CVH--Rebecca Katzman, MD

Rebecca Katzman, MD

As cases of coronavirus infection (COVID-19) in Idaho pass 50,000 and deaths in the United States approach a quarter of a million, the search for useful treatments for this infection continues. One of the frustrating (and confusing) issues around coronavirus infections has been the lack of clear cut and very effective treatments. Since the beginning of the pandemic, numerous treatments have been trialed or studied with the simultaneous goals of showing that the medicine helps infected people recover while not causing harm or side effects that outweigh any benefits of treatment.

Currently, as of the third week of October 2020, national guidelines recognize two medications that can be used in hospitalized patients with severe COVID-19 disease. To date, there are no treatments proven to work or recommended for patients who do not require hospitalization. The two medications currently being used in hospitals are an antivirus medicine called remdesivir and a steroid medicine called dexamethasone.

In clinical studies, remdesivir has been shown to help speed recovery in seriously ill patients needing oxygen, meaning that on average, patients got better somewhat faster. Remdesivir is an antiviral drug that prevents or slows a virus from replicating (forming more copies) inside of a cell. Additionally, in certain groups of seriously ill patients the steroid medicine dexamethasone was shown to make death from COVID-19 less likely, perhaps by limiting the amount of inflammation as a response to this infection. Unfortunately, these medications have not been helpful for everyone, and many patients with severe disease still have a difficult or fatal illness despite treatment.

A number of other treatments have been in the news since the start of the pandemic because of some hopeful initial reports in a few patients, but in subsequent large and carefully performed studies they have not been shown to be helpful. Other treatments for which the evidence is not yet clear include treatment with antibodies, which are proteins that fight viruses and are part of the human body’s normal immune system. “Convalescent plasma” is made from the blood of many people who have had and recovered from coronavirus infections and might contain the antibodies that can help fight infection. A laboratory-made antibody preparation is also being researched. More time is needed to assess the role of these antibodies for treating patients with this coronavirus infection.

New evidence is being updated regularly and is followed very closely by health care providers. We would love to have effective and safe treatments that also are affordable and available for any patient who needs them. In the meantime, it is important that everyone take steps to prevent becoming infected or spreading the infection to others – wearing masks, washing hands, avoiding large gatherings especially indoors, and staying away from other people if we are sick.

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