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đi?u tr? va ki?m soat COVID-19 ? Wikipedia ti?ng Vi?t B??c t?i n?i dung

đi?u tr? va ki?m soat COVID-19

Bach khoa toan th? m? Wikipedia

Hi?n t?i, v?n ch?a co co ph??ng phap ho?c thu?c đ?c tr? hi?u qu? cho b?nh virus corona 2019 (COVID-19), do virus SARS-CoV-2 gay ra. [1] [ C?n c?p nh?t ] [2] Sau m?t n?m k? t? khi đ?i d?ch bung phat, cac v?c-xin co hi?u qu? cao hi?n đa đ??c gi?i thi?u va b?t đ?u lam ch?m s? lay lan c?a SARS-CoV-2; tuy nhien, đ?i v?i nh?ng ng??i đang ch? tiem ch?ng, c?ng nh? đ?i v?i hang tri?u ng??i (con s? ??c tinh) b? suy gi?m mi?n d?ch khong co kh? n?ng đap ?ng m?nh m? v?i tiem ch?ng, vi?c đi?u tr? v?n đong m?t vai tro quan tr?ng. [3] Do v?y, s? thi?u ti?n tri?n trong vi?c phat tri?n cac ph??ng phap đ?c tr? hi?u qu? đ?ng ngh?a v?i vi?c: n?n t?ng c?a vi?c ki?m soat COVID-19 la ch?m soc h? tr? hay đi?u tr? tri?u ch?ng , bao g?m đi?u tr? đ? lam gi?m cac tri?u ch?ng , thay th? d?ch l?ng , li?u phap oxy , thay đ?i t? th? sang n?m s?p khi c?n thi?t, c?ng nh? s? d?ng cac lo?i thu?c ho?c thi?t b? đ? h? tr? nh?ng c? quan thi?t y?u trong c? th?. [4] [5] [6]

H?u h?t cac ca m?c COVID-19 đ?u ch? m?c nh? ho?c v?a. Trong nh?ng tr??ng h?p nay, ch?m soc h? tr? bao g?m s? d?ng thu?c nh? paracetamol ho?c NSAID đ? gi?m cac tri?u ch?ng (s?t, đau nh?c c? th?, ho) c?ng nh? th?c hi?n hi?u qu? cac bi?n phap nh? b? sung d?ch l?ng, ngh? ng?i va th? b?ng m?i. [2] [7] [8] [9] V? sinh ca nhan t?t va m?t ch? đ? ?n u?ng lanh m?nh c?ng đ??c khuy?n khich. [10] Trung tam Ki?m soat va Phong ng?a D?ch b?nh Hoa K? (CDC) khuy?n cao nh?ng ai nghi ng? minh mang virus nen t? cach ly ? nha va đeo kh?u trang. [11]

Nh?ng ng??i v?i bi?u hi?n n?ng h?n co th? s? c?n ph?i đi?u tr? t?i b?nh vi?n. ? nh?ng ng??i co m?c oxy th?p, glucocorticoid dexamethasone đ??c khuy?n ngh? s? d?ng, vi no co th? lam gi?m nguy c? t? vong. [12] [13] [14] Thong khi khong xam l?n va n?ng h?n la, nh?p vi?n khu h?i s?c tich c?c đ? th? may la cac bi?n phap co th? c?n trong h? tr? ho h?p. [15] Trao đ?i oxy qua mang ngoai c? th? (ECMO) đa đ??c s? d?ng đ? gi?i quy?t v?n đ? suy ho h?p, nh?ng l?i ich c?a no v?n đang đ??c xem xet. [16] [17] M?t s? tr??ng h?p b?nh di?n ti?n n?ng la do qua trinh viem nhi?m toan than, đ??c g?i b?ng cai ten la bao cytokine . [18]

