Supportive therapy better than novel treatments for COVID-19, say scientists

Scientists have cautioned against the use of premature novel therapies instead of traditional critical care principles in patients with COVID-19 in a recent correspondence letter.

Dr Benjamin Singer, Assistant Professor of Medicine and Biochemistry & Molecular Genetics, Department of Medicine at Northwestern University Feinberg School of Medicine, US, and co-authors write that “the intensive care unit is already optimised for the care of COVID-19 patients and that departures from standard of care require evidence.”

According to the letter, the overwhelming patient demand and dwindling resources combine to trigger a cascade of emotions, stress and fatigue. As hospital staff mobilise to meet the growing demand of COVID-19 patients, some clinicians are making note of a pattern that has emerged where proven interventions are neglected or even rejected.

Singer argued that this is not the time to abandon reason. Instead, he calls for “a rational approach to translating science to the bedside as we care for patients with severe COVID-19. We want to come out of the COVID-19 pandemic knowing what works and what does not work for severe viral pneumonia patients.”

He added that physicians continuously learn from their patients by making observations and so far what they have learned is that the most effective treatment for COVID-19 patients is supportive therapy. Until there are clinical trials that offer clear direction on a different treatment approach, state-of-the-art supportive care is the best option, the scientists say. 

“Off-label and off-study use of novel or repurposed therapeutics prevents potential benefits or harms from being clearly defined and puts some of our most vulnerable people at risk,” cautioned Singer.

The letter was published in the American Journal of Respiratory Cell and Molecular Biology.