Doctors from Mayo Clinic, St. Clair Hospital address multiple facets of COVID-19

For at least three-quarters of a century, nothing has dominated the lives of Americans as pervasively as the SARS-CoV-2 virus.

Most know it better as COVID-19, and hear about it constantly. But the information tends to come at at a dizzying pace, with facts often mixing with opinion, conjecture and downright falsehoods.

For those confused over the vast amount of information surrounding the virus, perhaps professionals who have spent the past several months fighting the coronavirus firsthand can make matters clearer.

A recent virtual presentation, dubbed “The Frontline. Online,” featured doctors from the Mayo Clinic and one of its care network members, St. Clair Hospital in Mt. Lebanon and Scott Township, speaking about various facets of COVID-19 and answered questions from the public that had been submitted beforehand.

Transmission and safety

One of the queries addressed a contentious point head-on.

“Does wearing a mask really defend against getting the virus?”

Dr. Stephen Colodny, St. Clair’s chief of infectious disease, said COVID-19 primarily is transmitted from person to person, with “the most efficient method” being the spread of droplets that are expelled by activities such as breathing or talking, and in larger amounts, sneezing, coughing or singing.

“These droplets are fairly heavy, and they generally tend to fall to the ground within about six feet, and hence that’s our recommendation for social distancing,” he said.

In that context, covering the face adds a measure of protection, likely for everyone involved.

“There is starting to be some body of evidence that suggests that wearing a mask may prevent you from getting the virus from others, or in the event that you do become infected that you may have a less severe clinical illness,” Colodny said.

“So I still urge people to wear masks when they’re within six feet of others, particularly indoors.”

He confirmed transmission also is possible through contact with contaminated surfaces.

“It’s been shown in the lab that the virus can survive on various surfaces for some periods of time, but in general, they don’t survive for a really long period of time,” he said. “Things like ultraviolet light, heat or humidity may kill virus particles, and most importantly, 60% or greater alcohol kills viruses, usually within a minute.”

To be on the safe side, he advises proper hygiene.

“If you wash your hands frequently, especially after you’ve touched common surfaces – think of things such as doorknobs or light switches – it will help in preventing you from self-contaminating,” he said.

Staying safe during the pandemic extends to considerations beyond precautions against COVID-19, according to Dr. John Sullivan, senior vice president and chief medical officer at St. Clair.

The hospital continues to follow protocols adopted by the Mayo Clinic, from enhanced cleaning to taking temperatures of people entering the building, and has resumed elective procedures following their temporary suspension, with no viral transmissions observed.

“We are concerned, however, that the perceptions of risk in seeking care are still limiting how some people are accessing their routine care,” Sullivan said. “Early on, we even saw examples where people with symptoms of a stroke or heart attack delayed seeking their care. And as we all know, that can be very consequential. Delay in care in those settings, even by minutes and certainly by hours, can lead to worsened outcomes.”

A similar scenario applies to procedures such as colonoscopies and mammograms.

“In almost all cancer diagnoses, early detection is often associated with improved survival,” Sullivan said. “Some parts of the country have seen the decrease in breast cancer screening by almost 50%.”

And so his recommendation is to keep up with basic health maintenance.

“If you have any questions about this, contact your primary care physician to help guide the decisions,” he said. “Many of them are conducting visits via telemedicine to help you as a starting place.”

Treatment and vaccines

Since COVID-19 started wreaking havoc globally, more than 7.5 million cases had been confirmed in the United States as of Oct. 6, including 169,000-plus in Pennsylvania.

How patients are treated varies as the disease progresses, according to Dr. Stacey Rizza, Mayo Clinic executive medical director for international academic affairs. In the early stages, the common practice is to use antiviral medications in attempts to prevent the virus from replicating.

“Then after about a week, people either get better or they get what we call an immune response that’s overreactive,” Rizza said. “It’s essentially the person’s immune system reacting dramatically to the virus, itself. And that’s what causes people to become severely ill.”

At that point, she said, treatment tends toward “medications that block the immune system or change how the immune system is reacting to the virus.”

