Pengobatan dan penanganan COVID-19: Perbedaan antara revisi
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'''Pengobatan dan penangangan COVID-19''' ([[
Sebagian besar penderita COVID-19 tergolong ringan. Dalam hal ini, dukungan perawatan suportif berupa obat-obatan seperti [[parasetamol]] atau [[NSAID]] dibutuhkan untuk meredakan gejala yang umum terjadi (seperti [[demam]], [[nyeri|nyeri tubuh]], [[batuk]]), adanya asupan cairan yang tepat, istirahat, dan wajib bernafas melalui [[hidung]] (pernapasan hidung).<ref>{{cite journal | vauthors = Wang Y, Wang Y, Chen Y, Qin Q | title = Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures | journal = Journal of Medical Virology | volume = n/a | issue = n/a | pages = 568–576 | date = Maret 2020 | pmid = 32134116 | doi = 10.1002/jmv.25748 | pmc = 7228347 | doi-access = free }}, Dikases tanggal 24 Maret 2021.</ref><ref>{{cite journal | vauthors = Martel J, Ko YF, Young JD, Ojcius DM | title = Could nasal breathing help to mitigate the severity of COVID-19 | journal = Microbes and Infection |volume=22|issue = 4–5| pages = 168–171 | date = Mei 2020|pmid =32387333|doi=10.1016/j.micinf.2020.05.002|pmc = 7200356}}</ref><ref>{{cite web |title=Coronavirus recovery: breathing exercises |url=https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-recovery-breathing-exercises |website=www.hopkinsmedicine.org |publisher=Johns Hopkins Medicine|access-date=24 Maret 2021}}</ref> Menjaga kebersihan tubuh dengan baik dan melakukan [[Diet|diet sehat]] juga direkomendasikan para ahli untuk penanganan COVID-19.<ref>{{cite journal | vauthors = Wang L, Wang Y, Ye D, Liu Q | title = Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence | journal = International Journal of Antimicrobial Agents | pages = 105948 |date=Maret 2020|volume = 55|issue=6|pmc = 7156162|doi=10.1016/j.ijantimicag.2020.105948|url = https://www.sciencedirect.com/science/article/pii/S0924857920300984 | access-date =24 Maret 2021| url-status = live | archive-url = https://web.archive.org/web/20200327232545/https://www.sciencedirect.com/science/article/pii/S0924857920300984 | archive-date = 24 Maret 2021}}</ref> [[Pusat Pengendalian dan Pencegahan Penyakit]] (''Centers for Disease Control and Prevention'', disingkat CDC) menyarankan agar kasus yang dicurigai mengidap [[virus]] untuk mengisolasi diri di rumah dan memakai [[masker]] wajah.<ref name="CDC2020IfSick">{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html |title=What to Do if You Are Sick |vauthors=((U.S. Centers for Disease Control and Prevention)) |date=5 April 2020|website=[[Centers for Disease Control and Prevention]] (CDC)|url-status=live|archive-url=https://web.archive.org/web/20200214153016/https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html|archive-date=24 Maret 2021|access-date=24 Maret 2021}}</ref>
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Pasien dengan kasus yang lebih parah memerlukan perawatan di [[rumah sakit]]. Dan pasien yang memiliki [[Oksigen|kadar oksigen]] rendah, disarankan untuk menggunakan [[glukokortikoid]] [[deksametason]], karena dapat mengurangi risiko [[kematian]].<ref name=":3">{{cite journal|date=November 2020 |title=Update to living WHO guideline on drugs for covid-19|journal=BMJ (Clinical Research Ed.)