M?t s? ph??ng phap đi?u tr? th? nghi?m đang đ??c tich c?c nghien c?u trong cac th? nghi?m lam sang . [1] [1] Co m?t s? ph??ng phap t?ng đ??c cho la co tri?n v?ng s?m trong đ?i d?ch, ch?ng h?n nh? s? d?ng hydroxychloroquine hay lopinavir/ritonavir , nh?ng cac nghien c?u sau đo ch? ra r?ng chung khong th?c s? hi?u qu?, th?m chi la co th? gay h?i. [1] [19] [20] M?c du cac nghien c?u đang đ??c ti?n hanh, v?n ch?a co đ? b?ng ch?ng ch?t l??ng t?t đ? khuy?n ngh? đi?u tr? s?m. [19] [20] Tuy v?y, t?i Hoa K?, hai li?u phap d?a tren khang th? đ?n dong đa co s?n đ? s? d?ng s?m trong nh?ng ca m?c đ??c cho la co nguy c? cao ti?n tri?n thanh b?nh n?ng. [20] Remdesivir v?i kh? n?ng khang virus hi?n đa co s?n ? Hoa K?, Canada, Uc va m?t s? qu?c gia khac, v?i cac h?n ch? s? d?ng khac nhau; tuy nhien, lo?i thu?c khong đ??c khuy?n khich cho nh?ng ng??i c?n th? may va hoan toan khong đ??c khuy?n khich b?i T? ch?c Y t? Th? gi?i (WHO), [21] do b?ng ch?ng h?n ch? v? tinh hi?u qu? c?a no. [1]

M?t s? ng??i co th? g?p cac tri?u ch?ng dai d?ng ho?c tan t?t sau khi ph?c h?i sau ph?i nhi?m; tinh tr?ng nay đ??c g?i la h?i ch?ng COVID keo dai . Nh?ng thong tin v? cach ki?m soat va ph?c h?i t?t nh?t cho nh?ng tr??ng h?p nay v?n con r?t h?n ch?. [15]

WHO, ?y ban Y t? Qu?c gia Trung Qu?c , Vi?n Qu?c gia v? Y t? va Ch?m soc Xu?t s?c V??ng qu?c Anh, va Vi?n Y t? Qu?c gia Hoa K? , cung v?i cac c? quan va t? ch?c khac tren toan th? gi?i, đ?u đa cong b? cac khuy?n ngh? va h??ng d?n ch?m soc ng??i b? COVID?19. [22] [23] [15] [24] Cac nha nghien c?u tri?u ch?ng va cac bac s? chuyen khoa ph?i ? Hoa K? đa t?ng h?p cac khuy?n ngh? đi?u tr? t? cac c? quan khac nhau thanh m?t ngu?n tai li?u mi?n phi, co t?i IBCC . [25] [26]

Cac thu?c ch?a tr? [ s?a | s?a ma ngu?n ]

M?t bac s? gay me ki?t s?c ? Pesaro , Y, thang 3 n?m 2020

đa co m?t s? l??ng l?n cac thu?c đ??c xem xet đ? s? d?ng cho b?nh nhan COVID-19. [27] Tinh đ?n thang 2 n?m 2021, t?i Hoa K?, remdesivir đa đ??c FDA ch?p thu?n cho s? d?ng tren m?t s? b?nh nhan COVID-19, va đa co gi?y phep s? d?ng kh?n c?p cho cac thu?c nh? baricitinib , bamlanivimab , bamlanivimab/etesevimab , va casirivimab/imdevimab . [28] Vao ngay 16 thang 4 n?m 2021, FDA đa thu h?i gi?y phep s? d?ng kh?n c?p (EUA) đ?i v?i li?u phap s? d?ng m?t minh khang th? đ?n dong bamlanivimab đ? đi?u tr? COVID-19 cho b?nh nhan nhi?m COVID-19 ? m?c nh? đ?n trung binh ? ng??i l?n va m?t s? b?nh nhan nhi. [29] T?i lien minh Chau Au , vi?c s? d?ng dexamethasone đa đ??c xac nh?n va thu?c remdesivir đ??c c?p gi?y phep l?u hanh co đi?u ki?n . [30] Dexamethasone cho th?y l?i ich lam sang trong đi?u tr? COVID-19, đ??c xac đ?nh trong cac th? nghi?m ng?u nhien co đ?i ch?ng. [31] [32] Nghien c?u ban đ?u cho th?y tac d?ng c?a remdesivir trong vi?c ng?n ng?a t? vong va rut ng?n th?i gian b? b?nh, nh?ng đi?u nay khong đ??c ch?ng minh b?i cac th? nghi?m sau đo. [1] M?t s? cac thu?c khac nh? budesonide va tocilizumab co cho th?y m?t s? k?t qu? đang h?a h?n nh?ng v?n đang đ??c nghien c?u k? h?n. [33] [34] [35]

