{"id":34804,"date":"2020-10-05T09:48:07","date_gmt":"2020-10-05T15:48:07","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=34804"},"modified":"2024-07-17T10:09:56","modified_gmt":"2024-07-17T16:09:56","slug":"best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients\/","title":{"rendered":"Best drugs to fight COVID-19: Dexamethasone and remdesivir that Trump is receiving also help other seriously ill patients"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><figure id=\"attachment_33783\" aria-describedby=\"caption-attachment-33783\" style=\"width: 536px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-33783 size-full\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/08\/19134323\/ICU-e1603127999998.webp\" alt=\"ICU team. Patients who are seriously ill from COVID-19, like President Trump, are getting dexamethasone and remdesivir.\" width=\"536\" height=\"395\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/08\/19134323\/ICU-e1603127999998.webp 536w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/08\/19134323\/ICU-e1603127999998-300x221.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/08\/19134323\/ICU-e1603127999998-150x111.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/08\/19134323\/ICU-e1603127999998-200x147.webp 200w\" sizes=\"auto, (max-width: 536px) 100vw, 536px\" \/><figcaption id=\"caption-attachment-33783\" class=\"wp-caption-text\">There&#8217;s no cure for COVID-19, but medical teams have gotten better at helping patients survive. Two drugs that President Donald Trump has received, dexamethasone and remdesivir, have also helped other COVID-19 patients. Here, an ICU team dons protective gear to work with COVID-19 patients at UCHealth Memorial Hospital. Photo: UCHealth.<\/figcaption><\/figure>\n<p>As cases of COVID-19 tick up in many states and President Donald Trump now is fighting the illness, doctors still have no cure, but better drugs and therapies are helping more COVID-19 patients survive the deadly virus.<\/p>\n<p>Some of the therapies that Trump received also are being used for seriously ill COVID-19 patients in Colorado and elsewhere, including the corticosteroid, <a href=\"https:\/\/www.uchealth.org\/today\/dexamethasone-may-or-may-not-be-a-breakthrough-coronavirus-treatment\/\" target=\"_blank\" rel=\"noopener noreferrer\">dexamethasone<\/a>, and, to a lesser degree, the antiviral drug, <a href=\"https:\/\/www.fda.gov\/news-events\/press-announcements\/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment\" target=\"_blank\" rel=\"noopener noreferrer\">remdesivir<\/a>.<\/p>\n<p>Trump also has received an experimental antibody cocktail made by Regeneron. The federal <a href=\"https:\/\/www.fda.gov\/home\" target=\"_blank\" rel=\"noopener noreferrer\">Food and Drug Administration<\/a> has not approved the Regeneron therapy yet for most COVID-19 patients, <a href=\"https:\/\/www.uchealth.org\/today\/does-regeneron-antibody-drug-that-trump-received-work-for-covid-19\/\">but clinical trials are underway in Colorado and elsewhere.<\/a><\/p>\n<p>So, which therapies work best and what are the go-to treatments now that frontline doctors have learned more about how to treat patients with COVID-19? Are the treatments that Trump received standard for most seriously ill patients? And which patients are most at risk for faring poorly if they get COVID-19?<\/p>\n<h3><strong>COVID-19 treatment: Dexamethasone and remdesivir helping, doctors no longer using hydroxychloroquine<\/strong><\/h3>\n<p>Care for patients who need to be hospitalized for COVID-19\u00a0has improved. In April, based on small, preliminary studies, hospitalized patients were being given hydroxychloroquine, a repurposed antimalarial, and the antibiotic azithromycin, says <a href=\"https:\/\/www.uchealth.org\/provider\/david-douin-md\/\">Dr. Josh Douin<\/a>, a <a href=\"https:\/\/www.cumedicine.us\/providers\/anesthesiology\/david-douin\" target=\"_blank\" rel=\"noopener noreferrer\">University of Colorado School of Medicine anesthesiologist and critical-care medicine specialist.<\/a><\/p>\n<p>Those treatments didn\u2019t pan out, Douin said.<\/p>\n<p>\u201cThat\u2019s the issue with a brand-new disease,\u201d he said. \u201cYou learn as you go along.\u201d<\/p>\n<p>The treatment of <a href=\"https:\/\/www.uchealth.org\/today\/dexamethasone-may-or-may-not-be-a-breakthrough-coronavirus-treatment\/\">dexamethasone<\/a>, and, to a lesser degree, the antiviral <a href=\"https:\/\/www.fda.gov\/news-events\/press-announcements\/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment\" target=\"_blank\" rel=\"noopener noreferrer\">remdesivir,<\/a> has helped survival rates for many who have been seriously ill.