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

다국어 초록 (Multilingual Abstract)

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.

참고문헌 (Reference)

1 "WHO coronavirus disease (COVID-19) dashboard"

2 Hoang Tung ; Anh Tho Tran Thi, "Treatment Options for Severe Acute Respiratory Syndrome, Middle East Respiratory Syndrome, and Coronavirus Disease 2019: a Review of Clinical Evidence" 대한감염학회 52 (52): 317-334, 2020

3 Ejaz A, "Thromboprophylaxis in intensive care unit patients : a literature review" 10 (10): e3341-, 2018

4 홍진영 ; 고재훈 ; 양진영 ; 하소영 ; Eliel Nham ; 허경민 ; 조선영 ; 강철인 ; 정두련 ; 백진양 ; 손유민 ; 박효정 ; 이범기 ; 허희재 ; 강은숙 ; 서지영 ; 정치량 ; 백경란, "Severity-Adjusted Dexamethasone Dosing and Tocilizumab Combination for Severe COVID-19" 연세대학교의과대학 63 (63): 430-439, 2022

5 Kim Sun Bean ; Ryoo Seungeun ; Huh Kyungmin ; Joo Eun-Jeong ; Kim Youn Jeong ; Choi Won Suk ; Kim Yae-Jean ; Yoon Young Kyung ; Heo Jung Yeon ; Seo Yu Bin ; Jeong Su Jin ; Park Dong-ah ; Yu Su-Yeon ; Lee Hyeon-Jeong ; Kim Jimin ; Jin Yan ; Park Jungeun ; Peck Kyong Ran ; Choi Miyoung ; Yeom Joon Sup ; Korean Society of Infectious Diseases (KSID), "Revised Korean Society of Infectious Diseases/National Evidence-based Healthcarea Collaborating Agency Guidelines on the Treatment of Patients with COVID-19" 대한감염학회 53 (53): 166-219, 2021

6 Wang Y, "Remdesivir in adults with severe COVID-19 : a randomised, double-blind, placebo-controlled, multicentre trial" 395 (395): 1569-1578, 2020

7 Beigel JH, "Remdesivir for the treatment of COVID-19-final report" 383 (383): 1813-1826, 2020

8 Horby PW, "Lopinavir-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial" 396 (396): 1345-1352, 2020

9 Kim Sun Bean ; Kim Jimin ; Huh Kyungmin ; Choi Won Suk ; Kim Yae-Jean ; Joo Eun-Jeong ; Kim Youn Jeong ; Yoon Young Kyung ; Heo Jung Yeon ; Seo Yu Bin ; Jeong Su Jin ; Yu Su-Yeon ; Peck Kyong Ran ; Choi Miyoung ; Yeom Joon Sup ; Korean Society of Infectious Diseases (KSID), "Korean Society of Infectious Diseases/National Evidence-based Healthcare Collaborating Agency Recommendations for Anti-SARS-CoV-2 Monoclonal Antibody Treatment of Patients with COVID-19" 대한감염학회 53 (53): 395-403, 2021

10 Kim Sun Bean ; Huh Kyungmin ; Heo Jung Yeon ; Joo Eun-Jeong ; Kim Youn Jeong ; Choi Won Suk ; Kim Yae-Jean ; Seo Yu Bin ; Yoon Young Kyung ; Ku Nam Su ; Jeong Su Jin ; Kim Sung-Han ; Peck Kyong Ran ; Yeom Joon Sup, "Interim Guidelines on Antiviral Therapy for COVID-19" 대한감염학회 52 (52): 281-304, 2020

11 Keyaerts E, "In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine" 323 (323): 264-268, 2004

12 Thachil J, "ISTH interim guidance on recognition and management of coagulopathy in COVID-19" 18 (18): 1023-1026, 2020

13 Mitjà O, "Hydroxychloroquine for early treatment of adults with mild COVID-19: a randomized-controlled trial" 73 (73): e4073-e4081, 2021

14 신형식, "Empirical Treatment and Prevention of COVID-19" 대한감염학회 52 (52): 142-153, 2020

15 Kalil AC, "Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19 : a double-bind, randomised, placebo-controlled, phase 3 trial" 9 (9): 1365-1376, 2021

16 Steinberg KP, "Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome" 354 (354): 1671-1684, 2006

17 Mariette X, "Effectiveness of tocilizumab in patients hospitalized with COVID-19 : a follow-up of the CORIMUNO-TOCI-1 randomized clinical trial" 181 (181): 1241-1243, 2021

18 Hermine O, "Effect of tocilizumab vs usual care in adults hospitalized with COVID-19 and moderate or severe pneumonia : a randomized clinical trial" 181 (181): 32-40, 2021