Trong nh?ng thang đ?u c?a đ?i d?ch, nhi?u bac s? ? khoa h?i s?c tich c?c khi đ?i m?t v?i tinh ch?t ch?t ng??i c?a virus đa m?o hi?m ke đ?n cac ph??ng phap đi?u tr? b?ng ph?ng đoan vi hoan c?nh ch?a t?ng co c?a đ?i d?ch. [36] Tuy nhien, tieu chu?n quan tam cho h?u h?t cac b?nh kho ch?a la khi c?n b?nh t?n t?i qua nhi?u n?m, cac bac s? s? xay d?ng m?t kh?i l??ng nghien c?u đ? ki?m tra cac ly thuy?t khac nhau, so sanh va đ?i chi?u li?u l??ng c?ng nh? xem xet hi?u qu? c?a m?t lo?i thu?c nay so v?i m?t lo?i thu?c khac. [36]

M?t s? lo?i thu?c khang virus đang đ??c xem xet đ? s? d?ng đ?i v?i COVID-19, m?c du ch?a co lo?i thu?c nao đ??c ch?ng minh la co hi?u qu? ro rang tren t? l? t? vong trong cac th? nghi?m đ?i ch?ng ng?u nhien đa đ??c cong b?. [37] Vi?c s? d?ng huy?t t??ng h?i ph?c nh? m?t l?a ch?n đi?u tr? đa đ??c nghien c?u nh?ng khong cho th?y hi?u qu?. [38] [39] Cac th? nghi?m khac đang đi?u tra xem li?u cac lo?i thu?c hi?n co co th? đ??c s? d?ng hi?u qu? đ? ch?ng l?i ph?n ?ng mi?n d?ch c?a c? th? đ?i v?i vi?c nhi?m SARS-CoV-2 hay khong. [37] [40] Nghien c?u v? cac ph??ng phap đi?u tr? ti?m n?ng đa b?t đ?u t? thang 1 n?m 2020, [41] va m?t s? lo?i thu?c khang virus đang đ??c th? nghi?m lam sang. [42] [43] M?c du co th? c?n đ?n t?n n?m 2021 đ? phat tri?n cac lo?i thu?c m?i, [44] m?t s? lo?i thu?c đang đ??c th? nghi?m đa đ??c phe duy?t cho cac m?c đich s? d?ng khac ho?c đa đang trong qua trinh th? nghi?m nang cao. [45] Thu?c khang virus co th? đ??c th? ? nh?ng ng??i b? b?nh n?ng. [4] WHO khuy?n khich cac tinh nguy?n vien tham gia vao cac cu?c th? nghi?m v? tinh hi?u qu? va an toan c?a cac ph??ng phap đi?u tr? ti?m n?ng. [46]

Cac ph??ng phap khang th? đ?n dong nh? bamlanivimab/etesevimab va casirivimab/imdevimab đa đ??c quan sat la giup gi?m s? ca nh?p vi?n, s? ca c?p c?u va s? ca t? vong. [47] [48] Hai lo?i thu?c k?t h?p nay đa đ??c cho phep s? d?ng kh?n c?p b?i FDA . [47] [48]

S? d?ng m?t s? lo?i thu?c khong ke đ?n nh? paracetamol hay ibuprofen c?ng nh? u?ng đ? n??c va ngh? ng?i h?p ly co th? giup lam gi?m cac tri?u ch?ng. [2] [49] Tuy thu?c vao m?c đ? nghiem tr?ng c?a b?nh, li?u phap oxy va tiem t?nh m?ch c?ng co th? la c?n thi?t. [50]