<\/p>\n<figure id=\"attachment_31014\" aria-describedby=\"caption-attachment-31014\" style=\"width: 225px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-31014\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/04\/15133643\/Dr.-Douin-headshot.webp\" alt=\"Dr. Josh Douin\" width=\"225\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/04\/15133643\/Dr.-Douin-headshot.webp 252w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/04\/15133643\/Dr.-Douin-headshot-225x300.webp 225w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/04\/15133643\/Dr.-Douin-headshot-113x150.webp 113w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/04\/15133643\/Dr.-Douin-headshot-200x267.webp 200w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><figcaption id=\"caption-attachment-31014\" class=\"wp-caption-text\">Dr. Josh Douin<\/figcaption><\/figure>\n<p>\u201cThe biggest breakthrough has been dexamethasone, which showed a pretty significant improvement for survival for folks who require ventilation,\u201d Douin said. \u201cEveryone who\u2019s admitted and requires intubation is getting dexamethasone.\u201d<\/p>\n<p>Some patients are also getting therapies as part of clinical trials. Trials involving hydroxychloroquine have stopped because of the therapies\u2019 questionable effectiveness with COVID-19. Trials involving convalescent plasma and <a href=\"https:\/\/www.uchealth.org\/today\/does-regeneron-antibody-drug-that-trump-received-work-for-covid-19\/\">specific monoclonal antibodies \u2013 man-made proteins like the Regeneron therapy \u2013 that could theoretically bind to the virus and alert the immune system to its presence<\/a> are continuing. There\u2019s also a <a href=\"https:\/\/www.uchealth.org\/today\/study-testing-tpa-to-break-blood-clots-in-covid-19-patients\/\" target=\"_blank\" rel=\"noopener noreferrer\">clinical trial<\/a> of tPA (tissue plasminogen activator) for patients with abnormal blood clotting, something that\u2019s been widely <a href=\"https:\/\/www.medicalnewstoday.com\/articles\/covid-19-possible-mechanism-for-blood-clotting-identified\" target=\"_blank\" rel=\"noopener noreferrer\">reported<\/a> among COVID-19 patients. That\u2019s in addition to prophylactic doses of anticoagulant given to all ICU patients, says Douin.<\/p>\n<h3><strong>Along with dexamethasone and remdesivir for COVID-19, doctors avoid &#8216;the vent&#8217;<\/strong><\/h3>\n<p>In addition to drugs that have been proven to help patients, including dexamethasnoe and remdesivir, doctors have discovered other ways to improve outcomes. Physicians at <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-university-of-colorado-hospital-uch\/\">UCHealth University of Colorado Hospital<\/a> were the first to describe the broader respiratory disease under which COVID-19\u2019s serious cases fall \u2013 acute respiratory distress syndrome, or <a href=\"https:\/\/www.uchealth.org\/today\/icus-work-to-stem-tide-of-covid-related-ards-patients\/\">ARDS<\/a> \u2013 back in 1967. But the coronavirus\u2019s version of ARDS has its wrinkles. While seriously ill coronavirus patients often need mechanical ventilation, physicians have learned to delay it as long as possible and even avoid mechanical ventilation entirely. One way they do that is with heated high-flow systems that deliver many liters of oxygen per minute through nasal cannulas, said <a href=\"https:\/\/www.uchealth.org\/provider\/marc-moss-md\/\">Dr. Marc Moss<\/a>, head of the\u00a0<a href=\"https:\/\/medschool.cuanschutz.edu\/pulmonary\">Division of Pulmonary Sciences and Critical Care Medicine<\/a>\u00a0at the\u00a0<a href=\"https:\/\/medschool.cuanschutz.edu\/pulmonary\">University of Colorado School of Medicine.