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(Reuters) – A medical worker called him “crazy,” another said he induces paranoia: The speed with which patients are dwindling and dying from the new coronavirus is impacting even veteran doctors and nurses as they struggle to determine. how to stop that sudden deterioration. .
Patients “look good, feel good, then you turn around and don’t respond,” said Diana Torres, a nurse at Mount Sinai Hospital in New York, the epicenter of the pandemic in the United States, where the virus has infected most 415,000 people. “I’m paranoid, I’m afraid to leave his room.”
It’s not just the elderly or patients with underlying health problems who can be fine one minute and on the doorstep of death the next. It can also happen for young and healthy people, health professionals told Reuters.
A young woman died unexpectedly while Nurse Laurie Douglas was on call at Our Lady of the Lake Hospital in Baton Rouge, Louisiana. After 34 years on the job, Douglas said he usually has “an intuition of who is going to fade and who can improve.”
“But these people are throwing that out the window,” said Douglas. “Last week, she was planning her wedding. This week, his family is planning his funeral, “he said, referring to the deceased patient.
Patients can enter the hospital with strong oxygen levels and strike up a happy conversation, said a resident emergency physician at New York Presbyterian Hospital, only to be “out of breath” and intubated a few hours later.
“What is scary is that there are no rules,” said the resident, who spoke on condition of anonymity.
These scenes are unfolding everywhere, as COVID-19, the respiratory illness caused by the new coronavirus, has infected more than 1.4 million worldwide and killed more than 83,400 as of Wednesday. Click tmsnrt.rs/3aIRuz7 in a separate browser to get a GRAPHIC tracking coronavirus worldwide.
The rapid changes for the worse are likely products of an “overly exuberant” reaction by the immune system while fighting the virus, said Dr. Otto Yang, an infectious disease specialist at UCLA Medical Center in Los Angeles.
Called a cytokine storm, it occurs when the body overproduces immune cells and their activating compounds, cytokines, which cause dangerously high blood pressure, lung damage, and organ failure.
‘MELTDOWN’
Emily Muzyka, 25, a nurse in the New York suburbs, said she reached her breaking point last week, when a relatively healthy 44-year-old woman needed a sudden intubation.
“I had a breakdown that night,” he said. “I cried for my boyfriend.”
For COVID-19 patients, intubation refers to the insertion of a tube into the mouth and through the airways of a patient struggling to breathe, so that they can be connected to a mechanical ventilator.
Associated Press journalist Anick Jesdanun, who was in good health and had run 83 marathons, died last week of COVID-19, according to a Facebook post by his cousin, Prinda Mulpramook.
Jesdanun, who was 51, did not initially need hospitalization, according to the publication. He had begun to recover and showed clean lungs and strong vital signs during a visit to the doctor in late March. But “a sudden setback” sent him to the emergency room on April 1 and “13 hours later we lost him,” wrote Mulpramook.
A nurse from the Mount Sinai intensive care unit recalled that the patients’ kidneys closed quickly, adding that many require intravenous drops of the anticoagulant Heparin. “It’s crazy how sick they get sick, how fast,” said the nurse. “We are really trying to figure out how to treat them.”
Doctors say they are having limited success in saving patients who require intubation.
At Columbia University Irving Medical Center, intubated patients spend about two weeks on ventilators, chief surgeon Dr. Craig Smith said in a public bulletin Friday.
The New York-Presbyterian resident ER doctor said more patients than normal die while on the machines. The exact numbers are not yet known as the epidemic breaks out and hospitals sometimes work in chaotic conditions.
Some of those hospitals are experimenting with unproven medications in hopes of helping patients, including hydroxychloroquine, the antimalarial medication.
“Basically, we’re throwing the kitchen sink at these patients,” said the New York Presbyterian resident.
Reports by Nick Brown and Deena Beasley; additional reports from Gabriella Borter, Kristina Cooke and Jonathan Allen; edition by Grant McCool
