Treatment options
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COVID-19 can cause a variety of symptoms such as fever, cough and problems with the senses of taste and smell. When the illness is severe, it can lead to pneumonia and affect other organs such as the heart, blood vessels, nervous system or kidneys. COVID-19 can also be a danger to mental health.
How the illness is treated depends on how it is expressed in each individual case. If the illness is mild, it is usually sufficient to rest and treat the individual symptoms, cough and fever for instance, as necessary. For patients who are at increased risk of becoming severely ill, antiviral treatment early on in the illness can also be helpful.
If you become infected, it’s important that you isolate at home to avoid infecting anyone else if at all possible.
When the illness is more serious, in-patient treatment in hospital is necessary. Many of the hospitalized patients need oxygen and some need mechanical ventilation.
A number of different medications are available to prevent and treat serious illness. Some are given as tablets while others are administered in the form of infusions into a vein.
Further information about treatment is available at the Federal Health Ministry’s website gesund.bund.de.
The Robert Koch Institute (RKI) provides an overview of the diagnosis and treatment of COVID-19 which is updated regularly.
Written by the HELPFÜRMICH editors and updated on 15.07.24 -
In children, a COVID-19 infection usually causes mild symptoms or no symptoms at all. The most frequent symptoms are cough, fever and runny nose. Diarrhea and problems with the senses of smell and taste are also possible. Depending on the individual symptoms and their severity, it can be helpful to give medicines to lower the temperature and/or relieve the cough, blocked nose and diarrhea.
Serious illness is very rare in children but can happen, affecting mainly infants, small children and children with pre-existing conditions. The Robert Koch Institute (RKI) provides a list of relevant pre-existing conditions (the list is to be found below the question “What does the STIKO recommend for children and adolescents aged 6 months to 17 years inclusive?”)
With regard to treatment, you should remember that not all the medications available to treat COVID-19 in adults are also authorized for use in children. Depending on the severity and the individual symptoms in each case, it is necessary to check which medications can be used to treat children and young people.
Further information about the illness in children and young people, and a wealth of helpful tips for parents, can be found at the website infektionsschutz.de run by BZgA, the Federal Centre for Health Education.
Written by the HELPFÜRMICH editors and updated on 27.09.23 -
Treatment guidelines are intended to help doctors with diagnosis and treatment. They represent the current state of medical knowledge, drawing on information from clinical studies to make recommendations about the diagnostic procedures and treatments that are helpful for a specific illness. Unlike legal rulings (Richtlinien), guidelines are not obligatory and their recommendations should always be applied as appropriate in the individual case.
Patient guidelines are available for a variety of illnesses and are of particular interest to patients and their loved ones because they present current medical knowledge in normal language.
Various guidelines on dealing with COVID-19 are accessible on the AWMF (Association of the Scientific Medical Societies) website:
- information and practical help regarding SARS-CoV-2/COVID-19 for community-based physicians
- patient guideline “Informationen zur Coronavirus-Pandemie”
- recommendations for in-patient treatment of patients with COVID-19
- treatment of patients with COVID-19 from a palliative perspective
- COVID-19 in patients with blood disorders and cancer
- post COVID syndrome / long COVID
Written by the HELPFÜRMICH editors and updated on 06.06.23
Medications
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Various different medications are available to treat COVID-19:
Antiviral medications
Antiviral medications act to prevent the coronavirus from spreading within the body. They can be used at different times in the course of the illness. Used at an early stage, antivirals can reduce the risk of hospitalization and can prevent the illness from becoming severe. Used at an advanced stage, antivirals can stabilize the patient’s condition, reduce the risk of death and shorten recovery time.
Antiinflammatory medications
In severe cases of COVID-19 there is often an overactive immune response which can be very harmful to the patient. Antiinflammatory agents can be used to combat the overactive immune response. This treatment is recommended primarily for intensive care patients on ventilation.
Anticoagulant medications
Infection with SARS-CoV-2 can increase the risk of blood clot formation (thrombosis). Anticoagulant medications can be used to counteract this.
Monoclonal antibodies
Antibody treatments are used to prevent the illness from becoming severe. Various antibodies are available and can be given individually or as a mixture (an “antibody cocktail”). They are commonly used for the early treatment of patients who are at increased risk of becoming severely ill.
Other medications
Infection with SARS-CoV-2 can lead to bacterial infections such as pneumonia and it can also cause organ damage. These need to be treated appropriately, for example with antibiotics. When deciding which medications might be suitable and which ones can be used, it is necessary to consider not only how the illness is expressed - for example, inhalation sprays may be helpful to treat the symptoms – but also to take account of factors such as the patient’s age and general physical state.