<\/a><\/p>\n<figure id=\"attachment_2605\" aria-describedby=\"caption-attachment-2605\" style=\"width: 235px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-2605\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144849\/EXT_051116-Marc20Moss.webp\" alt=\"Dr. Marc Moss\" width=\"235\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144849\/EXT_051116-Marc20Moss.webp 469w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144849\/EXT_051116-Marc20Moss-235x300.webp 235w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144849\/EXT_051116-Marc20Moss-117x150.webp 117w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144849\/EXT_051116-Marc20Moss-200x256.webp 200w\" sizes=\"auto, (max-width: 235px) 100vw, 235px\" \/><figcaption id=\"caption-attachment-2605\" class=\"wp-caption-text\">Dr. Marc Moss<\/figcaption><\/figure>\n<p>All that said, and despite thousands of academic papers about the virus and the disease it causes, the biological mechanisms through which the SARS-CoV-2 does its damage remain poorly understood.<\/p>\n<p>\u201cIt hits every patient in variable ways. It\u2019s still difficult to predict with an admitted patient who will do well and who will do poorly,\u201d Douin said. \u201cWe do feel more confident in our ability to treat these patients safely.\u201d<\/p>\n<p>Even as the infection demographics shift and the months grind by, we\u2019re still in the infancy of COVID-19 treatment, Moss says, and there\u2019s a reason for optimism.<\/p>\n<p>\u201cI just think it\u2019s really remarkable how much progress has been made understanding the virus and how we can help people, all in a relatively short period of time,\u201d he said. \u201cI think that\u2019s because the medical community has worked collaboratively and avoided previous hurdles to make sure we can really care for patients. It\u2019s unprecedented.\u201d<\/p>\n<h3><strong>COVID-19 now: Greatest risk factors, highest case numbers<\/strong><\/h3>\n<p>Demographics \u2013 in particular, age \u2013 matter. Older patients\u00a0continue to fare poorly if they get the illness. The U.S. Centers for Disease Control and Prevention (CDC) <a href=\"https:\/\/covid.cdc.gov\/covid-data-tracker\/#demographicsovertime\">reports<\/a> that those ages 75-84 have eight times the risk of being hospitalized with COVID-19 than young people in the 18-29 age bracket; among those 85 and up, the risk jumps to 13 times higher than the younger cohort\u2019s. And the younger you get, the less likely it is that you will end up hospitalized: youths ages 5-17 are nine times less likely to be hospitalized than those ages 18-29. In other words, while COVID-19 can put anyone in the hospital, younger people fare much better.<\/p>\n<p>And it\u2019s younger people who are being increasingly <a href=\"https:\/\/cdphe.colorado.gov\/covid-19\/data\" target=\"_blank\" rel=\"noopener noreferrer\">diagnosed<\/a> with the coronavirus in Colorado. Back in the spring, during the week of April 19, those under 40 accounted for 32% of cases; by the week of Sept. 13, they accounted for 68% of them. The percentage of cases among those over 60 fell from 28% to 10% over that same period. Critically, those over 80 \u2013 for whom COVID-19 death rates hover around 65% \u2013 saw their percentage of confirmed Colorado cases fall from about 10% to just 1.7%. Experts attribute these trends to behavior. Many older adults have quarantined themselves and have been very cautious about socializing. Meanwhile, young adults have returned to colleges and universities where parties have spread the virus.<\/p>\n<h3><strong>Testing &amp; prevention<\/strong><\/h3>\n<p>Those numbers don\u2019t paint a full picture of actual case counts, though. People with mild or no symptoms (The CDC\u2019s current <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/\" target=\"_blank\" rel=\"noopener noreferrer\">best guess<\/a> is that 40% of COVID-19 patients are asymptomatic) largely weren\u2019t being tested early in the pandemic. Testing was scarce enough that many who were quite sick didn\u2019t get tested at all. That shows in the data, too: on April 19, a whopping 22.4% of 1,477 coronavirus tests statewide came back positive. On Sept. 13, 10,485 tests yielded 2.75% positives. More testing across a broader sample of people led positivity numbers closer to \u2013 if surely still higher than \u2013 the actual assumed infection rates. (The Colorado COVID-19 Modeling Group <a href=\"https:\/\/drive.google.com\/file\/d\/1osVuztn6Z27GJLtTsKrqThJb-lvGQLYP\/view\" target=\"_blank\" rel=\"noopener noreferrer\">estimates<\/a> that about half the new infections in the state are being detected through testing).