Overall, a major caveat is practically all of the drugs that could turn out to be effective in battling COVID-19 are in various stages of development and testing.

“Thus far, we really only have one therapeutic that has been proven to be efficacious in the appropriate randomized control trials, and that’s the antiviral medicine called Remdesivir,” Rizza said. It’s been reviewed by the FDA and given what we call emergency use authorization. We know that using it a little bit earlier, during that viral replication phase, seems to be where we see a lot of evidence that it works well.”

The use of steroids also has been the subject of study, although no control trials have been completed.

“But there is very strong evidence around them that keep showing that they do have some effect at protecting patients who are severely ill,” Rizza said.

“So they work more in that second phase, when the body’s immune system is overreacting and steroids are blocking that immune response.”

Perhaps of more interest to Americans in general is the progress of potential COVID-19 vaccines.

Dr. Andrew Badley, who chairs Mayo’s molecular medicine department, said testing is taking place on about 180 potential vaccines.

“What they’re intended to do is determine if it is safe, and if people who get the vaccine develop an immune response,” he said. “The hope is that the fact that you generate an immune response will translate into reducing the incidence of the disease or reducing the severity of the disease. But today, that is unknown.”

Prior to a vaccine’s approval by the U.S. Food and Drug Administration, some people may want to consider participating in trials.

“At that point, it will be experimental, and you’ll either get the vaccine or a placebo, Badley said, advising those who opt in to, “talk to the investigators. Very much learn about the potential side effects. And then you, as an individual, have to make a cost-benefit decision as to, do the risks outweigh the benefits?”

Approval of a vaccine is unlikely to occur before mid-2021, Badley said.

“When we’re in that situation, much more will be known about the vaccine,” he said, “and so you’ll be able to have a much more detailed discussion with your healthcare provider.”

Families and children

COVID-19 has prompted numerous discussions between concerned parents and Dr. Ruth Christoforetti, a family medicine and primary care physician affiliated with St. Clair Hospital.

And as the summer progressed, a primary topic was education.

“It’s been very challenging to make decisions about sending children to school in person versus keeping them at home as virtual learners, and neither really seems like an ideal situation for the majority of our children and our families,” said Christoforetti, a mother of three. “I think it is very important to keep in mind that there is no right or wrong decision, and each family situation is unique.”

She acknowledged attending school in an environment where other people are present “does increase the risk of transmission.”

“If the school is following safety precautions – such as spacing desks apart, requiring students to wear masks and frequently wash their hands, making sure that there’s adequate ventilation in the school, maybe having the kids spend some time outdoors – those things will help to reduce the risk,” she said.

“It’s also important to think about the school’s plan for if or when there is a case of COVID-19 within the school, and how they would manage that in order to keep other students and teachers and staff safe.”

Colodny fielded a question about the safety of scholastic athletic events.

“Obviously, it depends on the sport and the proximity of the children to each other,” he said. “It depends upon whether they’re outdoors or indoors, and it depends on the risk to other family members.”

He gave a reminder the academic year is relatively new.

“I think that it’s too early to tell whether, in youth sports and high school sports, how much transmission there will be,” Colodny said. “But I would say that running cross country is a whole lot safer than wrestling.”

Christoforetti provided a reminder of COVID-19’s impact on mental health.

“It’s widely known that there are increased rates of depression and anxiety during times of crisis, and this pandemic has been no different,” she said. “In these challenging times with tremendous stress, it’s important that we be kind to each other. If we notice a loved one is struggling, perhaps from depression or anxiety, that we encourage them to reach out for support from family and friends, as well as to seek professional help when needed.”

By Harry Funk, Multimedia Reporter – The Almanac

Link:  https://thealmanac.net/news/doctors-from-mayo-clinic-st-clair-hospital-address-multiple-facets-of-covid-19/article_ce23d32e-0803-11eb-8436-1356a8746c15.htmlhttps://thealmanac.net/news/doctors-from-mayo-clinic-st-clair-hospital-address-multiple-facets-of-covid-19/article_ce23d32e-0803-11eb-8436-1356a8746c15.html

St. Clair Hospital Appoints Maxim D. Hammer, M.D., MBA as Chief of Neurology

MT. LEBANON, Pa. – St. Clair Hospital has appointed noted neurologist Maxim D. Hammer, M.D., MBA, as its new Chief of Neurology.

