How Doctors Treat The Sickest Coronavirus Patients

- Mar 12, 2020-

Specialists outside of China applaud the treatment given by the Chinese doctors to their patients in the study, saying that similar levels of care would be found in American and European critical care units.

“They had an explosion of cases in China that overwhelmed hospitals,” said Kristina Crothers, a pulmonary and critical care medicine specialist and a professor of medicine at the University of Washington.

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“Those doctors were making heroic efforts to keep their patients alive,” said James Chalmers, a clinical professor at the School of Medicine at the University of Dundee in Scotland. “They were doing everything they could.”

Of the 52 patients with pneumonia, most had to be given supplemental oxygen — 37 were put on mechanical ventilators.

A wave of very sick patients with pneumonia could outstrip not only available beds in ICUs but also the number of ventilators available in many countries. In the Northern Hemisphere, the outbreak of the novel coronavirus is coming on top of the winter influenza season.

The Chinese doctors gave their patients antibiotics to fight secondary infections, and antivirals, including medicines considered experimental. They also tried antibodies and steroids.

“They were losing patients left and right. They’re trying their best. They’re using every tool in the toolbox,” said Charles Dela Cruz, an associate professor of pulmonary care medicine at the Yale School of Medicine. “They’re doing the right things … everything that might help and not hurt.”

They were still losing many patients.

The WHO report and the Chinese study found that those who died were older and had preexisting conditions such as cardiovascular disease, uncontrolled diabetes, high blood pressure, chronic respiratory diseases and cancer.

The Chinese report on the 52 patients did not list a cause of death for the 32 who did not make it out of the ICU.

But doctors with long experience treating serious pneumonia and ARDS assume the Chinese caregivers saw their patients’ inflamed lungs overwhelmed by fluids, their blood pressure dropping dangerously, and their organs failing and then shutting down as they were starved of oxygen.