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Professor Grant Waterer
Clinicians have been urged to resist the urge to do “something” in severe COVID-19 disease and instead remember their Hippocratic oath to do no harm – and stick with evidence-based therapies.
A Comment article in the AJRCCM, led by Professor Grant Waterer from the University of Western Australia, said it was disappointing that people, admittedly in desperation, were trying any number and combination of experimental therapies.
Many therapies including hydroxychloroquine, ritonavir, lopinavir, interferon alpha-2-beta, azithromycin and methylprednisolone were potentially cardiotoxic and many had never been tested in critically ill patients, it said.
In another example, Professor Waterer and colleagues said high dose corticosteroids may be associated with delirium, agitation and psychosis that complicates the weaning of intubated patients.
“These physicians believe that the chance of potential benefit outweighs the chance of harm,” they said.
“Whether this approach has harmed more patients that it has helped remains to be seen. Desperate times are felt to justify desperate measures.”
The authors were responding to a case series of 85 fatal cases of COVID-19 from two hospitals in Wuhan, also published in the Blue Journal.
It showed most patients had received a cocktail of drugs including antibiotics, antivirals and glucocorticoids, with probably little benefit.