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Mayo specialists looking at use of experimental drugs, convalescent plasma for COVID-19 treatment

Mayo specialists looking at use of experimental drugs, convalescent plasma for COVID-19 treatment

From the The pandemic hits home: Keep up with the latest La Crosse area news on COVID-19 series
Dr. Raj Palraj

Dr. Raj Palraj

Dr. Joseph Poterucha

Poterucha

Months into the COVID-19 pandemic, there are few answers about the exact origins, reinfection odds and treatment of the virus.

As researchers worldwide continue to investigate the unknowns, health-care specialists are exploring ways to fight the infection in their patients, turning to trial drugs and exploring convalescent plasma.

At Mayo Clinic Health System in La Crosse, infectious disease specialist Dr. Raj Palraj and Dr. Joseph Poterucha, principal investigator for covid convalescent plasma for Mayo Clinic, have been collaborating with Mayo Clinic Rochester to identify the best course of care for each COVID-19 patient who is treated at the La Crosse hospital.

Thus far, two patients have received plasma through the convalescent program, supplied by the Red Cross using plasma donations from recovered COVID-19 patients. The plasma, taken from those who tested positive for the coronavirus but are now 14 to 28 days recovered, is transfused to those currently hospitalized with severe or life-threatening symptoms of COVID-19.

“It’s too early to tell if the plasma is effective,” says Palraj, though the course of treatment has proved beneficial in treating other viruses.

Plasma transfusions have few complications, Poterucha says, with a small risk of virus transmission, infection or lung fluid. Each dose of plasma undergoes specialized testing before being administered to a specific individual.

Trials are underway nationally and worldwide for the use of experimental drugs in treating the virus. One of special interest to Palraj is Lenlizumab, which was given FDA approval for clinical trials in early April.

Lenlizumab is a recombinant monoclonal antibody which researchers hope will reduce the cytokine storm which causes the body to attack its own cells, leading to acute respiratory distress syndrome. Humanigen Inc. is conducting phase three trials on COVID-19 patients.

Tocilizumab, used to reduce inflammation from ailments such as rheumatoid arthritis and may help the lungs heal, has been used on just a few Mayo Clinic patients, says Palraj, though improvement was seen in that small population.

Undergoing clinical trials at Mayo in Rochester is the use of Remdesivir, an intravenous drug used for treatment of Ebola and Marburg. The drug inhibits the replication of the virus in the body and lungs, and for the Rochester patients, Remdesivir has shown a reduction in symptom length, Poterucha says.

“IV medications are only used for select patients in the ICU — we don’t offer them to anyone,” Poterucha says of Remdesivir, the distribution of which is controlled by the FDA and U.S. government. “It’s for a very specific subset and is not without side effects.”

COVID-19 patients given any of the experimental drugs are screened prior to administration, and monitored for the duration of use. The course of treatment, Poterucha and Palraj say, will be tailored to the specific patient. Whether plasma or drugs prove more productive, they say, will also likely be individualized.

Infected individuals receiving novel therapies, Poterucha notes, “seem to have some hope and anticipation...but not without apprehension.”

“Patients don’t walk unscathed,” Poterucha says of the virus and the side effects of treatment.

However, with the projected timeline of an approved COVID-19 vaccine around 18 months away, other interventions will be essential. Palraj is “cautiously optimistic” about an increase in treatment options in the meantime, though he says handwashing, wearing of face coverings and social distancing remain the most imperative course of action.

Says Palraj, “Prevention is always better than cure.”

Emily Pyrek can be reached at emily.pyrek@lee.net.

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