Dr. Hammer joins St. Clair from UPMC, where he held numerous titles, including Vice Chairman, Clinical Affairs, Department of Neurology; Clinical Director of Neurology; and Director of Stroke Services at UPMC Mercy Hospital, where he helped develop the Stroke Clinic. Dr. Hammer founded and directed the Neurosonology lab, which provides outpatient and inpatient services, using carotid duplex and transcranial ultrasonography.

Dr. Hammer earned his medical degree at Albany Medical College, Albany, N.Y., and completed his neurology residency at Cleveland Clinic, where he was elected chief resident. He also completed a Vascular Neurology Fellowship at UPMC. Dr. Hammer holds an executive healthcare master’s degree in business administration from the University of Pittsburgh Katz School of Business. He is an associate professor, Department of Neurology, at University of Pittsburgh School of Medicine. Dr. Hammer is board-certified in neurology, as well as in vascular neurology.

“We are very pleased to welcome Dr. Hammer to St. Clair,” says John T. Sullivan, M.D., MBA, Senior Vice President and Chief Medical Officer at St. Clair. “He brings substantial clinical and programmatic expertise in the management of stroke patients. In terms of the impact on health and quality of life, stroke outcomes are arguably one of the most important for our region and  Dr. Hammer brings cutting-edge practices to our team.”

“Joining St. Clair,” says Dr. Hammer, “is an excellent opportunity for me to be part of a health system that is so supportive of neurology. I look forward to working with my colleagues at St. Clair to make an excellent program even better.”

Dr. Hammer practices with Southwestern PA Associates in Neurology, part of St. Clair Medical Services, and is seeing patients at St. Clair Hospital Outpatient Center – Peters Township. To contact Dr. Hammer, please call 412.942.6300.

St. Clair Hospital Named A ‘Most Wired’ Hospital

PITTSBURGH, Pa. – St. Clair Hospital has been named a Level 9 Most Wired hospital in the College of Healthcare Information Management Executives’ (CHIME) 2020 Digital Health Most Wired Survey. A Level 9 designation highlights hospitals that have deployed technologies and strategies (e.g., population health/cost-of-care analytics, HIEs/integration engines, and patient portals) to help them analyze their data and are achieving meaningful clinical and efficiency outcomes.

The mission of the CHIME Digital Health Most Wired program is to elevate the health and care of communities around the world by encouraging the optimal use of information technology (IT). The program does this by conducting an annual survey to identify, recognize, and certify the adoption, implementation, and use of information technology by health care provider organizations. The results are intended to improve patient safety and outcomes by driving change in the health care IT industry.

“We are once again honored to receive CHIME’s Digital Health Most Wired award,” said Richard Schaeffer, Vice President and Chief Information Officer at St. Clair. “At St. Clair, we’ve had a long-standing strategic commitment to the use of systems and technology to not only deliver safe, high quality care, but to additionally promote wellness through the use of patient engagement tools.”

Louis Civitarese, D.O., M.M.I., Chief Medical Information Officer at St. Clair, added: “St. Clair’s ability to consistently deliver high quality care is due in large part to the collegial environment among physicians, nurses, and staff to work together to continually improve systems and processes through the refinement of the best technologies available.”

A total of 30,135 organizations were represented in the 2020 Digital Health Most Wired program, which this year included four separate surveys. The surveys assessed the adoption, integration and impact of technologies in health care organizations at all stages of development, from early development to industry leading.

Health care organizations earning Levels 8-10 are being honored with awards. St. Clair’s Level 9 earned it a Performance Excellence Award. CHIME says organizations in Level 9 are leaders in health care technology who actively push the industry forward. These organizations, according to CHIME, are realizing meaningful outcomes, including improved quality of care, improved patient experience, reduced costs, and broader patient access to health care services. Some of the advanced technologies used to achieve these outcomes include telemedicine solutions, price-transparency and cost-analysis tools, access to data at the point of care, and tools to engage patients and their families throughout the care process.

