Frontline therapies for COVID-19 continue to evolve

Hudson County hospitals have the go-to treatments

Dexamethasone is now a common frontline therapy.
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Dexamethasone is now a common frontline therapy.

Since the onset of COVID-19 in March, the way doctors treat patients across the United States has changed numerous times.

In an interview with the Bayonne Community News, Chief Hospital Executive Dr. Vijay Singh described the therapies given to patients admitted to Bayonne Medical Center (BMC).

Frontline therapies include Dexamethasone, Remdesivir, convalescent plasma therapy, IL-6 inhibitors, and ECMO therapy. The same therapies are used at other CarePoint hospitals, including Hoboken University Medical Center and Jersey City’s Christ Hospital.

Singh said that BMC staff has learned how to treat asymptomatic patients.

“We do not have to wait for them to develop respiratory symptoms or a certain level of fever,” Singh said. “We deploy therapies as soon as they come in. We do not wait for them to go to the ICU.”

Timeline for treatment 

Hydroxychloroquine, used to treat malaria and lupus, became a household name in April after President Trump repeatedly promoted it. At the onset of the pandemic, the drug was given to BMC patients.

While Trump had peddled the drug, some officials have said that the downsides of Hydroxychloroquine are too great to ignore, including irregular heart rates that increase the risk of a potentially fatal heart arrhythmia.

By May, a new drug was commonplace that proved effective: Remdesivir. As Hyrdroxychloroquine fell out of use, Remdesivir and other therapies became the go-to treatment.

IL-6 inhibitors including Actemera are also used. IL-6 inhibitors work to stop the cytokine storm created by the virus.

A cytokine storm occurs when the virus activates the proteins lining the blood vessels and turns them against the body.

This reaction causes inflammation, swelling vessels, blood clots, and loss of lining in the lungs. Stopping the cytokine storm allows the removal of ventilators.

Convalescent plasma therapy involves the distribution of collected COVID-19 survivor blood plasma containing antibodies that can overcome the virus.

For the most compromised patients, Extracorporal Membrane Oxygenation (ECMO) therapy treats respiratory failure. ECMO serves as an “external lung” bypassing the failing lungs.

Storm warnings

According to Singh, Dexamethasone, a steroid that treats inflammation, is commonly given to asymptomatic patients.

It also combats the cytokine storm. The protocol has changed in recent months from fighting the cytokine storm, to preventing it. Singh said therapies are given earlier rather than later to prevent the cytokine storm which can cause pneumonia, or fluid in the lungs.

Once fluid in the lungs is present, more serious therapies such as Remdesivir are used. However, Singh said that more often than not, patients will receive both medications when they are admitted.

He said that there has also been a lot of talk about monoclonal antibodies, a stem cell therapy, used to treat Trump when he contracted COVID-19.

Singh said BMC has developed a relationship with Holy Name Medical Center, the only hospital in New Jersey offering such therapies, including Regeneron and monoclonal antibody therapy.

“That collaboration helps because, while all the community hospitals like us offer every frontline treatment, there could be a potential patient who might benefit and qualify for those investigational therapies,” Singh said. “And we have access to that as well.”

While COVID-19 cases continue to increase in Bayonne, albeit slowly, hospitalizations at BMC remain low. If there is another virus surge, BMC is prepared.

For updates on this and other stories, check www.hudsonreporter.com and follow us on Twitter @hudson_reporter. Daniel Israel can be reached at disrael@hudsonreporter.com.