Doctor develops process for identifying extreme COVID-19 cases and how to treat them
Dr. Tom Yadegar, pulmonologist and medical director of the intensive care unit at Providence Cedars-Sinai Tarzana Medical Center, explains.
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A California pulmonologist explained on “Fox & Friends” on Tuesday the protocol he created to help identify and treat the most extreme COVID-19 cases, saying the key is to find these patients and prevent them from going on ventilators.
The new coronavirus is spread by microscopic droplets from coughs or sneezes and causes mild to moderate symptoms in most. For some, especially older adults and the infirm, it can cause pneumonia and lead to death.
Speaking from Los Angeles on Tuesday, Dr. Tom Yadegar, a specialist in critical care medicine who has been treating COVID-19 patients, said he noticed several patients were deteriorating quickly and needed to be put on ventilators. He said he realized that he had to find out why these patients were experiencing sudden deterioration.
“This happened to me just like it's happened to every other doctor who is taking care of these patients and it was very alarming that I didn't understand what happened,” said Yadegar, medical director of the intensive care unit at Providence Cedars-Sinai Tarzana Medical Center.
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He said that prompted him to start researching what was happening to those COVID-19 patients. Yadegar explained that through his research he found out that “what was happening is a process called cytokine storm syndrome.”
According to the National Cancer Institute (NCI), cytokine storm, which can occur as a result of infection, autoimmune conditions or diseases, is “a severe immune reaction in which the body releases too many cytokines into the blood too quickly.”
“Cytokines play an important role in normal immune responses, but having a large amount of them released in the body all at once can be harmful,” NCI explained.
On Tuesday, Yadegar explained that “in this syndrome, the immune system is activated – you have intense inflammation and subsequently it leads to patients requiring mechanical ventilation.”
He said once he figured out what the diagnosis was, he started doing more research to try and figure out “how do we look for it in a laboratory value so that we can find it before it happens because when it happens, it's almost too late.”
He added that “it’s very important to find these patients and prevent them from going on ventilators.”
Yadegar said he came up with “a handful of lab tests” that he thought were useful “and we started ordering them on admission when the patients were presenting to the ER [emergency room] and then tracking them every few days and it was a very clear pattern that we learned.”
He noted that it is not the case that every COVID-19 patient that is admitted to the hospital develops cytokine storm syndrome.
“You can predict on presentation who is going to be at risk for it and then if you follow certain markers and their clinical course you can actually tell who is going to develop it and, more importantly, you can intervene to prevent them from getting to that point where they need a ventilator,” Yadegar said.
He said that as people’s immune systems kick in, he has a better result by actually suppressing that person’s immune system, which he said was “pretty counterintuitive.”
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“For the past few months we have heard about this virus that's killing everyone," he said, "and the way to disarm it is disarm the immune system."
Fox News’ Gregg Re and The Associated Press contributed to this report.