Saving patients from COVID-19 takes every tool, old and new, say local ICU doctors

Around our area, doctors have been in an unprecedented fight to save people stricken with COVID-19.

It's challenging, even for the most experienced ones.

We talked with two, to learn some of the strategies two have been using.

Even for top doctors like Dr. R. Phillip Dellinger of Cooper University Hospital, and Dr. Gerard Criner of Temple Health, COVID-19 is mind-boggling.

"We've never really seen anything like it before," says Dr. Dellinger.

"Really nasty type of disease," says Dr. Criner.

This novel coronavirus doesn't behave like other viruses, even the flu.

"Patients that have very low oxygen levels in the blood with very little abnormalities in the chest x-ray," says Dr. Dellinger.

"Clots in both the veins and the arteries," notes Dr. Criner.

"Large clots, like clots to the lung," adds Dr. Dellinger.

In some patients, the coronavirus touches off a "cytokine storm," an immune system reaction that attacks internal organs...patients needing critical care.

"We had up to 198 patients that were in the house one day, with half of them being, getting critical forms of care," says Dr. Criner.

"I never thought I'd be happy," when that number came down to 170.

Dr. Criner's acquaintance with doctors in Wuhan, China, helped Temple prepare for the surge by converting the Boyer Pavilion to a separate COVID-19 hospital, with every service in one place.

They also committed to using less invasive ways to deliver oxygen, saving intubation as a last resort - for about 15 percent of patients.

"That's the opposite of what was done in Italy and other parts of Europe," note Dr. Criner.

There are also numerous clinical trials underway, close to 2 dozen of them at Temple alone.

Rheumatoid arthritis drugs, including some still in their own clinical trials, are being tested.

Dr. Criner treated the first patient in the U.S. in the BREATHE trial evaluating intravenous treatment with gimsilumab.

Actemra is another drug getting a trial: serilumab (Kevzara) is also being tested at Temple.

Dr. Criner is also in another trial using inhaled nitric oxide.

Providers are also using a simple, old-time technique called "proning" - putting patients onto their stomachs.

It helps get more oxygen into the blood.

Both hospitals are also trying convalescent plasma on some patients, in which they receive donated plasma from a recovered COVID-19 patient.

Hopes that the antibodies will fight off the virus.
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