|volume=371|pages=m4475|issn=1756-1833|s2cid=227059995}} Diakses tanggal 24 Maret 2021</ref><ref name=":0">{{cite web|title=Q&A: Dexamethasone and COVID-19|url=https://www.who.int/news-room/q-a-detail/q-a-dexamethasone-and-covid-19|access-date=24 Maret 2021|website=[[World Health Organization]] (WHO)}}</ref><ref name=":1">{{cite web|title=Home|url=http://covid19evidence.net.au/|access-date=24 Maret 2021|website=National COVID-19 Clinical Evidence Taskforce}}</ref> Masuk ke [[unit perawatan intensif]] untuk [[ventilasi mekanis]] mungkin diperlukan untuk mendukung pernapasan. Oksigenasi membran ekstrakorporeal (''Extracorporeal membrane oxygenation'', disingkat ECMO) telah banyak digunakan untuk mengatasi masalah [[pernapasan|gagal napas]], namun manfaatnya masih dalam tahap pertimbangan.<ref name="Henry 2020 p.">{{cite journal | vauthors = Henry BM | title = COVID-19, ECMO, and lymphopenia: a word of caution|journal=The Lancet. Respiratory Medicine|volume=8|issue=4| pages=e24|date=April 2020|pmid=32178774 | pmc=7118650| publisher=Elsevier BV}} Diakses tanggal 24 Maret 2021.</ref>
Beberapa [[penelitian klinis|pengobatan eksperimental]] sedang dipelajari secara aktif di [[uji klinis]].<ref name="BMJLivingReview"/> Pada awal [[pandemi COVID-19]] ada beberapa pengobatan dianggap baik, seperti [[
== Pengobatan ==
[[File:Covid-19 San Salvatore 09.jpg|thumb|right|220px|Seorang [[Anestesiologi | dokter anestesi]] yang kelelahan di [[Pesaro]], [[Italia]], Maret 2020]]
Sejak bulan Februari 2021, di [[Amerika Serikat]], [[remdesivir]] memiliki persetujuan FDA untuk pasien COIVD-19 tertentu, dan ada [[
Beberapa [[obat antivirus]] COVID-19 sedang diteliti, namun belum ada obat yang terbukti efektif mematikan virus berdasarkan uji coba terkontrol acak yang sudah dipublikasikan.<ref name="sanders">{{cite journal|vauthors=Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB|date=April 2020|title=Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review|journal=JAMA|volume=323|issue=18|pages=1824–36|doi=10.1001/jama.2020.6019|pmid=32282022|doi-access=free|s2cid=215752785}} Dikases tanggal 24 Maret 2021.</ref> Keamanan dan efektivitas [[plasma sembuh]] sebagai pilihan dalam pengobatan juga masih memerlukan penelitian lebih lanjut.<ref>{{cite journal|vauthors=Chai KL, Valk SJ, Piechotta V, Kimber C, Monsef I, Doree C, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Estcourt LJ, Skoetz N | display-authors=6 |date=Oktober 2020|title=Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review|journal=Cochrane Database of Systematic Reviews|volume=10|pages=CD013600|doi=10.1002/14651858.CD013600.pub3 }} Diakses tanggal 24 Maret 2021.</ref> Percobaan lain sedang dilakukan, apakah obat-obatan dapat digunakan secara efektif untuk melawan reaksi kekebalan tubuh terhadap infeksi [[SARS-CoV-2]].<ref name="sanders" /><ref name="McCreary">{{cite journal|vauthors=McCreary EK, Pogue JM|date=April 2020|title=Coronavirus Disease 2019 Treatment: A Review of Early and Emerging Options|journal=Open Forum Infectious Diseases|volume=7|issue=4|pages=ofaa105|doi=10.1093/ofid/ofaa105|pmc=7144823|pmid=32284951}}</ref> Penelitian untuk menemukan pengobatan yang potensial telah dimulai sejak Januari 2020,<ref>{{cite news|date=17 Februari 2020|title=Chinese doctors using plasma therapy on coronavirus, WHO says 'very valid' approach|newspaper=Reuters|url=https://www.reuters.com/article/us-china-health-hospital-idUSKBN20B1M6|url-status=live|access-date=24 Maret 2021|archive-url=https://web.archive.org/web/20200304173709/https://www.reuters.com/article/us-china-health-hospital-idUSKBN20B1M6|archive-date=24 Maret 2021}}</ref> dan beberapa [[antivirus|obat antivirus]] masih sedang dalam uji klinis.