Research and Innovation Fuel UH's Response to COVID-19

We are among the first hospitals to conduct a clinical trial on the drug remdesivir, and are “thinking outside the box” in many other ways 

By Cliff Megerian, MD, President, University Hospitals

UH Clinical Update | May 2020

When we responded to the COVID-19 crisis in early March, our obligation as a health care system was to care of our community, stand up testing for our patients, and provide a safe environment for our patients and caregivers.

We clearly did that.

But as an academic medical center, we also are responsible for being part of a larger solution to this pandemic – and we achieved this, too.

UH quickly became one of the first hospitals to conduct a clinical trial on the drug remdesivir. To date, we have enrolled 95 patients in the trial. Results from another trial showed that this treatment decreased the length of stay, from an average of 14 days to 11, and increased the likelihood of survival for patients with significant COVID-19 disease. The drug’s manufacturer is now switching from research mode to making more of the drug.

UH also joined a Phase 1 clinical trial for the intravenous drug from Athersys – a stem-cell product to treat patients suffering from acute respiratory distress syndrome, known as ARDS, which can be fatal for patients with COVID-19. As of this writing, we have enrolled four patients.

Another trial underway is for a defensive spray called Halo Oral Antiseptic developed by the Cleveland-based ARMS Pharmaceutical firm. This formulation of cetylpyridinium chloride may prevent infections, including COVID-19. It is under FDA review and UH is leading the trial, along with 20 other hospitals around the country. 

Most impressive is how our best and brightest people at UH are able to think outside the box. One of the principal concerns with treating COVID was the potential shortage of respiratory ventilators.

So let’s look back to the late 1990s, when Dr. Raymond Onders, now the UH Chief of General and Gastrointestinal Surgery,  was experimenting with the notion of using electrical stimulation to pace and drive the diaphragm and help ventilation and breathing. Soon this technology began to be successfully used in patients with chronic ventilation issues, including those with quadriplegia and ALS. 

Being able to breathe without a ventilator was life-changing for them. “Superman” actor Christopher Reeve was the best-known of these patients treated here and Dr. Onders became renowned as a pioneer in diaphragm pacing.

More recently, Dr. Onders improved care for patients who must be on a ventilator, at least temporarily – such as those who have open-heart surgery. He and Dr. Alan Markowitz, UH Chief Surgical Officer Co-Director, Valve & Structural Heart Disease Center, realized that as the incision from the surgery is being closed, it is fairly simple to place temporary pacing wires on the diaphragms of these patients. 

In some circumstances, this allowed them to avoid the use of a ventilator. Now this process is being done here at UH in high-risk patients and in an FDA study. 

During the COVID threat, Dr. Onders determined that this approach could reduce ventilator burden in COVID-19 patients or other patients in our intensive care units by 26 percent. This would help free up more ventilators in a time of great demand. This temporary diaphragm pacing has been used in COVID patients in our system and in the hard hit area of Detroit, with the guidance of Dr. Onders during the patients’ prolonged recovery process.  

There’s no question that accomplishments such as these will accelerate. UH will continue advancing the practice of medicine and saving lives.