Tuesday, April 7, 2020

Doc says he heads off deadly cytokine storms

ICU chief figures out how to keep patients off ventilators,
uses immune suppressors to block severe reaction;

battery of tests spots those in peril as they enter ER

A California pulmonologist said today he is using a battery of tests he developed in order save patients from the deadly "cytokine storm" reaction to Covid-19. Once their tests show a probability of trouble, he administers an immuno-suppressive drug in order to prevent the reaction and keep them off ventilators -- when "it's almost too late."

After seeing some patients go into sudden crashes, he decided to find out what could be done to prevent those crashes, said Dr. Tom Yadegar, chief of intensive care at Providence Cedars-Sinai Tarzana Medical Center in Los Angeles.

Once he realized that the problem is the "cytokine storm syndrome" in which the body overreacts to the Covid virus, causing severe lung inflammation and damage, along with dangerous levels of mucos, Yadegar came up with a "handful of lab tests" that can be used to spot those in danger of the cytokine storm.

Patients are tested as soon as they come in the door, with some marked for continued checks. Those whose tests put them in the danger zone are given a drug to suppress the immune system, thus heading off the body's aberrant and often deadly immune reaction.

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.

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 added that “it’s very important to find these patients and prevent them from going on ventilators.”

“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.

Yadegar's method could sharply reduce the number of deaths among the infirm and elderly because those with various chronic health problems often have damaged immune systems, placing them in the cross-hairs for cytokine storms.

Louisiana's Covid death rate is double New York State's. Some 97% of those killed by Covid-19 in Louisiana arrived for care with a chronic health problem, according to the state health department.

Diabetes was seen in 40% of the deaths, obesity in 25%, chronic kidney disease in 23% and cardiac problems in 21%, according to data released last week.

The federal Centers for Disease Control also reported 39% of residents have high blood pressure, 36% suffer from obesity and 15% have diabetes.

Family members often suffered from the same medical conditions before becoming sick, leaving them similarly vulnerable to the coronavirus despite their age gaps. A woman in her mid eighties and her three sons, aged between 58 and 70, died of Covid within days of each other. All had serious health conditions before entering hospital.
Fox News, AP and the Daily Mirror are sources of this report.

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