January 2021 | Page 53

SPONSORED CONTENT l COVID-19 RESEARCH AT BROWN pandemic , when doctors gave sick patients plasma from those who had already recovered from that century ’ s most deadly virus . Their theory was that the transfusion would help sick patients struggling to mount their own antibody defense by giving them the antibodies of someone else who already made it through to the other side .

Doctors in 2020 found themselves in a similar situation as their colleagues in 1918 : with no proven treatment or vaccine for COVID-19 , they looked to treating patients with the plasma of those who had already survived it .
Knowing when to give patients convalescent plasma ( CP ), and how effective it might be in different phases of the illness , are the key points of the current studies , which are taking place at multiple health centers . Adam C . Levine , MD , MPH , associate professor of emergency medicine and director of Brown ’ s Division of Global Emergency Medicine , is running the trials here .
In one , CP is given to individuals who have had high-risk exposure to COVID-19 , like if they live with someone who has tested positive for the virus or if they ’ re a health care worker . These subjects are enrolled in the study and randomized to CP or standard plasma before they show any signs or symptoms . The goal is to see if giving antibodies to people exposed to COVID-19 can work as prophylactic treatment , to prevent an infection from taking hold .
“ Given that so much transmission happens within a household , and we don ’ t really have a way to prevent that , and frontline workers are putting themselves at risk , this could be a powerful way to prevent those infections ,” says Levine , who also worked in Liberia during the Ebola outbreak in 2014 . If this kind of preventive measure works , he adds , it can also help health care workers feel more confident about continuing to do their jobs . In the second study , participants who recently tested positive for COVID-19 and have mild symptoms are treated with CP in their first week of disease to see if it prevents them from getting severely ill .
“ Based on what we know about convalescent plasma from other diseases and from this disease , it ’ s probably more likely to be effective early in the course of the disease , before the viral load is too high ,” Levine says . “ Then the antibodies have the best shot at neutralizing what is there .”

“ Little Rhode Island has made a big impact ... I ’ m really proud of that .” — Karen Tashima

REDEPLOYING REMDESIVIR
Karen Tashima , MD , a professor of medicine , calls remdesivir a “ drug looking for a disease to treat .” The antiviral was developed in 2009 by Gilead Sciences in hopes of treating RNAbased viruses that could spark global pandemics . It didn ’ t work as well as antibodies for Ebola in a 2014 study , despite showing activity in the lab .
“ Why not try it for COVID-19 ?” asks Tashima , who is the director of clinical trials at the immunology center at Lifespan and clinical research site leader for The Miriam Hospital .
That ’ s exactly what she and her colleagues did as part of a global study . In it , 397 people hospitalized for COVID-19 received remdesivir for five or 10 days . The goal was to determine how long patients should be given the drug . Researchers found that in patients who didn ’ t require ventilators , giving remdesivir for five days was just as effective as 10 days .
“ We can ’ t say how effective it was in this study because it was not compared to a placebo , but we know that after five days , people had very few adverse reactions , and that five days is just as good as 10 days for patients who are not intubated ,” Tashima says . These results can stop patients from getting medication in doses they don ’ t need , especially a medication that at times has been in short supply .
The study was conducted at the height of the spring outbreak , and brought a potential treatment into Rhode Island ’ s hospitals that might not have been available otherwise . “ We really wanted to have a treatment available to patients in Rhode Island because what else could we do ?” she says . “ We wanted to have something to give patients that wasn ’ t just supportive care . We wanted to be able to offer this drug .”
Tashima says researchers made sure to have doctors fluent in Spanish on their team , and consent forms in Spanish , to ensure Spanish speakers could be enrolled in the trial too — key since COVID-19 has disproportionally affected Black and Latinx Americans . Now Tashima is focused on the next frontier : she ’ s heading up a clinical trial of the COVID vaccine at The Miriam . z
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