Doctors seek new solutions for helping seriously ill Covid-19 patients

“The single most important thing we have done is to restrict population movement and introduce social distancing early. This bought Ireland’s healthcare system extra time in preparing for this pandemic, especially relative to the UK,” respiratory consultant Oisin O’Connell stresses.

However, even when serious cases occur, doctors increasingly have a variety of treatment options as their understanding of the disease, and international learning on it, broadens.

“We expect the disease to come in waves, and with each wave we want to be able to have learned from previous ones,” O’Connell says.

About 15 per cent of patients will require hospitalisation, and 5 per cent will need to be admitted to ICU. In countries where systems were overloaded, over half of the ICU patients have died but Irish figures could be better if we can remain within our surge capacity.

“Patients are referred to the ICU because they fail to maintain adequate levels of oxygen in their blood despite having an oxygen mask,” explains Dr Michael O’Dwyer, head of critical care at St Vincent’s Hospital.

These patients then require mechanical ventilation in an ICU. “Our experience is that patients with Covid-19 coming to an ICU require a period of 7-14 days, at least, on a ventilator before their lung function improves substantially.”

While many patients improve with this standard treatment, given the vast numbers involved researchers have been searching for additional treatments to shorten the length of the disease and improve death rates.

“Whilst most of the motivation in this field is altruistic, undoubtedly financial gain and academic progression also plays a role,” O’Dwyer cautions.

Hypoxia

Doctors have learned Covid-19 can manifest itself in different ways among different groups of seriously ill patients. Many patients will show the classic signs of oxygen depletion known as “hypoxia” and respiratory distress associated with various subtypes of pneumonitis, which are a form of inflammatory condition of the lung tissue. They are increasingly recognising patients can display several patterns of pneumonitis.