COVID-19: revised WHO technical guidance focuses on severe acute respiratory infection

  • World Health Organization
  • World Health Organization
  • 14 Mar 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Updated WHO technical guidance focuses on managing severe acute respiratory infection (SARI) in patients with suspected COVID-19.

Why this matters

  • All clinicians should consult the technical guidance.

Key points

  • Screen, isolate all patients with suspected COVID-19 at first point of contact with the health care system. 
  • Initiate infection prevention and control (IPC) at point of hospital/facility entry: mask/isolate suspected cases, maintain >1 m between patients.
  • Conduct point-of-care risk assessment at every patient contact to determine need for additional precautions (e.g., droplet, contact, airborne).
  • Adhere to specimen collection, processing, laboratory testing , and biosafety procedure guidance; consider prioritizing testing of symptomatic pregnant women to enable specialized care.
  • Treat pregnant, recently pregnant women with suspected or confirmed COVID-19 with supportive and management therapies, accounting for immunologic, physiologic adaptations during/after pregnancy. 
  • Data in children remain scarce, and relatively few cases have been reported in infants; both populations appear to experience less severe to mild symptoms.
  • Infections with non-COVID-19 pathogens does not rule out COVID-19.
  • Severe cases (SARI, respiratory distress, hypoxemia, shock): provide immediate airway management, oxygen therapy (target SpO 2 >94%).
  • Initiate supportive care interventions in patients with clinical deterioration.
  • Tailor treatment to comorbidities.
  • Avoid aggressive fluid management in SARI patients with evidence of shock. 
  • Consult guidance for additional measures.