Abstract

Review Article

Evidence-based primary care approach to treating people with COVID-19 infection to prevent life-threatening complications: A review of the evidence for practical application in a clinical setting

Thomas A Sharon*

Published: 16 March, 2021 | Volume 5 - Issue 1 | Pages: 009-014

The NIH has published treatment guidelines for treating COVID-19 patients in the hospital. However, as of this writing, there are no established protocols for treating COVID-19 positive patients in primary care. Accordingly, this investigator has taken on the task of reviewing the medical literature to be able to propose evidence-based protocols for treating COVID-19 positive patients in primary care. The CDC is advising people to do nothing when they find out they are positive for COVID-19 unless they have symptoms.

The evidence from the literature irrefutably shows COVID-19 infection evokes a massive and deadly hyperinflammatory response called the “Cytokine storm” and that Cytokine levels in the blood have a predictive value in identifying an impending Cytokine storm. With such data primary care providers can effectively lower Cytokine levels and prevent critical illness and death.

Accordingly, this paper presents identification of the problem of not having standard practices in primary care for people who are positive for COVID-19 and not knowing who is at risk. Moreover, the evidence shows that knowing vitamin D levels and correcting deficiencies can go a long way in reducing Cytokine levels. Additionally, the literature review presents evidence that undeniably shows the stark possibility that many of the COVID-19 related deaths can be prevented by identifying who is at risk for the Cytokine storm and other complications and providing early treatment even before symptoms appear.

Read Full Article HTML DOI: 10.29328/journal.cjncp.1001031 Cite this Article Read Full Article PDF

Keywords:

COVID-19; Cytokines; Cytokine storm; inflammation; Vitamin D; Blood clots; Platelets; D-dimer; Pneumonia; Pulmonary embolism

References

  1. Center for Disease Control and Prevention website. 2020. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html.
  2. Kaur S, Bansal R, Kollimuttathuillam S, Gowda AM, Singh B, et al. The looming storm: Blood and cytokines in COVID-19. Blood Rev. 2020; 100743. PubMed: https://pubmed.ncbi.nlm.nih.gov/32829962/
  3. Liu Y, Zhang C, Huang F, Yang Y, Wang F, et al. Elevated plasma level of selective cytokines in COVID-19 patients reflect viral load and lung injury. National Sci Rev. 2020.
  4. Ragab D, Salah Eldin H, Taeimah M, Khattab R, Salem R. The COVID-19 cytokine storm; what we know so far. Frontiers Immunol. 2020; 11: 1446.
  5. Fara A, Mitrev Z, Rosalia RA, Assas BM. Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines. Open Biol. 2020; 10: 200160. PubMed: https://pubmed.ncbi.nlm.nih.gov/32961074/
  6. Lu L, Zhang H, Zhan M, Jiang J, Yin H, et al. Preventing mortality in COVID-19 patients: which cytokine to target in a raging storm? Front Cell Dev Biol. 2020; 8: 677. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379422/
  7. National Institute of Health Website. Therapeutic Management of Patients with COVID-19. NIH Covid-19 Treatment Guidelines. 2020. https://www.covid19treatmentguidelines.nih.gov/therapeutic-management/
  8. Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, et al. Remdesivir for the Treatment of Covid-19—Final Report. [published online October 8, 2020]. New Engl J Med. 2020; 383: 1813-1826. PubMed: https://pubmed.ncbi.nlm.nih.gov/32445440/
  9. Rhodes JM, Subramanian S, Laird E, Griffin G, Kenny RA. Perspective: Vitamin D deficiency and COVID‐19 severity–plausibly linked by latitude, ethnicity, impacts on cytokines, ACE2 and thrombosis (R1). J Intern Med. 2020. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361294/
  10. Han H, Ma Q, Li C, Liu R, Zhao L, et al. Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors. Emerg Microbes Infect. 2020; 9: 1123-1130. PubMed: https://pubmed.ncbi.nlm.nih.gov/32475230/
  11. Lammers T, Sofias AM, van der Meel R, Schiffelers R, Storm G, et al. Dexamethasone nanomedicines for COVID-19. Nat Nanotechnol. 2020; 15: 622-624. PubMed: https://pubmed.ncbi.nlm.nih.gov/32747742/
  12. Sang Y, Roest M, de Laat B, de Groot PG, Huskens D. Interplay between platelets and coagulation. Blood Rev. 2020. 100733. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354275/
  13. Xu ZS, Shu T, Kang L, Wu D, Zhou X, et al. Temporal profiling of plasma cytokines, chemokines and growth factors from mild, severe and fatal COVID-19 patients. Signal Transduct Target Ther. 2020; 5: 100.

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More