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Seven months after the first confirmed case of covid-19 in Brazil, the pandemic has already caused irreparable damage, killing more than 150,000 Brazilians.
Although we still cannot consider the situation controlled, since there is no medicine or vaccine against the virus, with the effort of scientists and health professionals, who have gained experience in recent months, advances in the care and treatment of patients with The disease was notable and probably kept the number of hospitalizations, complications and deaths from being even higher. All of this contributed to the reduction of the hospitalization rate, reducing the risk of collapse of the health system at that time, allowing life to gradually return to “normality.”
Next, Igor Marinho, infectious diseases specialist at Hospital das Clínicas de São Paulo and Mauro Gomes, head of the pulmonology team at Hospital Samaritano and professor at FCMSC-SP (Faculty of Medical Sciences of Santa Casa de São Paulo), both experienced in treatment. of patients infected by the new coronavirus (Sars-CoV-2), comment on the main factors that contributed to improving the treatment of covid-19:
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Better knowledge of the disease
Many aspects of COVID-19 are still mysterious, such as the prolonged lack of smell and strange smells that patients report feeling months after being infected with the virus. But, over time, health professionals are already familiar with most of the manifestations caused by the virus, they know the stages of evolution and how the body usually fights the invader.
“Something that we already do constantly is risk assessment, as we now know more about the possible complications. We request, for example, laboratory tests that indicate whether the patient is at risk of thrombosis, a condition that can trigger covid-19. If so, we can prescribe anticoagulant prophylactically, even after discharge, “explains Gomes.
Other specific strategies were also adopted. “We learned that pronation, a technique that turns the patient face down to increase the amount of oxygen that enters the lungs and that is already used in the treatment of other respiratory diseases, also works for covid-19,” says Marinho.
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Better understanding of respiratory failure
“Before, it was believed that the patient with respiratory failure needed to be intubated quickly. Today it is known that this need is better evaluated ”, indicates the pulmonologist. According to the doctor, methods such as the high-flow catheter and masks, which are less invasive, work in several cases.
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Pharmacological understanding
By now, science already knows that some drugs did not have the expected effectiveness at the beginning of the pandemic, as is the case with hydroxychloroquine, which is also important to prevent unnecessary side effects.
An example that shows positive results is the use of corticosteroids for patients in serious condition. “But it should be remembered that patients without a medical indication for the drug should not buy it. It does not work as a prophylaxis,” warns Gomes.
There are also those that are considered promising by researchers, such as the use of plasma and antibody treatments, but which, so far, have not shown conclusive results in scientific studies.
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Adoption of protocols in most hospitals
Hospitals have trained their professionals, from doctors to security personnel, at different levels, to offer faster, safer and more effective care. Recommendations range from telling the patient where to screen, depending on the symptoms that occur, to how to properly place and remove PPE (personal protective equipment).
“Education contributes to prevention, so compared to the start of the pandemic, we already have a much faster and more efficient service in most hospitals. Large centers already have specific tests for those with symptoms and also divide areas of the hospital to reduce the risk of infection, “says the infectologist.
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Communication with the families of patients
To improve contact and not leave loved ones in danger, many hospitals have created “humanization centers”.
“At first it was a great difficulty to make the family aware that the visits were not safe. Little by little, hospitals created a strategy to call every day. Many services already offer tablets and smartphones as a communication bridge, ”says Marinho.
