COVID-19 treatment outlook
Community Hospital follows the National Institutes of Health’s guidelines on evidence-based treatments for COVID-19. Treatments range from management of symptoms to medications. Each patient’s treatment plan is individualized, depending on the complexity of their condition and any underlying health conditions.
We are still at a point in this pandemic where there are few specific treatments for COVID-19 and general supportive care, which includes management of symptoms and use of supplemental oxygen when appropriate, is a large component of the treatment plan. We have ready access to the FDA-approved anti-viral Remdesivir for use in patients admitted to the hospital with more moderately severe COVID-19. In addition, the FDA has given emergency approval for some other treatments that have shown promise in reducing the severity and mortality rate of patients with COVID-19, including monoclonal antibody infusions and COVID convalescent plasma. Finally, there are numerous ongoing clinical trials to evaluate a large variety of possible treatments. The treatments currently utilized for appropriate patients at Community Hospital are described below.
Remdesivir is now the only FDA-approved therapy for the treatment of COVID-19. It appears to have few side effects and is well tolerated by most all patients. There are a few conditions which would prevent this medication from being given such as significant liver or kidney disease. The best use of this medication is in patients in the early stages of the infection and those who are sick enough to require supplemental oxygen and inpatient hospital care. Remdesivir is now commercially available and supplies are not limited at the current time. Remdesivir is given intravenously and only in the hospital to those patients meeting appropriate criteria.
The FDA has granted Emergency Use Authorization for two antibody infusions to treat mild COVID-19 in patients who are high risk for developing severe disease. The two products are bamlanivimab made by Eli Lilly and a combination mix of casirivimab plus imdevimab made by Regeneron. These treatments are not commercially available, rather are distributed from the federal government to local county authorities for use in our hospitals. The current supply is limited and future shipments are uncertain and unpredictable. These treatments are also distributed to skilled nursing facilities with COVID-19 outbreaks to treat patients there who may have early, mild symptoms. These infusions are only approved for a select group of people who are highest risk for developing severe disease. Those groups include the following:
Diabetics, people with chronic kidney disease, people on immunosuppressive treatments (like cancer treatment), people with obesity with BMI >35, anyone 65 or older, and anyone 55 or older with chronic lung disease, high blood pressure or heart disease. Children ages 12-17 are eligible if they have obesity with BMI >85%, sickle cell disease, congenital/acquired heart disease, neurodevelopmental disease (e.g. cerebral palsy), a medical device dependency (e.g. feeding tube or breathing tube) or asthma/respiratory disease requiring daily medication for control.
These infusions are beneficial only if given early in the course of disease while symptoms are still mild (for example, not needing any supplemental oxygen). The treatment must be given within the first 10 days of symptoms and before blood oxygen levels are affected. The research studies showed that when given to high risk people with early, mild disease there was a lower chance of having to return to the Emergency Department and lower chance of needing to be hospitalized for COVID-19 treatment. If you were tested at Community Hospital and you meet the criteria for treatment, then someone will contact you by phone to discuss this treatment option. The antibody infusions have not received full FDA review and approval and, like all other medications, come with some risk. Click on the links below to get more information about the specific antibody treatments.
Monoclonal Ab patient information in English.
Monoclonal Ab patient information in Spanish.
Early studies show that Dexamethasone, an anti-inflammatory steroid, has been seen to improve the condition of some patients with COVID-19. This steroid is widely available and utilized with many patients.
COVID-19 convalescent plasma
COVID-19 convalescent plasma may have benefits for some patients with COVID-19. Plasma is the liquid part of blood that contains infection-fighting antibodies. Plasma donated from those recovered from COVID-19 contains antibodies that can be transfused into those sick with COVID-19 and may help them recover faster. Community Hospital is a registered site with the National U.S. COVID Plasma Expanded Access Program. Appropriately selected patients who may benefit from receiving a COVID convalescent plasma transfusion are enrolled in the program after discussing the relative risks and benefits with their treating physician.
Most patients can recover from COVID-19 with supportive care. This care can include supplemental oxygen, fluids, fever reducers, and other methods to reduce the effect of the symptoms on our patients. Remember, the majority of people with COVID-19 and no underlying chronic medical conditions will not need hospitalization and can care for themselves at home with over-the-counter medications.
These treatment plans can change and vary widely due to new evidence and best-practices as more information is known about treating COVID-19.
COVID-19 in our community resources
Learn more on our coronavirus informational webpage and also view COVID-related testing and inpatient data (including the number tested, deaths, and those hospitalized).