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Don't put the facemasks away just yet

Experts at Silver Cross in New Lenox put dexamethasone study in context

Pictured (from left) are Dr. Christopher Udovich, Silver Cross Hospital chief medical officer, and Dr. Atul Gupta, chairman of infection control for Silver Cross Hospital in New Lenox
Pictured (from left) are Dr. Christopher Udovich, Silver Cross Hospital chief medical officer, and Dr. Atul Gupta, chairman of infection control for Silver Cross Hospital in New Lenox

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The results of a study regarding steroid dexamethasone as a treatment for the virus that causes is exciting because it's the first drug for COVID-19 that may reduce mortality rates.

This is why Dr. Christopher Udovich, Silver Cross Hospital chief medical officer and Dr. Atul Gupta, chairman of infection control for Silver Cross Hospital in New Lenox, are hopeful - because it may change outcomes for certain patients with the coronavirus.

That and the fact that the study seems very well put together, Udovich said.

However, this doesn't change the value of remdesivir in its current treatment role.

"Remdesivir may help people get out of the hospital quicker," Udovich said, "but steroids may decrease mortality in certain people.

The study from England, which is not yet published or peer reviewed, showed that out of 2,104 out of 4,321 patients to receive the steroid, deaths were reduced by 35% in patients on ventilators and 20% in patients receiving supplemental oxygen.

Gupta said the pulmonologists at Midwest Respiratory in Joliet, who see patients at Silver Cross, have been treating certain covid patients with steroids for several weeks now "with very good results."

"This is for people in the hospital needing oxygen," Udovich said. "This isn't for someone who's at home and tests positive."

Gupta added, "This is just one thing that somewhat reduces your risk of dying from covid."

Dexamethasone, Gupta added, may become "just one of many treatments we can use to improve the outcome of patients."

Udovich said initial thinking with the virus was to not prescribe steriods as they can make some respiratory viruses worse by suppressing the immune system.

"But covid causes a different type of inflammation or inflammatory response - cytokine storm," Udovich said. "If you block those [cytokines] then patients seem to do better."

Gupta said even as scientists and researchers are learning more about this coronavirus, information is lagging on the optimal way to treat it.

But Gupta does know the pulmonologists have used blood thinners with certain patients with good results since having the COVID-19 virus can increase the risk of clots in blood vessels.

Charles Thompson of Joliet, who spent five weeks at Silver Cross with a severe form of the virus, said the virus caused his blood to be “so thick” that he received blood thinners to prevent blood clots.

Udovich said "proning" patients has also helped them recover. When patients are "proned," they lie on their stomach for a portion of the day to take the pressure off their lungs.

Silver Cross has also treated patients with convalescent plasma therapy as part of a natationwide study ed by researchers at Mayo Clinic in Rochester, Minnesota

The treatment uses antibodies from plasma donated by individuals who have recovered or in the process of recovering from COVID-19. The plasma is then transfused into patients currently fighting the virus.

Udovich said the same study that looked at dexamethasone as a possible treatment for COVID-19 is also looking at several other medications, too. These include an antibiotic, another antiinflammatory and an HIV drug.

"But we don't have information on that yet," Udovich said.

However, the public should not abandon handwashing, facemasks or social distancing. Dexamethasone will not be prescribed as a preventative for COVID-19 or as a treatment for mild cases, Udovich said.

Gupta added, "The treatment we've been using isn't gong to change much."

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