Private labs see increase in wait times for Covid-19 testing results

Most Pittsburgh-region hospitals aren’t seeing an increased lag in Covid-19 test results, although an Allegheny County health official said an extended timeline for some results has occurred due to a crush of testing at the national level.

Allegheny County Health Department Director Dr. Debra Bogen brought up the lag Tuesday afternoon as the county and the rest of southwestern Pennsylvania see the highest case numbers so far in the pandemic. Another 230 cases were reported Tuesday and 1,449 cases since the beginning of July. There were 1,997 new test results overnight with an 11% positivity rate.

“For a while our tests were returning very quickly, usually within two or three days. I have heard about a lag in results recently,” Bogen said. “I think that’s because the national labs are overwhelmed with the new surge in cases.”

Two major test providers, Quest Diagnostics and LabCorp, on Wednesday acknowledged increases in testing around the country has led to a longer-than-normal wait time for results. Quest said priority patients’ wait times are still one day but the average turnaround times for all others have gone from 3-5 days to 4-6 days recently. LabCorp said it could take 1-2 days longer for test results to come in.

“In recent weeks, we have seen a steady increase in demand for Covid-19 molecular testing, and we are doing everything we can to continue delivering results in a timely manner while continually increasing testing capacity,” a LabCorp spokeswoman said.

Neither UPMC nor Allegheny Health Network, the region’s two biggest players in health care, have reported any lag in test results. UPMC, which developed its own test and has deployed it across its system by the tens of thousands, generally gets results back within 24-48 hours, said UPMC spokesman Paul Wood.

AHN also has not seen a lag in testing, and most patients receive their results within 3-5 days. It administers about 300 tests per day across its testing sites and its mobile unit but doesn’t include inpatient tests.

“That number has increased notably since the first two weeks of June where we saw roughly 130 tests on average, per day,” said AHN spokeswoman Nikki Buccina.

St. Clair Hospital in Mt. Lebanon uses a combination of rapid-result tests in its own lab where the results come within the hour and its partnership with the Mayo Clinic for the bulk of its tests, said Dr. John Sullivan, St. Clair’s chief medical officer. There’s been no lag among St. Clair Hospital patients, but Sullivan said he’s heard in the community of some delays elsewhere.

The partnership with the Mayo Clinic has helped St. Clair maintain its testing turnaround times throughout the pandemic, said Meredith Borst, executive director of strategic initiatives at St. Clair.

“We definitely have seen an increase in the number of tests that have come through, but in our turnaround times, they pretty much are constant,” Borst said.

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Region’s top doctors make plea to community

The chief medical officers of the region’s big hospitals and health systems and the head of the Allegheny County Health Department on Tuesday afternoon released a letter to the community and businesses urging southwestern Pennsylvania to come together to stop the spread of Covid-19 and protect the economy.

The letter was signed by the chief medical officers of UPMC, Allegheny Health Network, St. Clair Hospital as well as Health Director Dr. Debra Bogen. It comes as Allegheny County struggles with more than 125 new cases daily since late June, including 206 reported Tuesday along with six deaths and seven hospitalizations.

“This public health crisis is unlike anything most of us have ever experienced in our lifetimes, and it is only through a collective focus and response by health care leaders, our business community and everyone who calls western Pennsylvania home that we can manage this pandemic in a manner that minimizes its serious associated health risks while also protecting the short- and long-term economic well-being of our region,” the letter said.

It was a show of solidarity between the health care systems during the Covid-19 pandemic, which has led to regular meetings of the systems’ chief medical officers and chief nursing officers as well as other collaboration. Each of the hospitals and health systems have been impacted by the Covid-19 pandemic, and each have had patients.

“We remain ready to provide care for patients — but we also need you to take some important steps to help reduce the spread of Covid-19 in our community,” the letter read. “We believe it’s imperative to not lose our focus on the basic steps that allow each of us to help all of us — protecting ourselves, our friends and our family members, particularly those who are most vulnerable.”