M?t s? ph??ng phap đi?u tr? thay đ?i b?nh ( disease-modifying ) đa đ??c nghien c?u va phat hi?n ra la khong hi?u qu? ho?c khong an toan, do đo khong đ??c khuy?n khich s? d?ng; chung bao g?m baloxavir marboxil , lopinavir /ritonavir , ruxolitinib , chloroquine , hydroxychloroquine , interferon β-1a va colchicine . [14] Favipiravir va nafamostat đa cho ra cac k?t qu? khac nhau nh?ng v?n đang trong qua trinh th? nghi?m lam sang ? m?t s? qu?c gia. [51] [52] [53]

H? tr? ho h?p [ s?a | s?a ma ngu?n ]

M?t b?nh nhan nguy k?ch đang đ??c thong khi xam nh?p trong phong ch?m soc đ?c bi?t c?a Vi?n Tim, đ?i h?c Sao Paulo, trong đ?i d?ch COVID-19 ? Brazil . Do thi?u may th?, may th? c?u đang đ??c s? d?ng đ? t? đ?ng kich ho?t m?t n? van tui .

Th? may [ s?a | s?a ma ngu?n ]

Bai chi ti?t: Th? may

H?u h?t cac ca m?c COVID-19 khong nghiem tr?ng t?i m?c c?n th? may ho?c cac ph??ng phap ho h?p hay th?, nh?ng v?n co m?t t? l? cac ca c?n đ?n nh?ng bi?n phap nay. [54] va đ?c bi?t la nh?ng ng??i tren 80 tu?i). [55] [56] Ki?u h? tr? ho h?p cho nh?ng ng??i b? suy ho h?p lien quan đ?n COVID-19 đang đ??c tich c?c nghien c?u cho nh?ng ng??i trong b?nh vi?n, v?i m?t s? b?ng ch?ng cho th?y: vi?c đ?t n?i khi qu?n co th? đ??c tranh b?ng cach thong khi l?u l??ng cao qua m?i ho?c thong khi ap l?c d??ng hai m?c . [57] Hai ph??ng phap nay co mang l?i l?i ich nh? nhau cho nh?ng ng??i b? b?nh n?ng hay khong la m?t đi?u v?n con ch?a sang ro. [58] M?t s? bac s? ch?n duy tri th? may xam nh?p khi co th? vi k? thu?t nay giup h?n ch? s? lan truy?n c?a cac gi?t sol khi n?u so v?i thong khi l?u l??ng cao. [54]

Vi?c th? may đa đ??c th?c hi?n ? 79% ng??i b?nh n?ng đang n?m vi?n, trong đo 62% đa nh?n đ??c cac ph??ng phap đi?u tr? khac tr??c đo. T? l? t? vong ? nhom nay la 41%, theo m?t nghien c?u ? Hoa K?. [59]

Cac ca chuy?n bi?n n?ng th??ng đ??c quan sat nhi?u nh?t ? ng??i l?n tu?i (nh?ng ng??i tren 60 tu?i, [54] va đ?c bi?t la nh?ng ng??i tren 80 tu?i). [55] Nhi?u n??c phat tri?n khong co đ? gi??ng b?nh tren đ?u ng?? i, lam h?n ch? n?ng l?c c?a h? th?ng y t? trong vi?c x? ly s? ca COVID-19 t?ng đ?t bi?n đ?n m?c ph?i nh?p vi?n. [60] Chinh s? gi?i h?n trong kh? n?ng l?c h? tr? nay la m?t đ?ng l?c quan tr?ng đ?ng sau nh?ng l?i keu g?i yeu c?u lam ph?ng đ??ng cong . [60] M?t nghien c?u ? Trung Qu?c cho th?y: trong s? 5% b?nh nhan đ??c đ?a vao h?i s?c tich c?c , co 2,3% c?n h? tr? th? may va co 1,4% t? vong. [16] ? Trung Qu?c, kho?ng 30% s? ng??i nh?p vi?n v?i COVID-19 cu?i cung s? đ??c đ?a đ?n đ?n v? h?i s?c tich c?c. [61]

Vi?c s? d?ng nitric oxide d?ng hit cho nh?ng ng??i đang đ??c th? may la khong đ??c khuy?n ngh?, nh?ng b?ng ch?ng y khoa v? ph??ng phap nay hi?n v?n con y?u. [62]

H?i ch?ng suy gi?m ho h?p c?p tinh [ s?a | s?a ma ngu?n ]

