A local hospital has been participating in clinical trials to evaluate whether new drugs can successfully neutralize coronavirus.
Providence Saint John’s Health Center recently received approval to begin three new clinical trials to treat COVID-19, adding to three other trials the hospital’s John Wayne Cancer Institute has been participating in for the last several weeks.
Institute executive director Dr. Steven O’Day said oncologists around the world who have previously used immunotherapy to treat cancer are now using their expertise in immunology to research COVID-19 treatments.
O’Day said the institute’s research is targeting both the virus itself and patients’ exaggerated immune response to the virus.
Saint John’s has been involved in clinical trials of remdesivir, which O’Day said may help patients recover from COVID-19 more quickly. Other antiviral drugs, however, have been ineffective.
O’Day said the hospital has also been testing sarulimab, which targets the protein that causes severe inflammation in the lungs of COVID-19 patients. About 20% of COVID-19 patients require hospitalization, he said.
“In 20% of patients, on day four to six of the illness, there’s a transition where the virus goes from the upper respiratory tract to the lower respiratory tract,” he said. “When it’s deep in the lungs, it causes scarring and damage.”
The hospital is also involved with clinical trials of a potential vaccine made by Novartis and has been using convalescent plasma to treat some patients.
Now, Saint John’s is opening a study with Regeneron on a drug with antibodies that can neutralize the main protein in SARS-CoV-2, O’Day said.
“Hopefully, we can eventually get people on antibodies before they get to a much sicker situation,” he said.
Saint John’s has also been experimenting with alternatives to ventilators.
Pulmonogist Dr. Terese Hammond said ventilators exert pressure on the lungs and can sometimes damage them. She said the hospital is increasingly turning to ECMO machines, which pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest.
“We still use ventilators, although we know they can be very harmful to the lungs of COVID-19 patients and so try to use other therapies as much as we can before we put them on ventilators,” Hammond said.
She said Saint John’s is approaching a 50% survival rate for patients who require ECMO machines.
The hospital has a responsibility to help patients outside its affluent Westside catchment area, she added.
“Community hospitals don’t always have the resources to have access to these treatments,” she said.
But O’Day said he hopes hospitals will be able to rely less on ECMO machines and ventilators in the coming months.
“Now that we have an antiviral with some benefit, and anti-inflammatories and plasma, it’s our task to identify the 20% who need more help before they crash and need ventilators,” he said.