Those include:

  • Wearing protective masks, and correctly
  • Washing hands regularly
  • Cleaning high-touch surfaces regularly
  • Practicing physical distancing everywhere
  • Staying home and calling a doctor if you get symptoms of Covid-19
  • Staying home if you think you have been exposed to Covid-19 and calling a doctor for advice

The letter ends with a version of Bogen’s continual advice to be kind, prescribed throughout the pandemic.

“A little more thoughtfulness, understanding and tolerance for the inconveniences we are experiencing may be the best medicine of all,” the letter said.

Here is the letter in full:

A letter from local health care leaders:

Over the past three months, our organizations have proudly come together in an unprecedented fashion to address the enormous challenges we have faced as a community due to the novel coronavirus (COVID-19) pandemic. This public health crisis is unlike anything most of us have ever experienced in our lifetimes, and it is only through a collective focus and response by health care leaders, our business community, and everyone who calls western Pennsylvania home that we can manage this pandemic in a manner that minimizes its serious associated health risks while also protecting the short- and long-term economic well-being of our region.

Despite success, the virus remains a threat. In recent days, the number of COVID-19-infected patients has risen locally and across the country. We remain ready to provide care for patients — but we also need you to take some important steps to help reduce the spread of COVID-19 in our community.

We believe it imperative to not lose our focus on the basic steps that allow each of us to help all of us — protecting ourselves, our friends, and our family members, particularly those who are most vulnerable. The latter includes the elderly, but also people with other compromising medical conditions — and it isn’t always easy to know who those individuals are at a glance. So we all must do the simple things that matter the most in helping to prevent illness and death during this pandemic — for the young, our seniors, and everyone.
As health care leaders, we ask the people of this region to:

  • Wear protective masks whenever you’re around others and wear them correctly (cover your nose and mouth) … do it for yourself, and do it for others.
  • Wash your hands and clean high-touch surfaces often … make it a habit.
  • Practice physical distancing everywhere, staying 6 feet apart.
  • If you have symptoms that you think could be COVID-19 or a respiratory illness, stay home and call your doctor.
  • If you feel you may have been exposed to COVID-19, but have no symptoms, stay at home and call your doctor. That allows the best planning for possible testing and care.
  • Finally, be kind to each other. A little more thoughtfulness, understanding, and tolerance for the inconveniences we are experiencing may be the best medicine of all.

Thank you. Be safe and well.

Donald Whiting, MD
Chief Medical Officer
Allegheny Health Network

Donald M. Yealy, MD
Senior Medical Director
UPMC

Carol Fox, MD
Chief Medical Officer
Excela Health System

John Six, MD
Chief Medical Officer
Washington Health System

David Rottinghaus, MD
Chief Medical Officer
Butler Health System

John Sullivan, MD
Chief Medical Officer
St. Clair Hospital

Michael Cratty, MD
Chief Medical Officer
Heritage Valley Health System

Debra Bogen, MD
Director
Allegheny County Health Department

Ali Sonel, MD
Chief of Staff
VA Pittsburgh Health Care

By Paul J. Gough  – Reporter, Pittsburgh Business Times

Link:  https://www.bizjournals.com/pittsburgh/news/2020/07/07/regions-top-doctors-make-plea-to-community.html

2 local hospitals named in IBM Watson top 100

PITTSBURGH — St. Clair Hospital and West Penn Hospital have been named among a prestigious ranking of top-performing hospitals by IBM Watson Health.

They were the only two hospitals named in the Pittsburgh region and two of four hospitals in the entire commonwealth. Fortune/IBM Watson Health’s 100 Top Hospitals list takes into account clinical outcomes, financial health and patient satisfaction across 3,134 hospitals in the United States.

St. Clair was named among large community hospitals in the country and West Penn Hospital as teaching hospitals in the nation.

IBM Watson praised the hospitals operations and efficiency and said that if all the health care facilities in the country followed their lead it would save 106,000 lives and reduce health care by $8.3 billion. Results of the study are published in Fortune Magazine.