<ref name="Reut_NIH_Moderna_3months">{{cite news|last1=Steenhuysen|first1=Julie|last2=Kelland|first2=Kate|date=24 January 2020|title=With Wuhan virus genetic code in hand, scientists begin work on a vaccine|work=[[Reuters]]|url=https://www.reuters.com/article/us-china-health-vaccines-idUSKBN1ZN2J8|url-status=live|access-date=24 Maret 2021|archive-url=https://web.archive.org/web/20200125203723/https://www.reuters.com/article/us-china-health-vaccines-idUSKBN1ZN2J8|archive-date=24 Maret 2021|name-list-style=vanc}}</ref><ref name="clinicaltrialsarena">{{cite web|last=Duddu|first=Praveen|date=19 Februari 2020|title=Coronavirus outbreak: Vaccines/drugs in the pipeline for Covid-19|url=https://www.clinicaltrialsarena.com/analysis/coronavirus-mers-cov-drugs/|archive-url=https://web.archive.org/web/20200219184512/https://www.clinicaltrialsarena.com/analysis/coronavirus-mers-cov-drugs/|archive-date=24 Maret 2021|work=clinicaltrialsarena.com|name-list-style=vanc}}</ref> Menemukan dan mengembangkan obat baru masih dilakukan hingga tahun 2021,<ref>{{cite journal|vauthors=Lu H|date=March 2020|title=Drug treatment options for the 2019-new coronavirus (2019-nCoV)|journal=Bioscience Trends|volume=14|issue=1|pages=69–71|doi=10.5582/bst.2020.01020|pmid=31996494|doi-access=free}}</ref> dan beberapa obat yang telah diuji sudah disetujui untuk kegunaan lain atau sudah dalam tahap pengujian lebih lanjut.<ref name="LiDeClerq">{{cite journal|vauthors=Li G, De Clercq E|date=March 2020|title=Therapeutic options for the 2019 novel coronavirus (2019-nCoV)|journal=Nature Reviews. Drug Discovery|volume=19|issue=3|pages=149–150|doi=10.1038/d41573-020-00016-0|doi-access=free}} Diakses tanggal 24 Maret 2021</ref> Pengobatan [[antivirus]] dapat diberikan pada pasien dengan tingkat penyakit yang parah.<ref name="NatureDale Fisher & David Heymann" /> Dan WHO merekomendasikan para sukarelawan untuk mengambil bagian dalam uji coba keefektifan dan keamanan perawatan yang potensial.<ref name="ThomReut_notreatment_20200205">{{cite news|last1=Nebehay|first1=Stephanie|last2=Kelland|first2=Kate|last3=Liu|first3=Roxanne|date=5 Februari 2020|title=WHO: 'no known effective' treatments for new coronavirus|agency=[[Thomson Reuters]]|url=https://www.reuters.com/article/us-china-health-treatments-who-idUSKBN1ZZ1M6|url-status=live|access-date=24 Maret 2021|archive-url=https://web.archive.org/web/20200205155653/https://www.reuters.com/article/us-china-health-treatments-who-idUSKBN1ZZ1M6|archive-date=24 Maret 2021|name-list-style=vanc}}</ref>
Melakukan terapi [[
Mengonsumsi [[obat bebas]] seperti [[parasetamol]] atau [[ibuprofen]], minum cairan, dan istirahat yang cukup, dapat membantu meringankan gejala yang muncul.<ref name="AutoDW-63">{{cite web |url=https://www.webmd.com/lung/coronavirus |title=Coronavirus |work=WebMD |url-status=live |archive-url=https://web.archive.org/web/20200201075444/https://www.webmd.com/lung/coronavirus |archive-date=24 Maret 2021|access-date=24 Maret 2021}}</ref><ref name="CDC Prevention">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html |title=Prevention & Treatment |date=15 Febsruari 2020|work=U.S. [[Centers for Disease Control and Prevention]] (CDC) |url-status=live |archive-url=https://web.archive.org/web/20191215193934/https://www.cdc.gov/coronavirus/about/prevention.html |archive-date=24 Maret 2021|access-date=24 Maret 2021}} {{PD-notice}}</ref> Merujuk pada tingkat keparahan pasien, penggunaan [[terapi oksigen]] dan [[terapi intravena| cairan intravena]] memungkinkan untuk dilakukan.<ref name="BMJ2020Best">{{cite web |url=https://bestpractice.bmj.com/topics/en-gb/3000165?q=Coronavirus,%202019%20novel&c=suggested |title=Overview of novel coronavirus (2019-nCoV)—Summary of relevant conditions |work=[[The BMJ]] |url-status=live |archive-url=https://web.archive.org/web/20200131054900/https://bestpractice.bmj.com/topics/en-gb/3000165?q=Coronavirus,%202019%20novel&c=suggested |archive-date=24 Maret 2021|access-date=24 Maret 2021}}</ref> Beberapa obat yang dianggap ampuh untuk mengobati, namun dalam penelitian, ternyata tidak efektif dan bahkan tidak aman untuk dikonsumsi pasien, beberapa obat tersebut termasuk diantaranya; [[baloxavir marboxil]], [[favipiravir]], [[lopinavir]] / [[ritonavir]], [[ruxolitinib]], [[klorokuin]], [[hidroksiklorokuin]], [[interferon beta-1a|interferon β-1a]], dan juga [[Kolkisina|kolkisin]].<ref name=":1" />
