioned on their front (proning), possibly because it opens up more of the lung and therefore allows for better exchange of gases between the air and bloodstream.
Ventilating is continued for 10 days on average and a large proportion die, in addition some acquire complications such as hospital-acquired bacterial infections of the chest, urine or bloodstream are common during treatment in ICU, which further increase the chance of the patient dying.
This treatment requires complex equipment and one highly-trained nurse per patient.
Extracorporeal Membrane Oxygenation (ECMO)
In the UK, a very small number of critically unwell patients whose lungs are severely damaged and who were otherwise fit and healthy before, can be treated with ECMO. This requires a machine with a pump that moves blood between the body and the machine, and a ‘membrane’ that acts as an artificial lung. It allows the body’s lungs to be rested which may give them a better chance to heal.
Other Organ support
In patients who are critically unwell, other organs such as the kidneys and the cardiovascular system (including the heart and blood vessels) may be affected. The kidneys perform the essential role of filtering the blood and removing waste products and fluid and in some cases the impairment of kidney function is so severe that the patient requires a machine to perform the kidneys’ role of filtering blood; this is called renal replacement therapy or dialysis.
A proportion of patients admitted to the Intensive Care Unit have very low blood pressure. If untreated, this could damage all organs by starving them of oxygen. Blood pressure can be maintained by infusing medications, such as noradrenaline.