Further information about treatment is available at the Federal Health Ministry’s website gesund.bund.de. The Robert Koch Institute (RKI) provides an overview of the diagnosis and treatment of COVID-19 which is updated regularly.
An overview of the COVID-19 medications that have been authorized, or for which authorization is pending, is given by vfa (the association of researching pharmaceutical companies).
Written by the HELPFÜRMICH editors and updated on 23.05.22 -
It is important to take and use medicines in the way the doctor has prescribed.
If several medicines are prescribed at the same time it’s easy to lose track. So ask your doctor for a medication plan. Anyone taking three or more prescribed medications for at least four weeks is entitled to one. The medication plan lists all the medications clearly. This enables you to keep track and allows you to check at any time and see which medication you need to take when.
Further information is available from the initiative “Medikationsplan schafft Überblick”.
Written by the HELPFÜRMICH editors and updated on 23.05.22 -
Treatment for COVID-19 can result in side effects including nausea, diarrhea, constipation, high blood pressure, water retention, weakened immunity, problems with kidney function and allergic reactions. If medications are administered by infusion into a vein, there may be bruising, pain, swelling and inflammation at the puncture site.
It is hard to predict which side effects are likely to occur in an individual case because different patients can react differently to the same treatment. What’s more, patients with severe COVID-19 are usually given several medications at the same time.
It is also worth remembering that medication used to treat COVID-19 could interact with other medications. It should therefore be established beforehand what pre-existing conditions the patient has and what medications they are already taking. These may mean that certain COVID-19 medications should not be used - in medical language they are “contraindicated” - in his or her individual case. Not all COVID-19 medications can be given to all patients.
If you experience side effects during your treatment it is important that you inform your doctor as soon as you become aware of them. Many side effects can be relieved by taking additional medications or using other procedures.
An overview of the COVID-19 medications that have been authorized, or for which authorization is pending, is given by vfa (the association of researching pharmaceutical companies).
Written by the HELPFÜRMICH editors and updated on 23.05.22
Ambulatory treatment
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If you have health problems, he first person to consult is usually your family doctor and this is the case with COVID-19 as well. After a positive test for COVID-19, you should contact your doctor quickly and discuss what you need to do.
The type of treatment depends on how the illness progresses in each individual case. If the symptoms are mild, it is not usually necessary to consult a specialist. In such cases, it is usually sufficient to rest and treat the individual symptoms, such as cough and fever, as necessary.
For patients who are at increased risk of becoming severely ill, antiviral treatment early on in the illness can also be helpful to prevent it from worsening.
In severe cases, patients typically experience a worsening, including increasing respiratory distress and/or hypoxemia (lack of oxygen in the arterial blood), about 7 to 10 days after the symptoms start.
If you find that your COVID-19 is getting worse, it’s important to call a doctor or the medical standby service quickly so that they can find out whether you need examination and treatment from a specialist or admission to hospital.
Further information about treatment is available at the Federal Health Ministry’s website gesund.bund.de.
Written by the HELPFÜRMICH editors and updated on 23.05.22
In-patient treatment
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When patients become seriously ill, their state worsens about 7-10 days after symptoms begin; the worsening is often noticeable in the form of increasing respiratory distress.
For this reason it is important that a doctor checks how the illness is progressing right from the start, especially in patients with risk factors for severe illness.
If, after 7 to 10 days, the symptoms have not improved or have become worse (especially fever and respiratory distress), it is often advisable for further examinations and treatment to be carried out in hospital.
Further information about the course and treatment of the illness is available from the Robert Koch Institute.
A short film by APS, the patient safety alliance, shows how you can prepare for a stay in hospital.
Written by the HELPFÜRMICH editors and updated on 23.05.22 -
Respiratory distress is a particularly common symptom in hospitalized patients with COVID-19. Many are given oxygen to support their breathing for this reason. A distinction is made between invasive and non-invasive methods of ventilation.
The non-invasive methods include the use of a face mask and the delivery of high dose oxygen via the nose (known as High Flow Nasal Oxygen Therapy). In these methods, oxygen is supplied at slightly increased pressure so that it is pushed into the upper airways.
With invasive ventilation, the patients are usually unconscious. In a procedure known as intubation, a pipe is inserted into the trachea (windpipe) through the mouth or a tracheostomy (incision in the trachea) so that the air from the ventilator is delivered directly into the lungs. Before intubation, the patient is put into an induced coma and he/she then remains unconscious throughout the ventilation period. Patients are often positioned lying face down during ventilation to improve the supply of oxygen to the rear areas of the lungs.
