12 minute read
Monoclonal Antibody Treatment Fights COVID-19 in South Arkansas
Lifesaving mAbs:
Monoclonal Antibody Treatment Fights COVID-19 in South Arkansas
By Alex Bennett
Monoclonal antibody therapy can help speed the recovery of high-risk patients testing positive for COVID-19. Medical Center of South Arkansas (MCSA) began using monoclonal antibody (mAb) infusions to treat COVID-19positive patients on December 8, 2020. These infusions treat confirmed COVID-19 patients who are at high risk of disease progression and hospitalization, with the intention of helping them recover without requiring hospitalization or trips to the emergency room. High-risk patients include anyone over age 65 and people with underlying health conditions.
The treatments are given in an outpatient setting at MCSA One Day Surgery and take around two and a half hours from start to finish. Like many hospitals across the state, MCSA received the mAbs free of cost from the Arkansas Department of
Health. Upon confirmation of the infusions’ arrival, MCSA began development of a plan for administering them and communicating the treatment’s benefits to area physicians and the community.
REDUCING HOSPITALIZATIONS, SAVING LIVES
MCSA Chief Nursing Officer Amy Triplet led the charge to form an implementation plan. It made sense to administer the infusions through a modified unit in MCSA’s One Day Surgery department.
Director of MCSA One Day Surgery Semekia Amerison quickly converted the area to accommodate COVID-19-positive patients in an environment safe for staff and patients, and One Day Surgery nurses Stacy Wagnon, RN, and Morgan Nash, RN, stepped up to serve as antibody infusion nurses.
Wagnon says she “feels a calling to care for these patients” because she wishes this treatment had been available when one of her family members fell ill with COVID-19. She believes the infusions could have made a major difference in that loved one’s recovery.
“Through MCSA’s participation in the monoclonal antibody treatment program, we believe we have been able to save many lives in our community and reduce the number of hospitalizations in south Arkansas,” Triplet says.
COMMUNITY BUY-IN
After developing and implementing MCSA’s mAb administration plan, the team turned toward its communication efforts. Because patients look to their own physicians for treatment guidance, local physicians are our most valuable resource in the fight against COVID-19. Educating local physicians on the benefits of mAb treatment became the team’s top priority.
This clip from a KTVE newscast features One Day Surgery Director Semekia Amerison, RN, BSN, discussing mAb use at MCSA. (Courtesy KTVE, the NBC affiliate serving the El Dorado, Arkansas and Monroe/West Monroe, Louisiana area.)
Medical staff were notified via email about the benefits this lifesaving treatment could offer their early-onset COVID-19-positive patients. The email also outlined the procedure and guidelines for ordering the mAb treatment.
Next, team members began calling all surrounding area clinics to let their medical teams know we were offering mAb treatments and how their patients could benefit.
After offering information to both physicians and clinics, efforts turned to community education. Throughout the course of the COVID-19 pandemic, community education has proven to be more important than ever. Because of social distancing requirements, MCSA has turned to virtual means to expand community education.
Amerison initiated these efforts with virtual presentations to local civic groups and news stations. She outlined information about mAb treatment and how the infusions are given. Facebook proved to be a popular resource when connecting with the public. Facebook reporting shows that MCSA’s educational posts have reached more than 35,000 people.
REGIONAL RESULTS
Due to our education efforts, MCSA began receiving referrals from all over southern Arkansas and northern Louisiana. Shortly after we began offering the infusions, we saw a reduction in hospitalization rates.
Members of our infusion team call each patient after their treatment to follow up, noting their progress and checking to see how they are feeling. Patients treated with antibody infusion report feeling better after 24 hours, and not one of them has been hospitalized due to COVID-19 complications.
“I believe this drug has been extremely effective in treating COVID-19 patients,” Nash says. “I call to check on our patients a couple of days after the infusion. It makes me feel good to hear their recovery stories and know that I had a part in their recovery.”
COVID-19 continues to present many challenges to health care organizations around the nation. Treatments like the COVID-19 mAb infusions can make a significant impact on the reduction of COVID-19related deaths and hospitalizations, and they are helping ease the strain on health care systems.
