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New system for COVID-19 patients at risk of dying created by doctors

FILE: A COVID-19 test being given at Glendale Middle School in Salt Lake City. Credit: Spenser Heaps, Deseret News, September 15, 2020

MURRAY – Doctors are calling it a breakthrough in how the most severe cases of COVID-19 can be treated.  They’ve come up with a new system that could spot potential complications, and give doctors a better idea of how those with COVID-19 need to be cared for.

Researchers say COVID-19 is causing reactions, unlike other viruses they’ve already studied.  The disease has been deadly for thousands, but for so many others the symptoms are minor, if noticeable at all.

However, in the more severe cases, doctors have been able to spot something known as “hyperinflammatory syndrome,” or a “cytokine storm,” which is when the immune system overreacts and produces too much of the chemicals it needs to fight the virus.

Doctor Brandon Webb with Intermountain Healthcare says, “Right from the earliest days of the pandemic, we recognized that some patients with COVID-19 develop an inappropriate and excessive inflammatory immune response.”

Webb and his partners studied 299 patients admitted to Intermountain hospitals and found several different possible red flags.  For instance, if doctors find too much of a compound called ferritin, it could be a sign that the macrophage cells are working too hard.  Also, blood may clot too easily, which can cut off the oxygen supply to affected organs.

Plus, doctors have to take a close look at how well the liver is working.

Doctor Samuel Brown says, “When the immune system throughout the body is in overload, it’s common that the liver function tests will be abnormal.  We’re seeing that in COVID-19 and in the patients who are quite severe.”

Brown says they believe hyperinflammatory syndrome can lead to severe illness or even death, but they want to take their models to other cities with higher death rates for further research.

“It looks like this is an important component of some of the COVID-19 deaths,” Brown says.

Health care workers can now take a look at all of the criteria researchers have found and add them to one simple test.  When the results come back, Webb says they create something called a “cHIS score” which can indicate the kind of treatment a patient should get.  He says patients who met certain kinds of criteria in their cHIS score are four times more likely to be placed on a ventilator.

“We’re treating them according to the complications that that particular patient is exhibiting,” Webb says.

Doctors are also able to tell if a patient should be put on anti-inflammatory steroids, or not, based on their cHIS score.  These steroids have worked wonders in some patients, but have made symptoms worse for others.

Webb and Brown’s study has been published in The Lancet Rheumatology, a British medical journal.

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