Bai chi ti?t: H?i ch?ng suy ho h?p c?p tinh

V?n đ? th? may tr? nen ph?c t?p h?n khi h?i ch?ng suy ho h?p c?p tinh (ARDS) c?ng ti?n tri?n trong đ?i d?ch COVID-19 va vi?c cung c?p oxy ngay cang tr? nen kho kh?n. [63] May th? v?i kh? n?ng ki?m soat ap su?t va ap l?c d??ng cu?i (PEEP) [64] la c?n thi?t đ? t?i đa hoa vi?c cung c?p oxy đ?ng th?i gi?m thi?u nguy c? t?n th??ng ph?i do may th? va tran khi mang ph?i . [65]

Trao đ?i oxy qua mang ngoai c? th? [ s?a | s?a ma ngu?n ]

Bai chi ti?t: Trao đ?i oxy qua mang ngoai c? th?

Trao đ?i oxy qua mang ngoai c? th? ( Extracorporeal membrane oxygenation , vi?t t?t: ECMO ) la cong ngh? ph?i nhan t?o đ??c ap d?ng t? nh?ng n?m 1980 đ? đi?u tr? suy ho h?p va h?i ch?ng suy ho h?p c?p khi th? may thong th??ng khong thanh cong. Trong ph??ng phap ph?c t?p nay, mau đ??c l?y ra kh?i c? th? qua cac ?ng thong l?n, đ??c chuy?n qua m?t may trao đ?i oxy d?ng mang đ? phan ph?i oxy va lo?i b? carbon dioxide (v?n la cac ch?c n?ng c?a ph?i), r?i đ??c đ?a tr? l?i c? th?. T? ch?c H? tr? S? s?ng Ngoai c? th? (ELSO) co l?u l?i m?t s? k?t qu? co lien quan đ?n cong ngh? nay, ECMO đa đ??c s? d?ng cho h?n 120.000 b?nh nhan t?i 435 trung tam ECMO tren toan th? gi?i v?i t? l? t? vong la 40% đ?i v?i b?nh nhan ho h?p ng??i l?n. [66]

Vi?c s? d?ng ECMO tren b?nh nhan COVID-19 t? Trung Qu?c trong giai đo?n s?m c?a đ?i d?ch thu l?i cac k?t qu? t??ng đ?i kem, v?i t? l? t? vong la tren 90%. [67] Vao thang 3 n?m 2020, b? ph?n d? li?u c?a ELSO b?t đ?u thu th?p d? li?u v? vi?c s? d?ng ECMO tren toan th? gi?i cho b?nh nhan m?c COVID-19 va bao cao d? li?u nay tren trang web ELSO theo th?i gian th?c. Vao thang 9 n?m 2020, k?t qu? c?a 1.035 b?nh nhan COVID-19 đ??c h? tr? ECMO t? 213 trung tam co kinh nghi?m ? 36 qu?c gia khac nhau đa đ??c cong b? tren t?p chi The Lancet , cho th?y t? l? t? vong la 38%, t??ng t? nh? nhi?u b?nh ho h?p khac đ??c đi?u tr? b?ng ECMO. T? l? t? vong c?ng t??ng t? nh? t? l? t? vong 35% đ??c th?y trong th? nghi?m EOLIA , th? nghi?m đ?i ch?ng ng?u nhien l?n nh?t đ?i v?i ECMO tren b?nh nhan co h?i ch?ng suy ho h?p c?p. [68] Cac d? li?u đa c? s?, đa qu?c gia nay cung c?p nh?ng b?ng ch?ng ?ng h? cho vi?c s? d?ng t?m th?i ECMO cho nh?ng b?nh nhan suy ho h?p c?p do gi?m oxy mau lien quan đ?n COVID-19. Do đay la m?t cong ngh? ph?c t?p va co th? gay t?n nhi?u tai nguyen, cac h??ng d?n s? d?ng ECMO trong đ?i d?ch COVID-19 đ??c cong b? va ph? bi?n. [69] [70] [71]

Ng?n ng?a lay truy?n ti?p [ s?a | s?a ma ngu?n ]

