Best Practices
A suburban Chicago medical group, using data and experience in the field, has developed their own treatment protocols for COVID patients.
LIKE OTHER physician practices across the country, DuPage Medical Group in west-suburban Chicago has been managing the care of COVID-19 patients who are recovering at home.
The patients—particularly those at high risk for negative outcomes from the coronavirus—would often ask the physicians at DuPage if there are treatments available to encourage a faster recovery and less severe symptoms. But because the coronavirus’ strain is new, and well-researched treatments were not available, physicians didn’t have much to offer.
Motivated to give patients remedies, a team at DuPage began looking into the recent data on hospitalized coronavirus patients to see if something could be offered to patients that may improve their chances of recovery. The result was a new treatment protocol involving aspirin and supplements such as vitamin D, zinc and iron.
“Generally in healthcare, we wait for all the data to be perfect before incorporating it, but now in the midst of this pandemic, we needed to take bold action with courage to try to do something to help patients during this terrible time,” said Dr. Mathew Philip, internal medicine physician and medical director of clinical innovation at DuPage.
Philip and his colleagues arrived at aspirin as a treatment after reviewing data showing those who died from COVID-19 in the hospital largely died from blood clots and inflammation. Blood thinners and steroids also helped decrease mortality, the data showed. Aspirin is one of the most recognized, over-the-counter treatments to prevent blood clots.
Additionally supplements like zinc and iron are well-researched remedies for viral infections, said Dr. Mia Taormina, chair of the medical group’s infectious disease department.
The team that developed the protocol included an infectious disease physician, two pulmonary critical-care specialists, two emergency department physicians and an internal medicine doctor. The doses involved in the treatment are at normal levels.
“This is all driven by physicians,” Taormina said.
DuPage implemented the treatment protocol initially in October with its high-risk COVID-19 patients. Philip said that of the 20 patients who received the treatment in his practice, all recovered and only one required an inpatient hospitalization. Patients have had minimal side effects from the medications and the feedback has been positive, he added.
Given the results, DuPage recently expanded the treatment protocol to all its adult patients that test positive for COVID-19.
The protocol is now part of the electronic health record, which allows the physician to order it during in-person or virtual visits with patients. The physician can also modify the remedy based on the patient’s needs, for instance, if the patients can’t take one of the supplements. The treatment can be picked up at the patient’s local pharmacy.
The protocol offers guidance to physicians who were likely already considering providing these treatments to patients or recommending them, Taormina said. “Maybe we had a doctor already recommending vitamin C across the board or already telling patients to take zinc,” she said. “To streamline and centralize these recommendations, to give an approach systemwide allows patients who go anywhere within our system to know that their provider has been given the information that we support and endorse.”
Since the treatment protocol has been developed, research has come out about the benefits of aspirin on hospitalized COVID-19 patients.
Taormina said she is aware of nursing homes that have implemented treatment protocols similar to DuPage’s. “As the data and evidence continues to evolve, I think that the concept of doing these types of strategies is going to be
● more widespread,” she added.