Link:  https://www.wpxi.com/news/business/2-local-hospitals-named-ibm-watson-top-100/BBNGWX3KJJGSDAWMAYPPGMPQRM/

 

2 local hospitals named in IBM Watson top 100

St. Clair Hospital and West Penn Hospital have been named among a prestigious ranking of top-performing hospitals by IBM Watson Health.

They were the only two hospitals named in the Pittsburgh region and two of four hospitals in the entire commonwealth. Fortune/IBM Watson Health’s 100 Top Hospitals list takes into account clinical outcomes, financial health and patient satisfaction across 3,134 hospitals in the United States.

St. Clair was named among large community hospitals in the country and West Penn Hospital as teaching hospitals in the nation.

IBM Watson praised the hospitals operations and efficiency and said that if all the health care facilities in the country followed their lead it would save 106,000 lives and reduce health care by $8.3 billion. Results of the study are published in Fortune Magazine.

“From small community hospitals to major teaching hospitals, the organizations on this list demonstrate a relentless commitment to high-value, patient-centered care and innovation,” said Dr. Kyu Rhee, VP and chief health officer at IBM Watson Health in a statement. “It is clear that the COVID-19 crisis will be a catalyst for reinvention, and we believe these top performing hospitals are positioned to emerge stronger and smarter out of this crisis.”

Since the Top 100 Hospitals list was established in 1993, West Penn Hospital made the list six times.

“This honor again is reflective of the extraordinary talent and dedication of our physicians, nurses, volunteers and employees at every level,” said West Penn Hospital President Ron Andro.

St. Clair has won the award five times since 2012 and three times in a row, only one of 32 hospitals that have done that. It has also been honored by U.S. News & World Report, Leapfrog Group and Healthgrades, among others.

“At a time when great health care has never been more important, we’re proud of the health care heroes who’ve made St. Clair one of the nation’s highest quality hospitals,” said Dr. John Sullivan, chief medical officer of St. Clair Hospital.

By Paul J. Gough  – Reporter, Pittsburgh Business Times

Link:  https://www.bizjournals.com/pittsburgh/news/2020/07/01/2-local-hospitals-named-in-ibm-watson-top-100.html?ana=wpxi

St. Clair Hospital Named One Of Nation’s Top 100 Hospitals In 2020

MT. LEBANON (KDKA) — Local healthcare heroes got a little more recognition recently.

St. Clair Hospital was found to be one of the nation’s top 100 hospitals by IBM Watson Health.

“Hospitals, health systems and the dedicated clinicians and staff who work at these organizations have emerged as true heroes of the COVID-19 pandemic and we are grateful to be able to recognize these extraordinary leaders at this time,” said Kyu Rhee, M.D., M.P.P., Vice President and Chief Health Officer, IBM Watson Health. “Organizations on this list demonstrate a relentless commitment to high value, patient-centered care and innovation.”

The hospital has received this distinction five times in total since 2012 and has consistently been included in this list for the last three years. According to a spokesperson from St. Clair Hospital, only 32 hospitals have been included on the list for three consecutive years.

“At a time when great health care has never been more important, we’re proud of the health care heroes who’ve made St. Clair one of the nation’s highest quality hospitals,” John T. Sullivan, M.D., M.B.A., Chief Medical Officer at St. Clair, said.

 

Link:  https://pittsburgh.cbslocal.com/2020/06/30/st-clair-hospital-top-us-hospital/?fbclid=IwAR0jGkV7UDKo-iM5-Ymy8xGVMqdm9pv8J-Fy0VkPEf4XdM-4Rjsj7M0vddo

St. Clair Hospital Named Among 100 Top Hospitals

IBM Watson Health today named St. Clair Hospital one of the nation’s 100 Top Hospitals for 2020. This marks the third consecutive year and sixth time that St. Clair has won this prestigious honor.

The 100 Top Hospitals are selected annually based solely on an objective analysis of multiple measures of patient safety, quality, patient satisfaction, and operational efficiency. All acute care hospitals in the United States are evaluated for potential inclusion on the list.

