‘Give It a Try’

His colleagues at the hospital put him on the anti-malarial drug hydroxychloroquine, whose effectiveness for the coronavirus is still unknown, but Dr. Padgett’s condition continued to worsen.

By March 16, his heart was struggling, his kidneys were failing and his lungs were not providing enough oxygen to his body. The levels became so dire that he was on the verge of injuring his brain through oxygen starvation.

Dr. Padgett’s team at EvergreenHealth decided to transfer him to cardiac specialists at Swedish Health Services in Seattle. Dr. Matt Hartman, a cardiologist there, said it was clear that Dr. Padgett’s condition was rapidly worsening and that if they did not do something, he would not survive.

“We didn’t know if this was someone who was just going to die no matter what we do,” he said. “We think with his age, and the fact that there’s no other major comorbidity or problem, that we should at least give it a try.”

The team decided to hook Dr. Padgett up to a machine known as an ECMO that could essentially serve as both an artificial heart and lung, taking his blood out of his body, oxygenating it and returning it to him. While such procedures are most often done in the surgery suites, in this case it was all done in the intensive care unit, to prevent the spread of the coronavirus elsewhere in the hospital.

“We brought the operating room to him,” said Dr. Samuel Youssef, a cardiac surgeon at Swedish.

The team also began consulting with oncologists. Indicators of inflammation in Dr. Padgett’s body were “astonishingly high,” suggesting that he was potentially dealing with a “cytokine storm,” a dangerous phenomenon in which the immune systems of otherwise healthy people overreact in fighting the coronavirus.

The doctors administered the drug tocilizumab, often used for cancer patients who can have similar immune system reactions. They added high-dose vitamin C after seeing reports that it might be beneficial. These experimental treatments had also been tried on another patient, a 33-year-old woman, with some success.