Study: Most Extreme COVID-19 Cases Can Be Treated With Standard Techniques

BOSTON — As scientists race to find a suitable treatment for COVID-19, many doctors are tempted to try using novel therapies to treat their most critically ill patients. Clinicians from Massachusetts General Hospital and Beth Israel Deaconess Medical Center in Boston report that existing therapies for the most severe COVID-19 symptoms are sufficient for treating even the sickest of COVID-19 patients.

The authors of the study are concerned that doctors worldwide are relying on treatment strategies that haven’t been thoroughly investigated for treating their patients that are infected with the SARS-COV-2 virus. The research team, led by C. Corey Hardin, MD, PhD, an Assistant Professor of Medicine at Mass General and Harvard Medical School, thoroughly examined the medical records of the most critically ill COVID-19 patients at the two hospitals.

The analysis includes 66 patients that experienced respiratory failure and had to be placed on mechanical ventilators and treated in the intensive care unit (ICU) of one of the two hospitals between March 11th and March 30th. The results of the analysis show that the most severe COVID-19 cases result in a syndrome called Acute Respiratory Distress Syndrome (ARDS), a life-threatening lung condition that causes the air sacs in the lung to fill with fluid.

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“The good news is we have been studying ARDS for over 50 years and we have a number of effective evidenced-based therapies with which to treat it,” says Dr. Hardin in a media release. “We applied these treatments—such as prone ventilation where patients are turned onto their stomachs—to patients in our study and they responded to them as we would expect patients with ARDS to respond.”

There was a fairly low death rate among the 66 patients that were treated using this method — 16.7%. Furthermore, after a follow-up period of at least 30 days 75.8% of these patients had been discharged from the ICU. It seems like using an ARDS treatment strategy is a good way to treat COVID-19 patients that are critically ill.

“Based on this, we recommend that clinicians provide evidence-based ARDS treatments to patients with respiratory failure due to COVID-19 and await standardized clinical trials before contemplating novel therapies,” concludes co–lead author Jehan Alladina, MD, an Instructor in Medicine at Mass General.

The study is published in the American Journal of Respiratory and Critical Care Medicine.

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