Local hospitals using recommended, investigative treatment methods to care for patients with COVID-19

Freeman infectious disease specialist says it's hard to know what's being effective

JOPLIN, Mo. – The talk for months now has been about the need for a vaccine for COVID-19.

And that hasn’t changed. But there are a handful of methods that doctors are trying in an attempt to help patients who are hit hard by the virus.

“It’s definitely a little frustrating,” says Dr. Uwe Schmidt, an infectious disease specialist with Freeman Health System, on the lack of approved treatment.

There’s currently no FDA approved treatment for COVID-19. But doctors at Freeman are trying three drugs. Remdesivir, an antiviral medication, Dexamethasone, a common anti-inflammatory medication, and Tocilizumab, a targeted immune suppressive drug. (More on what each drug does at the bottom of this article).

Not every COVID patient who ends up in the hospital receives those treatments. In fact, during a press briefing on July 2nd, Dr. Rob McNab, Director of the COVID unit at Freeman, said that around 6 of the 25 patients in the COVID unit were in “a critically ill condition.”

If the aforementioned treatment methods don’t work, Schmidt says then they try convalescent plasma, which has been taken for patients who’ve recovered from the disease.

“The Remdesivir we’ve given so far to 33 patients. The convalescent plasma to fifteen patients, and then the tocilizumab, the monoclonal antibody, in eight patients. The majority gets the dexamethasone, which we have given in 36 patients,” says Schmidt.

The drugs haven’t received FDA approval as treatments for COVID-19, but have been included in recommendations after trials and studies have suggested their effectiveness.

So, KOAM asked Schmidt what methods seem to be working so far.

“That’s difficult to say you know. The only which we use on a regular basis is Remdesivir. It has some benefit in shortening the duration of hospitalization, [but] it does not necessarily lower the mortality of the disease,” says Schmidt. “Most of the people get better luckily. But how much it’s because of treatment or how much it’s just the natural history of the disease… we don’t know for sure.”

So until a proven and approved treatment method — and vaccine — have been rolled out, health professionals still recommend following CDC guidelines, like social distancing and wearing a mask in public, to help slow the spread and flatten the curve.

“We really need to do our best as a community to really limit the spread of this,” says McNab.

Mercy Hospital is also using many of these treatments.

KOAM also spoke with pharmacist Desi Sweet at Stones Corner Pharmacy to get a breakdown on what each of the drugs actually does.

Remdesivir

On May 1st, the FDA issued an emergency use authorization for Remdesivir in severe cases after the drug showed to shorten the time to recovery in some patients in a clinical trial.

“The Remdesivir I think is one of the most popular ones out there. It’s an antiviral medication, which basically means that it’s gonna inhibit that viral replication process,” says Sweet.

Dexamethasone

Dexamethasone was added to the COVID-19 Treatment Guidelines Panel recommendations by the National Institute of Health on June 25th, after “preliminary, unpublished analysis from a large, multicenter, randomized, open-label trial for hospitalized patients in the United Kingdom showed that patients who were randomized to receive dexamethasone had a reduced rate of mortality compared to those who received standard of care.”

“Dexamethasone has been around for a long time. I think I read earlier that it’s been around since like the 1950’s,” says Sweet. “It is an anti-inflammatory, so it’s gonna help decrease inflammation and help dampen that immune response. With Coronavirus, I think one of the main things to point out is that our immune response is basically in overdrive, especially for severely ill patients. They’re showing that their immune system basically goes into overdrive and starts producing lots and lots of immune cells. So, they’re giving that Dexamethasone to help dampen that immune response to help patients get better sooner.”

Tocilizumab

The FDA has approved a phase three clinical trial for Tocilizumab to see its effectiveness in patients with severe symptoms.

“It’s a monoclonal antibody. So, it originally came out to treat rheumatoid arthritis, and monoclonal antibodies are basically target-specific therapies,” says Sweet. “So, in severely ill people with the Coronavirus, their immune system goes into overdrive, and they have basically what is called an inflammatory storm. So, their immune system is producing lots and lots of immune cells, and what happens for those severely ill patients is it can basically attack their body and cause them to go into acute respiratory distress syndrome and have multi-system organ failure. So, that particular drug targets immune cells and blocks the production of a specific type of immune cell called interleukin 6.”

Sweet says that she commonly fills prescriptions for Dexamethasone. But it requires a prescription, written by your doctor.

The FDA has also given “Investigational New Drug” status to Convalescent Plasma, providing a pathway for doctors to use plasma from patients who have recovered as a treatment. Freeman uses the Emergency Investigational new Drug pathway, getting approval from the FDA each time they administer the treatment to a patient.

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