19 Horby P, "Effect of hydroxychloroquine in hospitalized patients with COVID-19" 383 (383): 2030-2040, 2020

20 Hong Kyung Soo ; Jang Jong Geol ; Hur Jian ; Lee Jong Ho ; Kim Hong Nam ; Lee Wonhwa ; Ahn June Hong, "Early Hydroxychloroquine Administration for Rapid Severe Acute Respiratory Syndrome Coronavirus 2 Eradication" 대한감염학회 52 (52): 396-402, 2020

21 Villar J, "Dexamethasone treatment for the acute respiratory distress syndrome : a multicentre, randomised controlled trial" 8 (8): 267-276, 2020

22 Horby P, "Dexamethasone in hospitalized patients with COVID-19" 384 (384): 693-704, 2021

23 National Evidence based Healthcare Collaborating Agency, "Coronavirus disease 2019 (COVID-19). Living Guideline"

24 COVID-19 Treatment Guidelines Panel, "Coronavirus disease 2019 (COVID-19) treatment guidelines"

25 Im Jae Hyoung ; Nahm Chung Hyun ; Baek Ji Hyeon ; Kwon Hea Yoon ; 이진수, "Convalescent Plasma Therapy in Coronavirus Disease 2019: a Case Report and Suggestions to Overcome Obstacles" 대한의학회 35 (35): 1-5, 2020

26 최준용, "Convalescent Plasma Therapy for Coronavirus Disease 2019" 대한감염학회 52 (52): 307-316, 2020

27 Peck Kyong Ran, "Collaborative Response to COVID-19 Pandemic, and Development of Treatment Guidelines" 대한감염학회 53 (53): 151-154, 2021

28 Adjei P, "Clinical characteristics of COVID-19 patients admitted at the Korle-Bu Teaching Hospital, Accra, Ghana" 54 (54): 33-38, 2020

29 Joo Eun-Jeong ; Ko Jae-Hoon ; 김성은 ; Kang Seung-Ji ; Baek Ji Hyeon ; Heo Eun Young ; Shi Hye Jin ; Eom Joong Sik ; Choe Pyoeng Gyun ; Bae Seongman ; Ra Sang Hyun ; Kim Da Young ; Kim Baek-Nam ; Kang Yu Min ; Kim Ji Yeon ; Chung Jin-Won ; Chang Hyun-Ha ; Bae Sohyun ; Cheon Shinhyea ; Park Yoonseon ; Choi Heun ; Lee Eunjung ; 이보영 ; Park Jung Wan ; Sohn Yujin ; Heo Jung Yeon ; Kim Sung-Han ; Peck Kyong Ran, "Clinical and Virologic Effectiveness of Remdesivir Treatment for Severe Coronavirus Disease 2019 (COVID-19) in Korea: a Nationwide Multicenter Retrospective Cohort Study" 대한의학회 36 (36): 1-13, 2021

30 National Medical Center, "Clinical Practice Guideline for Coronavirus disease 2019 (COVID-19)"

31 Lee Choongman ; Ahn Mi Young ; Byeon Kyeongmin ; Choi Jae-Phil ; Hahm Chorom ; Kim Hyeonmok ; Kim Suhyun ; Kim Tae Ho ; Oh JungKyun ; Oh Dong Hyun, "Clinical Experience with Use of Remdesivir in the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2: a Case Series" 대한감염학회 52 (52): 369-380, 2020

32 Eu Suk Kim ; Bum Sik Chin ; 강창경 ; Nam Joong Kim ; Yu Min Kang ; Jae-Phil Choi ; Dong Hyun Oh ; Jeong-Han Kim ; Boram Koh ; Seong Eun Kim ; Na Ra Yun ; Jae Hoon Lee ; Jin Yong Kim ; Yeonjae Kim ; Ji Hwan Bang ; 송경호 ; Hong Bin Kim ; Ki-hyun Chung ; 오명돈, "Clinical Course and Outcomes of Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a Preliminary Report of the First 28 Patients from the Korean Cohort Study on COVID-19" 대한의학회 35 (35): 1-12, 2020

33 김미선 ; 유정래 ; 허상택 ; 이향란 ; 오현주, "Clinical Characteristics and Risk Factors for Severe Disease of Coronavirus Disease 2019 in a Low Case Fatality Rate Region in Korea" 대한감염학회 53 (53): 718-729, 2021

34 Wu Z, "Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention" 323 (323): 1239-1242, 2020

35 Kalil AC, "Baricitinib plus remdesivir for hospitalized adults with Covid-19" 384 (384): 795-807, 2021

36 Baek Ae-Rin ; Choo Eun Ju ; Kim Ji-Yeon ; Ha Tae Sun ; Park Sung Woo ; Shin Hee Bong ; Shin Hee Bong ; Park Joo Hyun ; Kim Tark, "A Transient Effect of Convalescent Plasma Therapy in a Patient with Severe Covonavirus Disease 2019: A Case Report" 대한감염학회 54 (54): 553-558, 2022