ECMO (extra-corporeal membrane oxygenation) devices are also known as artificial lungs because they allow oxygen uptake to happen outside the body. These devices may also be used in the invasive ventilation of COVID-19 patients if their lung tissue is no longer able to take up oxygen. In ECMO, the patient’s blood is pumped through the device so that carbon dioxide can be removed and oxygen added. The treated blood is then put back into the patient’s blood vessels.
According to the Robert Koch Institute (RKI) more than one in every two COVID-19 patients in ICUs (56%) needs invasive ventilation.
Written by the HELPFÜRMICH editors and updated on 23.05.22 -
It is generally the case that the more severe the illness and the longer the hospital stay and the period in intensive care, the longer the patient takes to recover from COVID-19.
After their time in hospital, patients who have been seriously ill are not always able to cope with everyday life on their own. Many of them need help and support; some have long COVID.
After in-patient treatment in hospital, a period of rehabilitation can follow on to stabilize the patient’s health. The doctor responsible for the patient in hospital and the hospital’s social service (Sozialdienst) can give advice about the options and apply for a period of rehabilitation.
When a patient is not transferred directly to a rehabilitation clinic, the family doctor takes over their care. The hospital providing the patient's acute treatment sends a letter to the family doctor giving comprehensive information about the illness and the examinations and treatments that were carried out in the hospital.
After a stay in hospital, patients are entitled to further treatment and assistive devices depending on their personal needs. The family doctor can coordinate and apply for these.
The World Health Organization (WHO) has published a leaflet for patients called “Support for Rehabilitation Self-Management after COVID-19-related Illness” which you can download free of charge here. It gives a lot of helpful information for your recovery, such as breathing exercises, brain training, tips on coping with anxiety and mood swings and instructions for physical exercise after leaving hospital.
Written by the HELPFÜRMICH editors and updated on 06.06.23
Psychological support
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This pandemic is an enormous psychological burden for many people. Some are ill for a long time and have difficulty returning to everyday life; others experience great anxiety that the illness could strike them or their family. Many people have also come to feel increasingly lonely because the limitations placed on social contact have disrupted their daily routines and prevented them from meeting up with others.
Young people and those with existing psychological problems are particularly strongly affected.
For some people, the psychological burden takes the form of diffuse anxious thoughts; others react with physical symptoms such as respiratory distress and racing heartbeat or sleep problems. However, certain strategies can be used to ensure that anxiety and negative mood don’t become constant companions.
An important initial step is to accept and express the negative feelings. Don’t suppress them. Regular exercise and relaxation techniques can also help you to overcome negative feelings. Find out which strategy is the right one for you. That way, you can learn to deal with your negative emotions and regain your quality of life.
To combat social isolation, it is helpful to intensify your contact with other people. You can also use all the many telephony and video-telephony options to do this. Get back in touch with old friends as well. Get in touch with people you haven’t heard from in a long time. Social connectedness helps everyone.
If you have the feeling that you cannot get your worries and cares under control, there are many people you can turn to for help. Go to the “Support” section for an overview of relevant links. Many advice centers offer the option of phone consultations. You can use telemedicine services and get advice in videoconferences or chats. And you can also contact your health fund and ask about the therapy options. Smartphone mental health apps can be helpful as well.
Perhaps you should consider consulting a doctor. Anxiety about the future and depression are often a feature of long COVID and may require psychotherapy. Your doctor can help you to consider whether psychotherapy could be helpful and can discuss the next steps with you.
If you cannot get an appointment with a psychotherapist in the near future, you can approach outpatient psychiatric clinics at hospitals. As a stop-gap until a therapy appointment becomes available, you can also make use of e-mental health programs such as apps giving psychotherapeutic support by smartphone. Many health funds offer programs that their clients can use free of charge.
The Institute for Psychology at Greifswald University provides videos and other help for dealing with mood swings, anxiety, depression and loneliness for adults, young people and children.
At the Max Planck Institute for Psychiatry website you can download a guide offering more tips and exercises to improve mental health in the pandemic.
Written by the HELPFÜRMICH editors and updated on 06.06.23 -
Many people use relaxation techniques to resolve the internal restlessness and tension that can often occur in the context of illness. There are many different options, such as yoga, progressive muscle relaxation, autogenic training and breathing or mindfulness exercises.
As an introduction to relaxation techniques you can watch online video tutorials. Try out different methods. See what you like best and what does you good. Sports clubs and adult education classes (Volkshochschule) offer suitable courses.
Ask your doctor about these and other ways to support your treatment. Ask his or her advice and find out which procedures you could use.
You may want to talk to other people who have been similarly affected. COVID-19 self-help groups have been established in many towns during the pandemic. They offer an opportunity for people to connect and share their experiences.
