When COVID-19 emerged in the U.S. roughly five months ago, doctors had to quickly figure out how to treat those infected with the virus that causes the illness, particularly those who became critically ill.
The physicians have learned a lot along the way, and that learning process continues.
To that end, researchers at the University of Nebraska Medical Center and clinical partner Nebraska Medicine have joined 350-plus medical centers in 48 countries in a study intended to help supply intensive care clinicians with the most up-to-date information so they can improve patient outcomes.
The UNMC researchers’ contribution will be data, stripped of identifying information, from the 70-plus COVID-19-positive patients treated in the Nebraska Medical Center’s intensive care unit, said Dr. Shaun Thompson, who is leading UNMC’s participation in the study.
What researchers are trying to decipher, said Thompson, an assistant professor of anesthesiology, are the factors that lead to critical illness in COVID-19 patients and how such patients’ illnesses progress from the time they’re first hospitalized until they require critical care.
Further, they will be looking at which patients progress to treatment with extracorporeal membrane oxygenation, or ECMO, a form of life support that partially replaces heart and lung function.
Three medical center COVID-19 patients have received such treatment, which can be time- and labor-intensive. It requires a dedicated nurse for each patient and extra equipment and monitoring.
During the 2009 H1N1 flu outbreak, Thompson said, ECMO provided a lifesaving tool for many patients, who spent an average of a week on the machine. COVID-19 patients seem to require more support, an average of about three weeks on ECMO.
Some ICUs around the world have reported patients requiring ECMO for as long as eight weeks.
“It’s a really big decision to put someone on ECMO,” said Thompson, medical director for the treatment. “We want to make sure we’re providing this level of care to someone who’s going to benefit from it.”
The study is hosted by the COVID-19 Care Consortium, he said, a global group based in Australia that partners with a group at Oxford University in the United Kingdom.
It originally was intended to look at acute respiratory distress syndrome, or ARDS, in influenza in southeast Asia. The condition occurs when fluid builds up in the tiny air sacs in the lungs and can result from injury or illness, including COVID-19. With the pandemic, the organizers expanded the program. They will be looking at 28 days’ worth of data from patients at the participating sites.
Thompson said data collected during the study also will be used to look at the virus’s other reported effects on the body, such as neurological impacts, cardiac effects, bleeding and clotting disorders and kidney injury.
“It’s just fascinating what we’ve learned that this virus is doing to people,” he said.