Most Critically Ill COVID-19 Patients Survive with Respiratory Failure Treatment Strategy, Research Finds

By Simon J. Levien, Crimson Staff Writer May 11, 2020

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The majority of critically ill COVID-19 patients survive under current treatment guidelines for respiratory failure, clinicians at two Harvard teaching hospitals found.

The team of doctors — led by Massachusetts General Hospital pulmonologist and Harvard Medical School professor Charles C. Hardin — announced the findings in a press release Wednesday after publishing their research in the peer-reviewed American Journal of Respiratory and Critical Care Medicine.

In the study, the nine-person team monitored and treated 66 critically ill and intubated COVID-19 patients at MGH and Beth Israel Deaconess Medical Center for more than two weeks.

The most severe COVID-19 cases can result in a condition known as Acute Respiratory Distress Syndrome, a type of life-threatening respiratory failure causing excess fluid buildup in the lung’s air sacs, the researchers found. They treated these patients with guideline-supported protocols for ARDS respiratory failure.

The death rate among COVID-19 patients treated under those ARDS protocols was 16.7 percent — which is lower than the rate reported by other hospitals, according to the press release. In intensive care units, 75.8 percent of patients on mechanical ventilators were discharged after a median follow-up time of just over a month.

“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,” Hardin said in the press 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.”

As hospitals worldwide have shared anecdotal and one-off treatment strategies, the findings point to a more robust treatment strategy for critically ill COVID-19 patients, according to the release.

“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,” Medical School instructor and study co-author Jehan Alladina said in the press release.

—Staff writer Simon J. Levien can be reached at simon.levien@thecrimson.com. Follow him on Twitter @simonjlevien.