Jewish General’s ICU uses lessons from COVID-19 for second wave

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Despite the reluctance of some hospitals to initially give COVID-19 patients the corticosteroid Dexamethasone – since the drug could prove harmful in flu patients – the Jewish general concluded early on that it was potentially a rescue.

“Part of the reason I think our ICU death rate was quite favorable is that we were the first to believe in steroid use,” Warshawsky said.

“It was a bit controversial at the time. But we had data indicating that with all comers with ARDS, giving them steroids could have a positive impact on mortality. In the first month of the first wave we used it in about half of the patients and in the second month in about 75% of the patients.

Most of the patients in the intensive care unit were at least 80 years old. But there were a few in their 30s and 40s, mostly patient attendants who worked in nursing homes and were not provided with adequate personal protective equipment. A 35-year-old patient spent 10 days on a ventilator in a medically induced coma.

“This patient scared us,” Warshawsky recalls, adding that the staff ultimately saved the individual’s life. “Because when you are on a ventilator, even healthy young people can die.”

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