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COVID-19 Therapeutics: What Works?

Creighton, CHI Health researchers identify effective medications, corroborate findings on racial disparities

CoronavirusIn the early days of the COVID-19 pandemic, when little was known about the virus and hospitals were in danger of being overwhelmed with critical cases, two Creighton researchers decided to identify medications effective for people whose cases were potentially fatal.

Faran Ahmad, MD, and Christopher Destache, PharmD, last March led a team of Creighton researchers in gathering data from throughout the CHI Health system, an effort that produced “COVID-19 Therapeutics: What Works?

That study, which names 15 co-researchers drawn from CHI Health Creighton University Medical Center-Bergan Mercy, CHI Health Pharmacy Division and Creighton University itself, is newly published in abstract form in the December 2020 edition of “Critical Care Medicine,” published by the Society of Critical Care Medicine.

The Creighton researchers found that convalescent plasma; dexamethasone, a corticosteroid that reduces inflammation; tocilizumab, an immunosuppressive drug typically used to treat rheumatoid arthritis; and proning intubated patients (placing patients horizontally on their stomachs) all positively impacted critical patient outcome.

They also found that approximately 50% of patients who contracted COVID-19 were racial minorities, even though the minority population in Nebraska and western Iowa is 5% African American, 2.7% Asian and 10% Hispanic. This disparity in contraction rates has since been noted consistently and more widely in other studies.

Data were gathered last year between March 15 and July 15, during which time 464 hospitalized COVID patients were treated at six CHI hospitals, of whom 127 were hospitalized in the intensive care unit.

Other findings included:
• Obesity or having acquired COVID-19 through occupational exposure were not significant mortality factors.
• People over the age of 72 were at greater risk of death.
• The overall COVID-19 death rate during the time of the study stood at 14%, lower than the national average of 20%.
• Occupational exposure was a prominent cause of acquiring COVID-19, representing 40% of all hospitalized patients during the course of the study. The study found that “many essential workers are at heightened risk of acquiring COVID-19 due to difficulties of social distancing in the workplace.”

Destache says the study was undertaken as an effort to understand whether treatments might exist that were more effective than those already in use.

“I think the results of the study primarily confirm other people’s results,” he says. “Other people have reported that ethnic minorities are at increased risk of mortality. Our study also shows that. I don't know if this study gives a good handle on what works overall as a COVID treatment, but it does give us a fairly good handle on what leads people to die from the virus.”

Ahmad, too, said the fact that contemporary and subsequent studies substantiated the Creighton study’s early conclusions is satisfying.

“The real-time data that we collected really supported the information that was coming, and has come, from other trials,” he says. “For example, that dexamethasone reduced mortality, that there exist racial disparities, and that Hispanic and African Americans are disproportionately infected.”

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