<\/p>\n<p>Prevention efforts \u2013 hand washing, social distancing, mask-wearing \u2013 have also helped keep hospital admissions down. We know now that lingering aerosols from talking, singing, or just breathing are a factor in COVID-19 transmission, and, with that knowledge, can <a href=\"https:\/\/www.uchealth.org\/today\/six-steps-to-slowing-airborne-aerosol-coronavirus-transmission\/\">do something<\/a> about it. Masks, in addition to protecting the wearer and those nearby from those aerosols and larger respiratory droplets, may even lower the <a href=\"https:\/\/www.thelancet.com\/journals\/lanres\/article\/PIIS2213-2600(20)30354-4\/fulltext\" target=\"_blank\" rel=\"noopener noreferrer\">dose<\/a> of viruses inhaled to <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp2026913\" target=\"_blank\" rel=\"noopener noreferrer\">provide a degree of inoculation<\/a>.<\/p>\n<p>For information on COVID-19 testing through UCHealth, please click <a href=\"https:\/\/www.uchealth.org\/services\/infectious-diseases\/coronavirus-covid-19\/covid-19-testing\/\">here<\/a>. To find community testing locations throughout Colorado, please click <a href=\"https:\/\/cdphe.colorado.gov\/covid-19\/data\" target=\"_blank\" rel=\"noopener noreferrer\">here<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As cases of COVID-19 tick up in many states and President Donald Trump now is fighting the illness, doctors still have no cure, but better drugs and therapies are helping more COVID-19 patients survive the deadly virus. Some of the therapies that Trump received also are being used for seriously ill COVID-19 patients in Colorado [&hellip;]<\/p>\n","protected":false},"author":23,"featured_media":33783,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[4859,4860,162,4781],"class_list":["post-34804","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-coronavirus","tag-covid-19","tag-infectious-diseases","tag-research-in-health-care"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Trump gets dexamethasone, remdesivir for COVID-19 - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Some therapies Trump received are used for seriously ill COVID-19 patients in Colorado and elsewhere, including dexamethasone and remdesivir.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.uchealth.org\/today\/best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Best drugs to fight COVID-19: Dexamethasone and remdesivir that Trump is receiving also help other seriously ill patients\" \/>\n<meta property=\"og:description\" content=\"Some therapies Trump received are used for seriously ill COVID-19 patients in Colorado and elsewhere, including dexamethasone and remdesivir.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.uchealth.org\/today\/best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients\/\" \/>\n<meta property=\"og:site_name\" content=\"UCHealth Today\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/uchealthorg\/\" \/>\n<meta property=\"article:published_time\" content=\"2020-10-05T15:48:07+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-07-17T16:09:56+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/08\/19134323\/ICU-e1603127999998.png\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Todd Neff, for UCHealth\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@uchealth\" \/>\n<meta name=\"twitter:site\" content=\"@uchealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Todd Neff, for UCHealth\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients\\\/\"},\"author\":{\"name\":\"Todd Neff, for UCHealth\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/person\\\/da7733ff5562e48e55c027d111ee5911\"},\"headline\":\"Best drugs to fight COVID-19: Dexamethasone and remdesivir that Trump is receiving also help other seriously ill patients\",\"datePublished\":\"2020-10-05T15:48:07+00:00\",\"dateModified\":\"2024-07-17T16:09:56+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients\\\/\"},\"wordCount\":1237,\"publisher\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2020\\\/08\\\/19134323\\\/ICU-e1603127999998.webp\",\"keywords\":[\"coronavirus\",\"COVID-19\",\"Infectious diseases\",\"Research in health care\"],\"articleSection\":[\"News\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients\\\/\",\"url\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/best-drugs-to-fight-covid-19-dexamethasone-and-remdesivir-that-trump-is-receiving-also-help-other-seriously-ill-patients\\\/\",\"name\":\"Trump gets dexamethasone, remdesivir for COVID-19 - 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Two drugs that President Donald Trump has received, dexamethasone and remdesivir, have also helped other patients. 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