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Remdesivir: Hope for Critically Ill COVID-19 Patients

Methodist Health System is at the forefront of studying Remdesivir — an anti-viral drug that could become the “standard of care” for reducing the recovery time and severity of COVID-19 for countless patients. In a medical trial that includes patients hospitalized at Methodist Dallas Medical Center, two-thirds of those who received Remdesivir had good results — and sometimes striking improvement.

“We have seen some extremely encouraging results where people on the verge of death were able to recover and leave the hospital,” says Parvez Mantry, MD, AGAF, FAASLD, CPE, executive medical director of the Methodist Health System Clinical Research Institute.

Although Remdesivir has yet to be approved by the Food and Drug Administration (FDA), hospitals across the country have been given the green light to use it when nothing else seems to work.

“Drug development is usually a long and tedious process,” says Crystee Cooper, DHEd, director of clinical research for Methodist Health System. “In this instance, the FDA and other regulatory bodies have expedited the approval process for testing and use of investigational therapies. We’ve witnessed unprecedented flexibility during the COVID-19 pandemic.”

‘A DRUG CAN BLOCK THIS VIRUS’

Remdesivir recently made headlines after a government trial released preliminary, but “highly significant,” results showing a “clear-cut” benefit to patients, according to Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.

“This is really quite important,” says Dr. Fauci, who has become the face of the U.S. response to the pandemic. “A drug can block this virus.”



Like other anti-virals (think Tamiflu), the sooner patients get Remdesivir, the better, Dr. Mantry says. The drug interferes with an important enzyme the coronavirus needs to multiply and invade more cells in the body, stopping viral replication in its tracks.

Patients who are able to receive this drug before they get extremely ill respond the best,” Dr. Mantry says. “We remain hopeful.”

WHAT’S OLD IS NEW AGAIN

Remdesivir isn’t the only experimental treatment that’s shown promise for COVID-19 patients at Methodist hospitals. In this case, it’s not a cutting-edge drug but instead a century-old therapy that has proved effective time and again.

Convalescent plasma, first pioneered in the late 1800s, has been used to combat every plague from diphtheria to Ebola. Now, it’s made another comeback.

“Convalescent plasma has never really stuck,” says Karen Roush, MD, vice-chair of pathology for Methodist Health System. “It’s always been pushed to the wayside for vaccines or other effective therapies.”

But with a vaccine still months away and anti-virals like Remdesivir early in the research phase, the age-old method of treating the sickest patients with the antibodies of a recovered patient, or convalescent, is popular again.

“Some of these patients may end up having convalescent plasma as a last resort if they fail the drug trial,” Dr. Roush says.

MORE DONORS, MORE HOPE

Convalescent plasma therapy depends on the supply of antibody-rich plasma, the liquid part of blood. Early on, there weren’t nearly enough immune blood donors to meet the demand.

That’s beginning to change as more generous donors reach out to give back to the hospitals that treated them.

All four Methodist Health System hospitals are now treating COVID-19 infected patients with convalescent plasma transfusions. While it’s still early, Dr. Roush says, “there have been some successes.”

Those who have recovered from COVID-19 are encouraged to consider donating plasma. Visit Carter BloodCare to request eligibility. We ask donors to put “directed donation for Methodist Health System” in the comment section of the form to ensure plasma helps patients at our hospitals.

FOLLOWING THE BREADCRUMBS

The plasma trials and Remdesivir research are only beginning, and there are many battles to come in the fight against COVID-19.

But if treatments like these continue to show promise, the trailblazing teams at Methodist will have helped pioneer lifesaving therapies that give hope to millions.

“We’re trying to follow the breadcrumbs that others before us have left,” Dr. Roush says. “It’s interesting times, for sure.”

Original article by SHINE Online Health.

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For those of you interested in learning more about, COVID-19 Pedagogy author Maureen Sullivan has written the course COVID-19: A Healthcare Pandemic.

The purpose of this educational offering is to familiarize the healthcare professional with the issues surrounding COVID-19, a coronavirus that is currently causing a healthcare pandemic. This novel or new coronavirus was identified last year (2019), and is currently causing increasing numbers of illness and death worldwide. As this viral infection takes a financial, medical, and emotional toll on the worldwide population, it is imperative that all healthcare workers have a basic understanding of the virus, its symptoms, and transmission, and most importantly, what measures can be taken to lower the risk of infection in all areas of work and home.

Objectives:

Upon completion of this course participants will be able to:
  1.  Discuss what is meant by the term coronavirus and the acronym COVID-19.
  2.  Identify signs and symptoms pertaining to the clinical presentation of a suspected coronavirus patient.
  3.  Outline infection control issues related to the care of the coronavirus patient.
  4.  Discuss the likely origin of coronavirus in Wuhan, China.
  5.  Cite proper hand washing guidelines and use of Personal Protective Equipment (PPE).
  6.  Describe ongoing research and development of treatments (medications, vaccines, and others) for confirmed coronavirus.
  7.  Discuss the differences between the terms outbreak, epidemic, and pandemic.
  8.  Discuss the term “social distancing”.
  9.  Discuss the term “vulnerable population” as a high-risk group for developing coronavirus.
  10.  State the differences between the terms contagious and infectious.
Curriculum:

Chapter 1: Introduction, and Learning Objectives
Chapter 2: Origin and Pathophysiology of COVID-19
Chapter 3: COVID-19 and Vulnerable Populations
Chapter 4: COVID-19 and Emerging Treatment Options
Chapter 5: Nursing Homes: Preparing to Deal with a Pandemic
Chapter 6: When the Caregiver Becomes the Patient
Chapter 7: Caring for the Caregiver: The Importance of Self-Care Amidst a Pandemic
Chapter 8: References
Chapter 9: Appendix
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