Helping Patients with COVID-19: Perspectives and Reality

  • Igor Klepikov
Keywords: Acute Pneumonia, COVID-19, coronavirus, SARS, severe acute respiratory syndrome


The presented data of the mini-review strongly suggest that the role of the COVID-19 virus as the sole cause of the disaster is exaggerated and indicates the urgent need to revise the general system of views on the nature of acute pneumonia. The current pandemic cannot be explained solely by the sudden aggression of the virus itself. Continuing important and necessary research on ways to prevent the disease and the ability of the coronavirus to penetrate the body's tissues, doctors should not forget about the general mechanisms of the development of the pathological process.


1. Koeckerling D, Barker J, Mudalige NL, et al. Awake prone positioning in COVID-19. Thorax. [Published Online First: 16 June 2020]. doi: 10.1136/thoraxjnl-2020-215133
2. Thompson AE et al. Prone positioning in awake, nonintubated patients with COVID-19 hypoxemic respiratory failure. JAMA Intern Med 2020.
3. Winearls S, Swingwood EL, Hardaker CL, et al. Early conscious prone positioning in patients with COVID-19 receiving continuous positive airway pressure: a retrospective analysis. BMJ, Open Respiratory Research 2020; 7: e000711. doi: 10.1136/bmjresp-2020-000711
4. Vianello A, Arcaro G, Molena B, et al. High-flow nasal cannula oxygen therapy to treat patients with hypoxemic acute respiratory failure consequent to SARS-CoV-2 infection. Thorax. [Published Online First: 23 July 2020]. doi: 10.1136/thoraxjnl-2020-214993
5. Berlin DA, Gulick RM, Martinez FJ. Severe Covid-19. N Engl J Med 2020. doi: 10.1056/NEJMcp2009575
6. Ranney ML, Griffeth V, Jha AK. Critical Supply Shortages - The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic. N Engl J Med, 2020; 382:e41. doi: 10.1056/NEJMp2006141
7. Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008; 86:408–416.
8. WHO Revised global burden of disease 2002 estimates. 2004. (accessed Nov 5, 2010).
9. Ruuskanen O, Lahti E, Jennings LC, Murdoch DR. Viral pneumonia 2011. Lancet. 377 (9773): 1264–75. doi:10.1016/S0140-6736(10)61459-6.
10. (accessed Nov 16, 2021).
11. Peyrani P, Mandell L, Torres A, Tillotson GS. The burden of community-acquired bacterial pneumonia in the era of antibiotic resistance, Expert Review of Respiratory Medicine 2018; 13:2, 139-152. doi: 10.1080/17476348.2019.1562339
12. Metlay JP, Waterer GW, Long AC at al.; on behalf of the American Thoracic Society and Infectious Diseases Society of America. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. American Journal of Respiratory and Critical Care Medicine 2019 200, 7, e45-e67. doi:full/10.1164/rccm.201908-1581ST
13. Rawson TM, Moore LSP, Zhu N, et al. Bacterial and fungal co-infection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing [published online ahead of print, 2020 May 2]. Clin Infect Dis. 2020; ciaa530. doi: 10.1093/cid/ciaa530
14. Beović M, Doušak, J, Ferreira-Coimbra J, et al. Antibiotic use in patients with COVID-19: a ‘snapshot’ Infectious Diseases International Research Initiative (ID-IRI) survey. Journal of Antimicrobial Chemotherapy, 2020, 75:11, 3386–3390. doi: 10.1093/jac/dkaa326
15. Kim D, Quinn J, Pinsky B, Pinsky B, Shah NH, Boen I. Rates of co-infection between SARS-CoV-2 and other respiratory pathogens. JAMA 2020; 323: 2085–2086. doi: 10.1001/jama.2020.6266
16. Lipman M, Chambers RC, Singer M, Brown JS. SARS-CoV-2 pandemic: clinical picture of COVID-19 and implications for research. Thorax 2020; 75: 614-616. doi: 10.1136/thoraxjnl-2020-215024
17. Huttner BD, Catho G, Pano-Pardo JR, Pulcini C, Schouten J. COVID-19: don't neglect antimicrobial stewardship principles! Clin Microbiol Infect. 2020; 26(7):808-810. doi: 10.1016/j.cmi.2020.04.024.
18. Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020, 2;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976.
19. Leiter RE. Reentry. N Engl J Med 2020; 383(27):e141. doi: 10.1056/NEJMp2027447
20. Rosenquist JN. The Stress of Bayesian Medicine — Uncomfortable Uncertainty in the Face of Covid-19. N Engl J Med 2021; 384:7-9. doi: 10.1056/NEJMp2018857
21. Liapikou A, Rosales-Mayor E, Torres A. The management of severe community acquired pneumonia in the ICU. Expert Review of Respiratory Medicine 2014; 8(3): 293-303. doi: 10.1586/17476348.2014.896202
22. Kim JW, Kim JJ, Yang HJ, at al. The Prognostic Factors of Pneumonia with Septic Shock in Patients Presenting to the Emergency Department. Korean Journal of Critical Care Medicine 2015; 30(4): 258-264. doi: 0.4266/kjccm.2015.30.4.258
23. Phua J, Dean NC, Guo Q, Kuan WS, Lim HF, limTK. Severe community-acquired pneumonia: timely management measures in the first 24 hours. Critical Care. 2016, 20:237. doi:10.1186/s13054-016-1414-2
24. Vidal A, Santos L. Comorbidities impact on the prognosis of severe acute community-acquired pneumonia. Porto Biomedical Journal, 2017; 2:6, 247-346. doi: 10.1016/j.pbj.2017.04.009
25. Ceccato A, Torres A. Sepsis and community-acquired pneumonia. Ann Res Hosp. 2018; 2:7. doi: 10.21037/arh.2018.06.01
26. Grasselli G, Zangrillo A, Zanella A, Antonelli M et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy. JAMA 2020; 323(16):1574-1581. doi: 10.1001/jama.2020.5394
27. Richardson S, Hirsch J, Narasimhan M. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA; 323(20):2052-2059. doi: 10.1001/jama.2020.6775
28. Seligman R, Seligman BGS. Pandemic in the 21st Century. The Challenge of COVID-19. EC Pulmonology and Respiratory Medicine 2020; 9.8:30-31.
29. Gupta S, Wang W, Hayek SS, et al. Association between early treatment with tocilizumab and mortality among critically ill patients with COVID-19. JAMA Intern Med. 2020; 180(11):1436-1446. doi:10.1001/jamainternmed.2020.3596
30. Alhazzani W, Moller MH, Arabi YM, Loeb M, et al. Surviving sepsis campaign: Guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med 2020; 46(5):854-887. doi: 10.1007/s00134-020-06022-5. Epub 2020 Mar 28.
31. Klepikov. Acute pneumonia. New doctrine and first treatment results. LAP-Lambert Academic Publishing; 2020. ISBN-10:6202679174; ISBN-13: 9786202679176
How to Cite
Klepikov, I. (2021). Helping Patients with COVID-19: Perspectives and Reality. Journal of Internal Medicine: Science & Art, 2(1), 2 - 5.