COVID-19 is the disease caused by the novel coronavirus, SARS-CoV-2. Symptoms include fever, cough, fatigue, shortness of breath, lack of appetite, loss of taste or smell, and diarrhea. Most people who develop COVID-19 have mild symptoms that can (and should) be managed at home. However, some people with COVID-19 develop serious illness and require hospital care. About 25 to 33% of those who are hospitalized need intensive care. Most people who are hospitalized for COVID-19 recover.
Unfortunately, there is no known cure for COVID-19. Scientists and physicians are still searching for effective treatments, but there are some promising therapies currently in use for severely ill COVID-19 patients.
A person who is persistently short of breath may need hospital care. Shortness of breath indicates the lungs are not delivering enough oxygen to the rest of the body; without treatment, oxygen levels may fall and cause organ failure.
Because there is no cure for COVID-19 at this time, hospital care for coronavirus is focused on what’s called supportive care, or treatment to support the body’s vital organs. Doctors, nurses and others will monitor oxygen levels and provide treatment to maintain a healthy supply of oxygen to the rest of the body. Some patients need only a nasal cannula, a tube that’s placed in the nostrils to deliver oxygen. Other patients require an oxygen mask, which can deliver high concentrations of oxygen.
Hospital staff monitor patients’ vital signs (heart rate, blood pressure, number of breaths per minute) to watch for any developing problems. A patient whose heart rate increases as their blood pressure decreases could be experiencing heart trouble; staff will likely run tests and administer IV (intravenous) fluids and medicine to support the heart’s function.
Some patients will be able to eat and drink normally; others are too sick to do so. If needed, hospital staff can deliver nutrition directly into patients’ veins via an IV.
Up until November 2020, there were no FDA-approved treatments specifically for COVID-19. Since then, the FDA has authorized monoclonal antibody drugs—bamlanivimab; combination bamlanivimab and etesevimab; and combination casirivimab and imdevimab—that target the virus"s spike protein. Clinical studies show the antibodies can reduce emergency room visits and hospitalizations in patients with mild to moderate COVID-19. Emergency use authorization (EUA) of the antibodies is for patients with mild-to-moderate COVID-19 at high risk for developing severe COVID-19.
Some existing drugs may help hospitalized patients with COVID-19, so doctors are using a variety of treatments. Patients may receive the following drugs:
Early research from China suggested the malaria drugs, hydroxychloroquine (HCQ) and chloroquine (CQ), might be effective in treating COVID-19. In some cases, they seemed to help; in others, there was no positive effect. The FDA recently withdrew emergency use approval (EUA) for these drugs because they "are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA." HCQ and CQ have serious side effects, including irregular heart rhythms and death.
For information about all COVID-19 clinical trials, visit clinicaltrials.gov and enter "COVID" in the condition field.
If a patient’s condition worsens despite supportive hospital care, the patient may be transferred to the intensive care unit (ICU). Patients in the ICU are monitored even more closely than other hospitalized patients; usually, an ICU nurse only cares for 1 to 2 patients per shift.
If the patient cannot breathe effectively, doctors may recommend intubation—placing a breathing tube in the patient’s airway—and ventilator treatment. A ventilator forces air and oxygen into the lungs. Critical care providers administer drugs so the patient remains sleepy and comfortable. If the patient’s condition improves, the healthcare team will gradually wean the patient off the ventilator.
Hospitalization for coronavirus may be a week or longer. According to the CDC (U.S. Centers for Disease Control and Prevention), the average length of hospitalization for survivors is 10 to 13 days. It is difficult to predict what will happen during coronavirus hospitalization. The healthcare team will do their best to keep you informed at all times.