Alex Bennett is the Executive Director of Business Development at Medical Center of South Arkansas. Originally from Hot Springs, Arkansas, Bennett attended the University of Central Arkansas and moved to El Dorado in 2012. As the Executive Director of Business Development, she assumes many roles including Business Development, Marketing Director, Physician Liaison, Recruitment, and Volunteer Director. For more information on the Medical Center of South Arkansas, visit TheMedCenter.net.
Supporting you, supporting patients.
As the economy recovers from the COVID-19 pandemic, BKD continues to stand firm in our commitment to helping health providers mitigate the financial effects. When you’re looking for audit, reimbursement, and operational assistance, our trusted advisors are here to help you reach your goals.
Everyone needs a trusted advisor. Who’s yours?
35 Years of Healthcare Experience Background Checks Sanctions and Compliance Drug Screenings Employment Verification Student and Faculty Screening Professional Reference Checks
gp1.com • sales@gp1.com • 800-683-0255
COVID-19 “Long-Hauler” Patients
Search for Answers and Help
By Rick Kushman, courtesy of UC Davis Health
If you survive COVID-19, you may have something else to fear, and it has nothing to do with how sick you were.
For some people – and there seems to be no consistent reason – symptoms can last and last, sometimes for months. The name many of these patients call themselves is “long-haulers,” but it does not begin to describe the confusion, anxiety, and distress that long-term COVID-19 patients endure. “It’s scary for them,” says Nicholas Kenyon, a University of California, Davis Health (UC Davis Health) professor and leading pulmonary and critical care expert. “They want to know, ‘Why am I still out of breath? Why am I still tired and coughing after months? Am I ever going to get better?’”
The answer for them is not clear, and it is certainly not simple.
That’s because even defining the problem is not simple.
There are no precise statistics on the number of long-haul patients – people who, in theory, have recovered from the worst impacts of the coronavirus, tested negative, but still have symptoms that can last for weeks or months. The Journal of the American Medical Association in a recent article, as well as a study from a team of British scientists, estimate about 10% of COVID-19 patients become longhaulers. That’s in line with what UC Davis Health is seeing, Kenyon says.
But it’s hard to quantify because it’s hard to define the length of time that lingering symptoms fit the longhaul COVID-19 category.
“Even after a month, it gets frightening,” Kenyon said. “People ask, ‘What’s wrong with me?’”
Teams of experts at UC Davis Health’s new PostCOVID-19 Clinic will work to help patients who battle complex, long-lasting symptoms.
NO LIMITS TO THOSE AFFECTED
Long-term COVID-19 appears to affect every kind of patient – from people who were hospitalized with severe COVID-19 to those with very mild bouts who recovered at home. It appears in regions with both high rates and low rates of COVID-19 infections. It attacks people who were battling other conditions before contracting COVID-19 and people who were completely healthy. And it hits both the old and the young.
“We’ve seen this in patients across the gamut, and there do not appear to be any clear connections in the cause,” Kenyon says. “What’s new is this is affecting some people who are quite young who were very healthy and never had other illnesses.”
It is not uncommon, Kenyon says, for patients hospitalized for a long time – whatever the reason – to take months to get back to feeling normal. But even those [long-hospitalized] COVID-19 patients are inconsistent. Most recover on a steady, if sometimes slow, upward line, but some have symptoms that persist for months.
“We have experience helping people who were hospitalized with other severe viral infections,” he says, “but this disease is so new, there is still much to learn. We don’t know why a few hospitalized patients continue to have symptoms and others don’t. We aren’t even exactly clear what all the symptoms are.”
COMMON SYMPTOMS OF LONG-HAUL COVID-19
The list of symptoms is long, wide, and inconsistent. For some people, they are nothing like the original symptoms they had when they first were infected by COVID-19. The most common include: • Coughing. • Ongoing, sometimes debilitating, fatigue. • Body aches. • Joint pain. • Shortness of breath. • Loss of taste and smell – even if this did not occur during the height of their illness. • Difficulty sleeping. • Headaches. • Brain fog.
