Abstract:
Coronavirus disease 2019 (COVID-19) was first identified in December 2019 in Wuhan, China. The first analyses of cases described high numbers of critically ill patients requiring intensive care admission with significant late inflammatory features. By the time the first cases of SARS-CoV-2 infection were diagnosed in the UK, a wide range of drugs were under consideration and it became clear that the input of clinicians covering all organ systems (in particular, infectious diseases, haematology, rheumatology, renal medicine and intensive care) and of expert specialist pharmacists was necessary at the local level. Thus, an expert multidisciplinary (MDT) group within our organisation was convened to offer a standardised approach and robust clinical governance for the treatment of COVID-19 patients admitted to our hospitals and rapidly develop standards of care as evidence evolved. This commentary explores the methods and mechanisms for creating an MDT COVID-19 treatment working group which are applicable to any hospital likely to admit and care for high numbers of COVID-19 patients and demonstrates how the structure and governance of the group allowed for rapid adoption of both dexamethasone and tocilizumab into standard of care as data became available.
摘要:
2019年冠状病毒病(COVID-19)于2019年12月在武汉首次被发现,中国。对病例的首次分析描述了大量需要重症监护的重症患者,这些患者具有明显的晚期炎症特征。到英国诊断出首例SARS-CoV-2感染病例时,正在考虑广泛的药物,很明显,临床医生的投入涵盖了所有器官系统(特别是,传染病,血液学,风湿病,肾脏医学和重症监护)和专家药剂师在地方一级是必要的。因此,我们组织内的多学科(MDT)专家小组召开会议,为我们医院收治的COVID-19患者的治疗提供标准化方法和强有力的临床治理,并随着证据的发展迅速制定护理标准。这篇评论探讨了创建MDTCOVID-19治疗工作组的方法和机制,该工作组适用于任何可能收治和护理大量COVID-19患者的医院,并展示了该小组的结构和治理如何允许在数据可用时将地塞米松和托珠单抗快速纳入护理标准。