A Fourteen-day Experience with Coronavirus Disease 2019 (COVID-19) Induced Acute Respiratory Distress Syndrome (ARDS): An Iranian Treatment Protocol

Jamaati, Hamidreza; Dastan, Farzaneh; Tabarsi, Payam; Marjani, Majid; Saffaei, Ali; Hashemian, Seyed MohammadReza

doi:10.22037/ijpr.2020.113337.14239

A Fourteen-day Experience with Coronavirus Disease 2019 (COVID-19) Induced Acute Respiratory Distress Syndrome (ARDS): An Iranian Treatment Protocol

Document Type: Research article

Authors

¹ Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

² Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

³ Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

⁴ Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

10.22037/ijpr.2020.113337.14239

Abstract

COVID-19 is currently causing concern in the medical community as the virus is spreading
around the world. It has a heavy global burden, particularly in low-income countries. The clinical
spectrum of COVID-19 pneumonia ranges from mild to critically ill cases and Acute Respiratory
Distress Syndrome. An expert panel was held and an internal protocol was developed to manage
the COVID-19 induced ARDS according to WHO recommendations and NIH guidelines.
Different therapeutic regimens were employed on this protocol based on the ARDS severity and
the patients’ special characteristics. The mortality rate, the rate of survivors, and non-survivors
were reported. Of the 231 suspected cases of COVID-19 admitted to the hospital during two
weeks, 72 patients were admitted to ICU with diagnosis confirmed by RT-PCR. In total, mortality
in the ICU was 25% (n = 18) among ARDS patients over two weeks. COVID-19 induced ARDS
is a major concern. The rapid progression of ARDS needs specific protocol based on patients’
characteristics and rapid action.

Graphical Abstract