Trung tam Ki?m soat va Phong ng?a D?ch b?nh Hoa K? (CDC) khuy?n ngh? b?n b??c đ? ap d?ng PPE. [72]

T? cach ly la bi?n phap đ??c khuy?n ngh? đ?i v?i nh?ng ng??i m?c COVID-19 nh? ho?c nghi ng? minh đa b? nhi?m virus, c? v?i nh?ng ng??i đa bi?u hi?n cac tri?u ch?ng khong đ?c hi?u, nh?m ng?n ng?a s? lay truy?n c?a virus va giup lam gi?m ganh n?ng b?nh nhan cho cac c? s? y t? . [2] T?i V??ng qu?c Anh , vi?c th?c hi?n nh?ng bi?n phap t? cach ly nay đ??c quy đ?nh b?ng lu?t. [73] Cac ch? d?n t? cach cach ly la khac nhau gi?a cac qu?c gia; CDC Hoa K? va D?ch v? Y t? Qu?c gia V??ng qu?c Anh đa ban hanh cac h??ng d?n c? th? v? v?n đ? nay, c?ng nh? nhi?u c? quan đ?a ph??ng co th?m quy?n khac. [73] [74]

Thong khi đ?y đ?, lam s?ch va kh? trung, va x? ly ch?t th?i c?ng r?t c?n thi?t đ? ng?n ng?a chu?i lay nhi?m c?a b?nh. [49]

Cac d?ng c? b?o v? ca nhan [ s?a | s?a ma ngu?n ]

Cac bi?n phap phong ng?a ph?i đ??c th?c hi?n đ? gi?m thi?u nguy c? lay truy?n virus, đ?c bi?t la trong cac c? s? y t? khi th?c hi?n cac bi?n phap co th? t?o ra gi?t b?n , ch?ng h?n nh? đ?t n?i khi qu?n ho?c thong khi b?ng tay. [75] đ?i v?i cac chuyen gia ch?m soc s?c kh?e đang h? tr? cho nh?ng b?nh nhan m?c COVID-19, CDC khuy?n ngh? nen đ?t ng??i đo vao Phong cach ly b?nh lay nhi?m qua đ??ng th? (AIIR) ben c?nh vi?c s? d?ng cac bi?n phap phong ng?a tieu chu?n , phong ng?a ti?p xuc va phong ng?a lay b?nh trong khong khi. [76]

CDC đa đ?a ra cac h??ng d?n v? vi?c s? d?ng thi?t b? b?o v? ca nhan (PPE) trong đ?i d?ch. Thi?t b? đ??c khuy?n ngh? la qu?n ao b?o h?, m?t n? phong đ?c ( respirator ) ho?c kh?u trang , kinh b?o v? m?t va g?ng tay y t? . [77] [78]

Khi co s?n, m?t n? phong đ?c (thay cho kh?u trang) đ??c ?u tien s? d?ng. [79] CDC khuy?n ngh? s? d?ng kh?u trang ? nh?ng n?i cong c?ng, khi khong th? duy tri c? ly gian cach xa h?i, va khi t??ng tac v?i nh?ng ng??i khong cung chung s?ng. [80] M?t n? phong đ?c N95 đ??c ch?p thu?n trong cac c? s? cong nghi?p nh?ng FDA c?ng cho phep s? d?ng cac kh?u trang theo gi?y phep s? d?ng kh?n c?p (EUA). Chung đ??c thi?t k? đ? b?o v? kh?i cac h?t trong khong khi nh? b?i nh?ng hi?u qu? ch?ng l?i m?t tac nhan sinh h?c c? th? la khong đ??c đ?m b?o n?u s? d?ng ngoai cac m?c đich đ??c ghi tren nhan. [81] Khi khong co kh?u trang, CDC khuy?n ngh? s? d?ng t?m che m?t ho?c dung ph??ng an cu?i cung la kh?u trang t? ch? . [82]

H? tr? tam ly [ s?a | s?a ma ngu?n ]

