Baptist, first to use remdesivir here to treat COVID patient, ‘cautiously optimistic’

By Updated: May 22, 2020 9:08 AM CT | Published: May 22, 2020 4:00 AM CT

Baptist Memorial is the first hospital in the region to use remdesivir, the experimental anti-viral drug the FDA approved May 1 for emergency use on patients with COVID-19, based on promising early signs.

“I can tell you, the patient is better, certainly from the standpoint of the lungs,” said Dr. Stephen Threlkeld, the infectious disease expert overseeing the treatment.


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Because the patient is critically ill and has received a number of other therapies, including serum plasma from people who recovered from the coronavirus, “We can’t read too much into the fact they are better because they are receiving remdesivir,” Threlkeld said.

The patient at Baptist Memorial-Memphis received the seventh dose Thursday of a 10-day regimen. It is being administered intravenously.

<strong>Stephen Threlkeld</strong>

Stephen Threlkeld

Remdesivir, which works by blocking the coronavirus’s ability to reproduce itself, received widespread publicity last month when early trials showed it shortened recovery time an average of four days.

The FDA lifted restrictions, making it publicly available May 1 for emergency distribution.

Gilead Sciences, the maker, donated its entire supply. The U.S. Department of Health and Human Services said the U.S. would receive 40% of the stockpile, or about 607,000 vials, in May and June.

HHS distributed the drug. Tennessee, one of the original seven states to receive doses in early May, has so far received 4,000 vials, enough to treat about 500 patients, according to the Tennessee Hospital Association.

THA was asked by the state Department of Health to recommend a distribution plan, said Kelly Insana, vice president of marketing and communications.


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“Using criteria consistent with FDA’s emergency use authorization, a clinical team at Vanderbilt University Medical Center reviews and approves requests from providers to treat individual patients in hospitals throughout the state on a first- come, first-served basis,” she said.

Because the supply is limited, patients have to meet specific criteria.

“We had a couple of patients that we talked to our colleagues at Vanderbilt about. This patient met all the criteria,” he said, including that organ function was strong and the person had not been sick for long,” Threlkeld said.

“That’s one of the problems in testing a lot of these new drugs,” Threlkeld said. “We have to try to get these medications fairly and apportion them to the people who are the sickest. The problem with that, as with drugs throughout human history, is that drugs do better when given before people are maximumly ill and in danger of not surviving.”

To protect the patient’s identity, Baptist did not report the person’s age or race, but it did say the person’s condition was complicated by several underlying conditions.


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The patient is on an ECMO (extracorporeal membrane oxygenation) machine, which pumps the blood out of the body, adds oxygen and subtracts carbon dioxide before returning it back to the body.

Threlked said he knew of only three or four other instances of coronavirus patients at Baptist who had needed ECMO.

“Like anyone that ill, there are other issues we are attending to,” Threlkeld said. “But, we are cautiously optimistic.”

Baptist is keeping “meticulous” records on the patient’s response, he said, which will become part of the FDA record on remdesivir.

Even though the FDA has given emergency approval, remdesivir is still experimental.

<strong>Jon McCullers</strong>

Jon McCullers

“We just don’t know much yet,” said Dr. Jon McCullers, an expert on infectious disease at University of Tennessee Health Science Center and chief pediatrician at Le Bonheur Children’s Hospital. “When available, some doctors are trying combination therapies, but we do not know if they work yet.”

A clinical trial funded by the federal government is testing to see if remdesivir works better in fighting the coronavirus if given with the anti-inflammatory drug, baricitinib.

Biotech firm CytoDyn is working on a clinical trial that would combine remdesivir with the drug leronlimab, which inhibits viral infection and also has shown some anti-inflammatory effects.

Baptist is not using the drug in combination with others, although the patient is receiving antibiotics.

Thursday, HHS announced it was collaborating with pharmaceutical company AstraZeneca to have at least 300 million doses of a coronavirus vaccine called AZD1222 by January. The first could be delivered as early as October.

Editor’s Note: The Daily Memphian is making our coronavirus coverage accessible to all readers — no subscription needed. Our journalists continue to work around the clock to provide you with the extensive coverage you need; if you can subscribe, please do

Topics

Dr. Stephen Threlkeld Baptist Memorial Health Care Corp. remdesivir anti-viral coronavirus Baptist Memorial-Memphis Dr. Jon McCullers Gilead Sciences
Jane Roberts

Jane Roberts

Longtime journalist Jane Roberts is a Minnesotan by birth and a Memphian by choice. She's lived and reported in the city more than two decades. She covers healthcare and higher education for The Daily Memphian.


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