key: cord-0010389-4hamvq0j
authors: Akay, Serhat; Akay, Huriye
title: An invited commentary on: “Evidence based management guideline for the COVID-19 pandemic - Review article”
date: 2020-04-21
journal: Int J Surg
DOI: 10.1016/j.ijsu.2020.04.032
sha: d0e68cc4513ef6e153ea3f4736850ddb48214205
doc_id: 10389
cord_uid: 4hamvq0j

nan

Considered to be one of the greatest pandemics of modern times, Coronavirus disease 19 (Covid-19) is an infectious disease caused by the novel "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2). Since World Health Organization declared pandemic on 11 March 2020, and the number of confirmed cases are growing exponentially with around 2 million cases with mortality rate of around 2% worldwide at the time of writing [1] . Early published data showed 25.9% of SARS-CoV-2 related pneumonia required ICU admission and 20.1% developed acute respiratory syndrome [2] .

With escalating understanding how SARS-CoV-2 infects the host and more treatment options emerge, there is more need for updated information for the medical professionals. Surging of cases and unpreparedness of health systems, physicians outside specialties that normally treat Covid-19 patients (intensive care, infectious disease, emergency medicine e.g.), physicians from other specialties need to take part in the diagnosis and treatment of patients. Maria Nicola et. al had written a comprehensive upto-date evidence-based review of current practice to implement in this pandemic [3] .

Although descriptive statistics may change from region to region, this compact review may serve as a general guideline for all disciplines.

Growing number of publications emerge in literature to understand the pathophysiology of the disease and treatments offered. There is one issue we want to add to this well-written review, which is passive immunization using convalescent plasma from recovered patients. Although a meta-analysis conducted for the effectiveness of convalescent plasma and hyperimmune immunoglobulin for previous coronavirus related severe acute respiratory syndromes concluded this therapy reduces mortality, this advice was based on low-quality, uncontrolled studies [4] . With a growing number of recovered Covid-19 patients, they can be a valuable resource for this purpose but randomized controlled trials are needed to reach a conclusion.

Practicing medicine in pandemic has many disadvantages; limited medicine and medical supplies, increased working hours, shortage of medical and public health infrastructure due to surge of cases and the list goes on. But we, as health professionals, are also lucky to witness a global pandemic when escalating amount of new information appear. Absence of a definitive management protocols, treatment plans tried out of desperation, lack of rigorous clinical trials may hinder optimum treatment but we need to follow the literature more closely to give the best treatment available to our patients.

Invited Commentary, internally reviewed

WHO Director-General's opening remarks at the media briefing on COVID-19 -11

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges

Evidence Based Management Guideline for the COVID-19 Pandemic -Review article

Convalescent Plasma Study Group. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis