April 2, 2020

Hematology PA Enrolls in COVID-19 Clinical Trial and Helps Further the Quest for a Treatment

Interview with Dwight Macero, PA-C, MS

By A. Kate MacDougall

As the number of confirmed COVID-19 cases began increasing in the United States and the World Health Organization declared a worldwide pandemic, Dwight Macero, PA-C, MS, a physician assistant in hematologic malignancies in Colorado, knew he wanted to help. But little did he know at the time, he would be aiding the effort as a patient.

After experiencing the symptoms we’ve all been warned about—achiness, chills, fever, dry cough—Macero contacted the employee hotline at his institution. Having met the criteria, he was scheduled for a COVID-19 test at a nearby drive-thru testing center and subsequently tested positive for the novel coronavirus.

“Our institution was very much on the ball in setting up processes for employees to have the ability to report symptoms, as well as a process for us to get screened and sent for testing as appropriate,” he said.

Prior to his diagnosis, Macero had joined the COVID-19 USA Physician/APP Facebook group —a platform for physicians and advanced practitioners to share clinical pearls and emerging data on COVID-19 diagnosis, management, and treatment. Through this group, Macero was able to sign up for a clinical trial out of the University of Minnesota investigating hydroxychloroquine versus placebo in patients who tested positive for COVID-19 early in the disease course.

“I found out my [positive COVID-19 result] at around 10:30 at night, and by 11:30 p.m., I had signed up for the clinical trial,” Macero explained. “As a provider, I wanted to help delineate the information that’s coming out [about COVID-19 and] contribute to the scientific effort.”

The study also includes an arm for household contacts who have known exposure within four days to COVID-19–positive patients to see if hydroxychloroquine post-exposure prophylaxis may have an effect. Macero’s wife, who has not yet experienced symptoms or tested positive for the virus, was enrolled in this arm.

As of the publication of this article, Macero is continuing to recover from the virus and, eager to start helping patients again, he’s planning to return to work soon. However, with so much unknown about this novel coronavirus, he said there is confusion over clearance criteria for healthcare workers on when it’s safe to return to direct patient care after recovering from COVID-19.

“As APs in hematology and oncology, a lot of our patients are going to be immunocompromised,” Macero said. “So knowing your institutional policy for your particular patient population is key.”

Macero also said that his medical knowledge and experience caring for patients has been instrumental in helping him navigate this healthcare crisis as an advanced practitioner and as a patient.

“As APs, we’re all trained and we’re all experienced in dealing with all sorts of crises in various different forms,” Macero said. “Relying on your knowledge base and on your instincts is going to get us very far in dealing with this crisis, not just from a physiologic standpoint, but from a psychologic standpoint as well.”

Read more from the APSHO Advance: Special COVID-19 Series