Xem them: ?nh h??ng c?a đ?i d?ch COVID-19 đ?i v?i s?c kh?e tam th?n

Cac ca nhan co th? g?p ph?i ?c ch? do gian cach xa h?i, h?n ch? di chuy?n, tac d?ng ph? c?a vi?c đi?u tr? ho?c lo l?ng v? vi?c nhi?m b?nh c?a b?n than. đ? gi?i quy?t nh?ng lo ng?i nay, ?y ban Y t? Qu?c gia Trung Qu?c đa xu?t b?n h??ng d?n qu?c gia v? can thi?p kh?ng ho?ng tam ly vao ngay 27 thang 1 n?m 2020. [83] [84]

T?p chi The Lancet đa xu?t b?n m?t l?i keu g?i hanh đ?ng dai 14 trang t?p trung vao V??ng qu?c Anh va neu ro: tinh tr?ng hi?n t?i co th? khi?n cho m?t lo?t cac v?n đ? lien quan đ?n s?c kh?e tam ly tr? nen ph? bi?n h?n. BBC d?n l?i Rory O'Connor noi, "S? gia t?ng trong gian cach xa h?i, s? co đ?n, lo l?ng v? s?c kh?e, c?ng th?ng va suy thoai kinh t? la m?t t? h?p hoan h?o đ? gay t?n h?i đ?n s?c kh?e tinh th?n va h?nh phuc c?a m?i ng??i." [85] [86]

Cac nhom ng??i đ?c bi?t [ s?a | s?a ma ngu?n ]

đi?u tr? đ?ng th?i cac b?nh ly khac [ s?a | s?a ma ngu?n ]

Th?i k? đ?u c?a đ?i d?ch, nh?ng lo ng?i v? ly thuy?t đa đ??c đ?t ra cho vi?c s? d?ng thu?c ?c ch? enzyme chuy?n hoa angiotensin va thu?c khang th? th? angiotensin . Tuy nhien, cac nghien c?u sau đo đa khong tim th?y b?ng ch?ng h? tr? cho vi?c ng?ng s? d?ng cac lo?i thu?c nay ? nh?ng ng??i s? d?ng chung vi m?c cac b?nh nh? huy?t ap cao . [15] [87] [88] [89] M?t nghien c?u t? ngay 22 thang 4 cho th?y nh?ng ng??i co COVID-19 va t?ng huy?t ap co t? l? t? vong do m?i nguyen nhan la th?p h?n khi s? d?ng cac lo?i thu?c nay . [90] M?i quan tam t??ng t? đa đ??c neu ra cho thu?c ch?ng viem khong steroid (NSAID) nh? ibuprofen ; nh?ng nghi ng? nay c?ng khong đ??c ch?ng minh b?ng nghien c?u va cac thu?c NSAID co th? đ??c s? d?ng đ? lam gi?m cac tri?u ch?ng c?a COVID-19 va ti?p t?c đ??c s? d?ng b?i nh?ng ng??i dung chung cho cac b?nh ly khac. [91]

Nh?ng ng??i s? d?ng corticosteroid t?i ch? ho?c toan than cho cac tinh tr?ng ho h?p nh? hen suy?n ho?c b?nh ph?i t?c ngh?n man tinh nen ti?p t?c dung thu?c theo quy đ?nh ngay c? khi h? m?c b?nh COVID-19. [31]

Trong khi mang thai [ s?a | s?a ma ngu?n ]

Bai chi ti?t: COVID-19 trong thai k?

Cho đ?n nay, h?u h?t cac th? nghi?m lam sang lien quan đ?n SARS-CoV-2 đa lo?i tr? ho?c ch? bao g?m s? it ph? n? mang thai ho?c cho con bu. H?n ch? nay gay kho kh?n cho vi?c đ?a ra cac khuy?n ngh? đi?u tr? d?a tren b?ng ch?ng ? nhom b?nh nhan nay va co th? c?ng gi?i h?n cac hinh th?c đi?u tr? COVID-19 ma h? co th? ch?n. CDC Hoa K? khuy?n ngh?: m?t quy?t đ?nh chung v?i s? tham gia c?a c? b?nh nhan va đ?i ng? lam sang nen đ??c th?c hi?n khi đi?u tr? cho ph? n? mang thai b?ng cac thu?c đang trong qua trinh nghien c?u. [92]

Tham kh?o [ s?a | s?a ma ngu?n ]

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