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Front Line COVID-19 Critical Care Consortium Recommends Early Delivery of Anti-Inflammatory Therapies

By HospiMedica International staff writers
Posted on 04 May 2020
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A group of five critical care specialists have jointly released a protocol for treating COVID-19 patients who are brought to hospitals, urging the immediate adoption of early intervention protocol to prevent mortality and reduce the need for ventilators.

The five leading critical care specialists, who together have formed the Front Line COVID-19 Critical Care Consortium, have released a protocol for treating patients who arrive in hospitals with COVID-19. Based on available research, the experience in China reflected by the Shanghai expert commission, and their decades-long professional experiences in Intensive Care Units (ICUs) around the country, the experts have strongly urged fellow physicians to immediately adopt a change in strategy by delivering powerful therapies earlier in the disease course, prior to admission to the ICU or the need for a mechanical ventilator. Based on early experiences with this more aggressive approach, they predict that early adoption of the protocol will reduce ICU admissions, obviate the need for mechanical ventilators, and most importantly, save many lives.

According to Dr. Pierre Kory, the Medical Director of the Trauma and Life Support Center and Chief of the Critical Care Service at the University of Wisconsin, it is the severe inflammation sparked by the coronavirus, not the virus itself that kills patients. Inflammation causes a new variety of Acute Respiratory Distress Syndrome (ARDS), which damages the lungs. The typical treatment for ARDS is to put patients on a mechanical ventilator, but Dr. Paul E. Marik, of the Eastern Virginia Medical School, says that should be the very last resort. The experts have emphasized that early intervention is critical in preventing the deterioration and death that has been described across the world once patients enter the ICU. By changing the therapeutic strategy towards initiating the combination of high-dose ascorbic acid and corticosteroids earlier in the disease course, the need for mechanical ventilation can be greatly reduced.

The critical care specialists have advised that in all COVID-19 hospitalized patients, the therapeutic focus must be placed on early intervention utilizing powerful, evidence-based therapies to counteract the overwhelming and damaging inflammatory response and the systemic and severe hyper-coagulable state causing organ damage By initiating the protocol within six hours of presentation in the emergency room, the need for mechanical ventilators and ICU beds will decrease dramatically, according to the experts.

“It is imperative that every hospital immediately adopt this safe, low-cost and highly effective treatment protocol, but they must implement it BEFORE the ICU, not after they reach the ICU because, in this disease, the organ damage tends to be so severe that patients rarely recover at that point,” said New York internist, Dr. Keith Berkowitz.

“This protocol will not only save patients’ lives, it will also lessen the danger to the doctors and nurses who treat them by decreasing the need for mechanical ventilators,” added Dr. Howard Kornfeld, President of the Pharmacology Policy Institute.


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