That last one is among the most confounding. Patients report being unusually forgetful, confused, or unable to even concentrate enough to watch TV.
“That sort of brain fog can happen to people who were in an intensive care unit for a length of time, but it is relatively rare,” Kenyon says. “But this is happening to all sorts of patients, including people who had mild cases and were not hospitalized.”
Symptoms for long-haulers are not uniform. Some report severe chest pain along with more general body aches. Others have chills and sweats or gastrointestinal issues. Some people have reported feeling better for days or even weeks, then relapsing.
For others, it’s a case of just not feeling like themselves.
“There are patients who can go for a run and test completely normal,” Kenyon says. “But they still don’t feel right. They aren’t back to their old selves, but we can’t fully define what’s wrong. Telling a patient who feels bad that they are fine and there is nothing we can identify is not a decent answer for them, or for us.”
TRYING TO EXPLAIN LONG-HAUL COVID-19
The problem for patients and experts trying to help is the same one that physicians and infectious disease experts face with COVID-19 in general – it’s so new that science is only beginning to grasp it. And long-haulers have only
recently gotten the attention of some experts who were first engaged with trying to slow the pandemic or care for dangerously ill patients.
The vast majority of long-haulers test negative for COVID-19, and there is no specific test to give them for lasting symptoms of the coronavirus, says Nam Tran, Associate Clinical Professor of Pathology and Laboratory Medicine and Senior Director of Clinical Pathology in charge of COVID-19 testing at UC Davis Health. “Unfortunately, we don’t know enough about the virus to test for its lingering effects,” Tran says. “There are questions about why their fatigue goes on and on, and science just hasn’t solved them yet. We’re all learning in real time.”
The most common theories about long-term COVID-19 patients include the hypotheses that the virus remains in their bodies in some small form, or that their immune systems continue to overreact even though the infection has passed.
“The idea that the virus is somehow persisting has been discussed,” Kenyon says. “This doesn’t mean the virus is growing or that we can test for it, but this might mean their bodies are reacting to it, or it’s still triggering ongoing inflammation.”
Some infectious disease experts, including Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, have speculated that long-term COVID-19 might be a form of what is called chronic fatigue syndrome, or myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). Unfortunately for long-haulers, ME/CFS is not well understood, either.
WHAT IS BEING DONE TO HELP?
As with many other COVID-19 issues, it’s hard just knowing how long some of the symptoms might last when the disease was identified [just over a year] ago. Learning how to treat these patients also requires time.
“First, we have to discover what we can about the disease and how to treat it,” Kenyon says. “That takes time and experience. Then we all have to share the information with other physicians and
Coronavirus Also Affects Minds
That’s why we are available anytime fromanywhere, offering all our services in the safest possible manner –
Telehealth for: • Outpatient and school-based counseling • Kaleidoscope Grief Center support • Methodist Behavioral Hospital physician services, family therapy, visitation • In-person psychiatric testing with plexiglass screen/PPE
Call 877-778-1197 info@MethodistFamily.org
Many long-haul COVID-19 patients battle exhaustion and a range of other symptoms.
the public. We don’t have that system of sharing in place yet for long-haulers.”
Early in the pandemic, pulmonary care chiefs around the U.S. gathered virtually on Sunday evenings to talk about caring for patients and to share information to help each other progress. Kenyon says he’d like to see something like that resume to discuss caring for long-term COVID-19 patients.
“It may not seem to be as much of an emergency as in the first days of the pandemic, but this is just as important,” he says. “Because of the pandemic, we don’t have some of our usual routes of communication, like in-person meetings and conferences.”
Also, because the disease is so new, much of the information about long-haul COVID-19 cases and care is anecdotal. That is changing, however, and UC Davis Health is working to bring its expertise together to help patients. [In fact, a new Post-COVID-19 Clinic was recently established by UC Davis Health to care specifically for long-haul patients.]
“These people need our help,” Kenyon says. “We don’t want anyone to have to go step-by-step through each symptom or to go through a list of referrals to find out what’s happening to them. We are uniquely set up to care for these patients, and we will.”
Article shared courtesy of University of California, Davis Health, Sacramento, California. Used with permission.