Joining St. Clair are such notable institutions as Stanford, UCLA, the University of Florida, and NorthShore University Health System (Evanston, Ill.). St. Clair is one of just 32 hospitals to make the list in three consecutive years.

“Hospitals, health systems and the dedicated clinicians and staff who work at these organizations have emerged as true heroes of the COVID-19 pandemic and we are grateful to be able to recognize these extraordinary leaders at this time,” said Kyu Rhee, M.D., M.P.P., Vice President and Chief Health Officer, IBM Watson Health. “Organizations on this list demonstrate a relentless commitment to high value, patient-centered care and innovation.”

John T. Sullivan, M.D., M.B.A., Chief Medical Officer at St. Clair, said, “At a time when great health care has never been more important, we’re proud of the health care heroes who’ve made St. Clair one of the nation’s highest quality hospitals.”

In an accompanying study, IBM Watson Health notes that, if all hospitals in the nation performed at the level of the 100 Top Hospitals, more than 106,000 lives could be saved, 49,000 patients could be complication free, and the cost of health care could be reduced by $8.3 billion.

Today’s announcement continues a tradition of excellence that is unsurpassed in western Pennsylvania. In recent years, St. Clair has received accolades from U.S. News & World Report, the Leapfrog Group, the Centers for Medicare & Medicaid Services (CMS), CareChex, Healthgrades, and others. St. Clair is western Pennsylvania’s exclusive member of the Mayo Clinic Care Network.

 

About St. Clair Hospital

St. Clair Hospital is a nationally recognized integrated health system with more than 2,500 employees and 600 physicians serving 500,000 residents of southwestern Pennsylvania. In 2016, it became a member of the Mayo Clinic Care Network. As the region’s largest independent hospital, St. Clair participates with all major insurers.

Researchers Say Drug Reduces Deaths In Severely Ill Coronavirus Patients

PITTSBURGH (KDKA) — Researchers are hopeful about a new drug to treat coronavirus patients.

“Up until now, nothing has been shown to be beneficial,” says Dr. Amit Kaura, AHN pulmonary critical care and medical director of medical ICU West Penn Hospital. “This is our first real breakthrough in terms of battling COVID.”

It’s an inexpensive, common medicine called dexamethasone.

“An IV or an oral steroid medication that we give for its anti-inflammatory properties,” said. Dr. Kaura.

In a British study, researchers randomly assign patients to get dexamethasone or the usual care. They compared the 2,000 patients who got the drug to the 4,000 patients who did not.

In patients on a ventilator, the drug group had a 35 percent lower death rate.

In patients who needed oxygen but not a breathing machine, the drug group had a 20 percent lower death rate.

For patients who did not need oxygen, there was no difference.

“….which is pretty statistically significant, as well as clinically significant,” Dr. Kaura says. “A third reduction means that there will be a lot of lives that will be saved as a result of using dexamethasone. The hospitals will make this part of their standard of care.”

While the study has not yet been peer-reviewed and published, the researchers stopped enrolling patients because the results are so clear.

“The manuscript for the study has not been released as of yet and it does make some people uneasy,” Dr. Kaura says but points out, “It’s not every day you have studies that are stopped because of overwhelmingly positive results.”

Local doctors have already been using steroids to treat coronavirus patients.

“The major factor that really turned him around was we started steroids,” says Dr. Gregory Fino, an intensive care doctor at St. Clair Hospital, in an April 24 report about a severely ill patient who survived.

There are other drugs in this class that could be used, as well.

“As of right now, dexamethasone was the one that’s been studied. But I think there will be some cross-play between other steroids. The dosages will vary, as well as the frequency,” says Dr. Kaura.

Dexamethasone also has potential side effects that can be serious, including an increased risk for infections.

“Initially, when the COVID pandemic started, there was a scare in using steroids,” Dr. Kaura says.

In the trial, these superimposed infections did not occur.

This type of drug can make your blood pressure and blood sugar go up; it can affect your bones, your eyes, your mood and your body chemistries. So it should be used only for appropriate patients and with caution.

Link:  https://pittsburgh.cbslocal.com/2020/06/17/dexamethasone-and-coronavirus/