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Primary care and COVID-19: cutting the Gordian knot – the Greek experience and algorithm

Ioannis Tomos, Konstantinos Kostikas, Georgios Hillas, Petros Bakakos, Stelios Loukides
ERJ Open Research 2020 6: 00468-2020; DOI: 10.1183/23120541.00468-2020
Ioannis Tomos
1National and Kapodistrian University of Athens, 2nd Respiratory Medicine Dept, “Attikon” University Hospital, Chaidari, Athens, Greece
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Konstantinos Kostikas
2Respiratory Medicine Dept, School of Medicine, University of Ioannina, Ioannina, Greece
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Georgios Hillas
35th Respiratory Medicine Dept, Sotiria Hospital, Athens, Greece
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Petros Bakakos
4National and Kapodistrian University of Athens, 1st Respiratory Medicine Dept, “Sotiria” Hospital, Athens, Greece
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Stelios Loukides
1National and Kapodistrian University of Athens, 2nd Respiratory Medicine Dept, “Attikon” University Hospital, Chaidari, Athens, Greece
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  • For correspondence: loukstel@med.uoa.gr
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    FIGURE 1

    Suggested algorithm for the management of different risks based on initial stratification. #: signs and symptoms of severe illness, such as altered mental status, dyspnoea, oxygen saturation measured by pulse oximetry <94% at room air, respiratory rate >30·min−1, systolic blood pressure <90 mmHg, shock. ¶: impending respiratory failure, acute respiratory distress syndrome, septic shock, life-threatening organ dysfunction.

Tables

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  • TABLE 1

    Categorisation of suspected patients based on case severity and risk factors for severe coronavirus disease 2019

    Mild risk<65 years old
    AND
    Mild symptoms for <7 days: fever <38.5°C, anosmia, sore throat, cough, gastrointestinal
    AND
    No comorbidities#
    AND
    SpO2 >94%
    Moderate risk>65 years old
    OR
    Comorbidities#
    AND/OR
    Symptoms >7 days: fever >38.5°C, with/without dyspnoea (on exertion), anosmia, sore throat, cough, gastrointestinal
    AND
    SpO2 >94%
    Severe risk>65 years old
    AND
    Comorbidities#
    AND/OR
    Symptoms: with/without fever >38.5°C, dyspnoea at rest, anosmia, sore throat, cough, gastrointestinal
    AND
    SpO2 <94%

    SpO2: oxygen saturation measured by pulse oximetry. #: comorbidities include diabetes mellitus, cardiovascular disease (including hypertension), chronic respiratory disease, end-stage renal disease, obesity and immunocompromising conditions.

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    Primary care and COVID-19: cutting the Gordian knot – the Greek experience and algorithm
    Ioannis Tomos, Konstantinos Kostikas, Georgios Hillas, Petros Bakakos, Stelios Loukides
    ERJ Open Research Jul 2020, 6 (3) 00468-2020; DOI: 10.1183/23120541.00468-2020

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    Primary care and COVID-19: cutting the Gordian knot – the Greek experience and algorithm
    Ioannis Tomos, Konstantinos Kostikas, Georgios Hillas, Petros Bakakos, Stelios Loukides
    ERJ Open Research Jul 2020, 6 (3) 00468-2020; DOI: 10.1183/23120541.00468-2020
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