Clinicians from Massachusetts General Hospital and Beth Israel Deaconess Medical Center in Boston reported that the majority of even most severe COVID-19 patients can be sufficiently treated with existing therapies. Those who require ventilators in intensive care units get better when they receive existing guideline supported treatment for respiratory failure.
Due to the emergence of the COVID-19 pandemic, hospitals around the world are sharing anecdotal experiences to help inform the care of affected patients, but such anecdotes do not always reveal the best treatment strategies, and they can even lead to harm.
To provide more reliable information, 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 66 critically ill patients with COVID-19 at the two hospitals. The patients who experienced respiratory failure and had to be placed on mechanical ventilators and be treated in the intensive care unit (ICU) of one of the two hospitals between March 11th and March 30th.
The investigators found that a wide range of pathogens can cause the most severe cases of COVID-19 result in a syndrome called Acute Respiratory Distress Syndrome (ARDS), a life-threatening lung condition that that causes the air sacs in the lung to fill with fluid.
Dr. Hardin made a statement, "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."
"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."
The results showed fairly low death rates among the 66 patients that were treated by using this method, 16.7%, not nearly as high as has been reported by other hospitals. Also, over a median follow-up period of at least 30 days, 75.8% of patients who were on ventilators were discharged from the intensive care unit. This suggested that even critically severe COVID-19 can be treated just as well with novel treatment currently available like the ARDS treatment
Author Jehan Alladina, MD, an Instructor in Medicine at Mass General added
"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,"