Thread by @bagheera79

ESICM live webinar on #COVIDー19 starting right now

Prof Bin Du Chinese CCM will be updating, Webinar chaired by ESICM President Dr Kesecioglu

Initial impression from Italy are the same as China - age and co-morbidity are the most likely to experience severe disease

First week is mild - and ~20% seem to be GI symptoms rather than resp.
Week two - worsening resp symptoms

“Severe defined as sats <93% on room air”
Critically ill:
Male:Female 2:1
Hypertension/DM important co-morbids
Pregnancy NOT worse (different to flu)
>90% severe hypoxaemia
Shock 30%
AKI 10-30%
Prolonged NIV worsened fatality - *INTUBATE EARLY*

When ventilated:
Refractory hypoxaemia v common
Rescue therapies: NMB, prone, recruitments effective in about 80% of patients

General discussion and feel is that intervention to mechanical ventilation early is a strong recommendation.

Refractory hypercapnia common in 3rd week - felt to be due to small airway plugging ⬆️⬆️deadspace

Given the infectivity, advice is to drill putting on and removing PPE so as to do it properly.

Prof Bin Du’s feel is that facemasks (FFP3/N95) and rigorous frequent handwashing are extremely important as regards PPE and transmission.

Corticosteroids: May be assoc with prolonged viral shedding
?? Beneficial - no data, RCT’s ongoing

Webinar being drawn to a halt due to very poor connectivity/audio issues.