Written by the HELPFÜRMICH editors and updated on 23.05.22 -
COVID-19 can cause a variety of longer-lasting symptoms such as psychological difficulties and problems affecting the heart, nervous system and/or lungs.
Some common long-term symptoms are
- quickly becoming exhausted and having breathing difficulties with physical exertion
- quickly becoming exhausted by mental (cognitive) work
- numerous neuropsychological problems such as difficulty with concentration, perception or memory
- headache
- impaired senses of taste and smell
- perpetual exhaustion (also known as fatigue).
Other possible long-term effects are
- aching muscles and limbs
- sleep problems
- depressive mood and anxiety
- concentration problems
- racing or irregular heartbeat
- hair loss
- gastro-intestinal symptoms
- metabolic problems (with the uptake and digestion of nutrients)..
When the symptoms are still present three months after a SARS-CoV-2 infection and they last longer than two months, the condition is known as long COVID or post-COVID syndrome.
It is thought that about 15% of the people who become infected with SARS-CoV-2 are subsequently affected by long COVID. Children and young people can also experience longer-lasting health problems. The precise causes are still unknown. The risk is higher after severe illness than after mild illness.
Treating long COVID faces doctors and patients with particular challenges. If fatigue symptoms (tiredness, exhaustion, lack of resilience) last for several months, they can develop into chronic fatigue syndrome.
Further information about long COVID and post COVID syndrome is available in a patient guide produced by AWMF (Association of the Scientific Medical Societies) and at the Federal Health Ministry’s website gesund.bund.de.
Written by the HELPFÜRMICH editors and updated on 15.07.24
Long COVID
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The treatment of long COVID depends on the symptoms that are present.
The goal of treatment is to improve the state of health and to prevent the existing symptoms from becoming chronic. If fatigue symptoms (tiredness, exhaustion, lack of resilience) last for several months, they can develop into chronic fatigue syndrome.
Different treatment options are available depending on the individual situation:
- pain therapy
- supporting psychotherapy, instruction on relaxation
- movement therapy, physio-training, fitness training
- special therapy programs combining neuropsychological training and relaxation exercises.
Specialist treatment may also be necessary if the function of particular organs and/or organ systems is damaged. Psychotherapeutic support is often necessary as well because long COVID causes depression and anxiety about the future in many cases.
Ambulatory or residential rehabilitation can also help to improve the overall state of health.
Further information about long COVID and post COVID syndrome is available in a patient guide produced by AWMF (Association of the Scientific Medical Societies) at an info portal from BZgA (longcovid-info.de) and at the Federal Health Ministry’s website gesund.bund.de.
Written by the HELPFÜRMICH editors and updated on 27.09.23
Additional measures
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As well as taking medication, there are plenty of other ways to help yourself and aid your recovery.
Make sure you get enough sleep and drink plenty of herbal tea or water.
Inhaling hot steam can be helpful to relieve symptoms such as a cough and blocked nose. Just add a spoonful of table salt to a bowl of hot water and inhale the steam it produces or use an inhalation device.
Depending on the course taken by the illness and the individual symptoms in your case, it can be helpful to investigate the rehabilitation options. After severe illness, rehabilitation can help you to overcome the physical and mental problems that may occur as a result of COVID-19.
As an alternative, you can consider trying respiratory physiotherapy or targeted stamina training to improve your lung function and fitness.
Ask your doctor about these and other ways to support your treatment. He/she can advise you and help you to consider which procedures could be helpful.
Written by the HELPFÜRMICH editors and updated on 23.05.22
Clinical trials
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Clinical trials are an important part of medical research. They are carried out to test whether new treatments are effective, safe, well tolerated and potentially better than the current standard treatment. Clinical trials are subject to special monitoring by national and regional authorities and others.
By taking part in clinical trials, patients can gain access to the newest medications and therapeutic approaches. In many cases, though, taking part in a clinical trial also means that not much is known about the treatment you are receiving. Most trials are therefore carried out by doctors known as investigators at specialized medical centers.
Before you take part in a clinical trial you should find out all about it and carefully weigh up the advantages and disadvantages.
Further information about clinical trials is available from vfa (Germany’s association of research-based pharmaceutical companies).
Written by the HELPFÜRMICH editors and updated on 23.05.22 -
There are several websites providing information about the latest clinical trials. You should discuss with your doctor whether these trials are suitable in your own situation. Also, you can contact the study center direct to find out about taking part.
DRKS (the German clinical trials register) and the EU Clinical Trials Register offer help with the search for clinical trials.
Written by the HELPFÜRMICH editors and updated on 23.05.22
