JACKSONVILLE, Fla. – Dr. Juan Pulido, a pulmonologist at Baptist Health, has been treating novel coronavirus patients for more than a month. He said he’s seen patients come in and get better with treatment. He’s also seen patients rapidly decline.
He said the tricky thing is trying to gauge the severity of the case as patients are admitted to the hospital.
“Is this someone that is going to have a mild to moderate course, or is this someone who is going to have a rapid deterioration that we need to be very aggressive from the beginning?” Dr. Pulido said.
He said patients with severe cases experience so much inflammation that the body’s process of filtering oxygen before it enters the bloodstream gets interrupted. When patients' conditions deteriorate, he said, oxygen stops flowing as well to the heart and brain.
Dr. Pulido said his team and the rest of Baptist Health’s health care workers are consulting their COVID-19 committee to decide how to best treat patients suffering from the virus.
“We are reviewing all aspects of research and latest and greatest technology,” Dr. Pulido said. “We are even looking at the non-FDA approved meds that are in consideration, so there is a lot happening in a short period of time in regards to how we treat these COVID-19 patients.”
He said physicians work with patients on a case-by-case basis. That includes keeping patients’ loved ones in the loop throughout the process about their condition and treatment options.
The FDA has yet to approve a treatment for COVID-19, but it’s allowing a limited use of chloroquine and the malaria drug hydroxychloroquine to treat coronavirus patients. These drugs can only be administered by a health care provider and are only used to treat patients without access to clinical trials.
Both drugs have raised questions about their safety and effectiveness.
According to Baptist Health, doctors in their health system are already using hydroxychloroquine for patients on an as-needed basis. Baptist is doing a retrospective study examining COVID-19 patient outcomes and the effectiveness of hydroxychloroquine.
Dr. Pulido said his team saw at least one patient improve after taking the drug along with zinc. He said it was the first coronavirus patient treated by Baptist. At first, he said, the patent was treated for bronchitis and pneumonia, but within four days the symptoms indicated it was COVID-19.
“We did not know the [the patient] was COVID positive, but clearly [the patient] was not responding to antibiotics,” he said. “So we decided we had to change course. There was already by that time talk about hydroxychloroquine. We ultimately decided to put the patient on hydroxychloroquine, plus zinc, as a form of antiviral therapy. That regimen, the patient showed a very clear, positive response.”
While he acknowledged there is more research to be done, Dr. Pulido said that treatment worked for at least one patient. He said Baptist Health’s committee is reviewing all aspects of research related to the novel coronavirus and its potential treatments.
“We are even looking at the non-FDA approved meds that are in consideration,” he said. “So there is a lot happening in a short period of time in regard to how we treat these COVID-19 patients.”
According to Baptist Health, the health system was selected for one prospective clinic trial focusing on using a fragment of an antibody that slows down lung inflammation. The health system is preparing to participate in five additional trials once they are approved by the FDA.
News4Jax reached out to other health systems in Northeast Florida including Mayo Clinic, UF Health Jacksonville, Orange Park Medical Center and Memorial Hospital, and Ascension St. Vincent’s.
Ascension St. Vincent’s said it is currently collecting plasma from recovered patients. To be eligible to donate, patients must: have a prior diagnosis of coronavirus that is documented by an FDA-approved lab tests along with documentation showing they have completely recovered from the virus.
In a statement released to News4Jax, a spokesperson said treatment is personalized to a patient’s circumstances, but treatment can include the potential use of certain investigational therapies such as convalescent plasma for critically ill patients.
Ascension St. Vincent’s did not say whether it is using any other treatments like hydroxychloroquine.
Mayo Clinic declined to answer our questions after multiple attempts to reach out to the health system.