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=== Ventilasi mekanis ===
Sebagian besar pasien COVID-19 masuk dalam kategori tidak parah dan tidak memerlukan [[ventilasi mekanis]] atau alternatifnya, namun beberapa kasus memerlukan ventilasi mekanis.<ref name="murthy">{{cite journal | vauthors = Murthy S, Gomersall CD, Fowler RA | title = Care for Critically Ill Patients With COVID-19 | journal = JAMA | volume = 323 | issue = 15 | pages = 1499–1500 | date = Maret 2020 | doi = 10.1001/jama.2020.3633 | url = https://jamanetwork.com/journals/jama/fullarticle/2762996 |access-date=24 Maret 2021| url-status = live | doi-access = free | archive-url = https://web.archive.org/web/20200318203852/https://jamanetwork.com/journals/jama/fullarticle/2762996 | archive-date =24 Maret 2021}}</ref><ref>{{cite web|publisher=[[World Health Organization]] (WHO)|date=28 Januari 2020|title=Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected|url=https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf|access-date=24 Maret 2021|archive-url=https://web.archive.org/web/20200226041620/https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf|archive-date=26 February 2020|url-status=live}}</ref> Jenis bantuan pernapasan untuk pasien COVID-19 yang mengalami [[gagal napas]] sedang dipelajari secara aktif, dan beberapa bukti bahwa [[intubasi trakea|intubasi]] dapat dihindari dengan [[Heated humidified high -flow therapy |''high flow nasal cannula'']] atau [[Positive airway pressure|''dwi-level positive airway pressure'']].<ref>{{cite journal | vauthors = Wang K, Zhao W, Li J, Shu W, Duan J | title = The experience of high-flow nasal cannula in hospitalized patients with 2019 novel coronavirus-infected pneumonia in two hospitals of Chongqing, China | journal = Annals of Intensive Care | volume = 10 | issue = 1 | pages = 37 | date = March 2020 | pmid = 32232685 | pmc = 7104710 | doi = 10.1186/s13613-020-00653-z }}</ref> Dan tidak diketahui apakah salah satu dari keduanya bisa memberikan manfaat yang sama bagi orang yang sakit kritis.<ref>{{cite journal | vauthors = McEnery T, Gough C, Costello RW | title = COVID-19: Respiratory support outside the intensive care unit | journal = The Lancet. Respiratory Medicine | date = April 2020 | volume = 8 | issue = 6 | pages = 538–539 | pmid = 32278367 | pmc = 7146718 | doi = 10.1016/S2213-2600(20)30176-4 }}</ref> Beberapa dokter lebih suka tetap menggunakan [[ventilasi mekanis]] invasif bila tersedia karena teknik ini dapat membatasi penyebaran partikel [[
Ventilasi mekanis telah dilakukan kepada 79% pasien kritis di rumah sakit, termasuk 62% yang sebelumnya telah menerima perawatan lain. Dari jumlah tersebut 41% meninggal, berdasarkan hasil penelitian di [[Amerika Serikat]].<ref>{{cite journal|vauthors=Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, Aaron JG, Claassen J, Rabbani LE, Hastie J, Hochman BR, Salazar-Schicchi J, Yip NH, Brodie D, O'Donnell MR | display-authors=6 |date=Juni 2020 |title=Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study |journal=The Lancet |volume=395|issue=10239|pages=1763–70|doi=10.1016/S0140-6736(20)31189-2|doi-access=free|title-link=doi }} Diakses tanggal 24 Maret 2021.</ref>
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