What are the current treatments of COVID-19?

“As the list of proven options is quickly changing, I am proud to say that LifeCare Medical Center is on the cutting edge of providing treatment that many Critical Access Hospitals are not able to utilize,” said David Simmons, Pharm.D, BCPS, BCIDP.

I am David Simmons, a Clinical Pharmacy and Infectious Disease Specialist at LifeCare Medical Center. Over the past 8 months, we health care providers have been working diligently to come up with the best treatment approaches to this new and devastating disease. As we all know, the current COVID-19 pandemic has left humanity with more questions than answers. There have been several proposed treatment options, as people try to grasp onto hope of a cure. Some of these treatments have offered benefit, and many have not. Let us start with more mild cases of COVID-19.

Currently, there are no medications that have shown consistent benefits in the treatment of COVID-19 in people that are not hospitalized. Several therapies have been proposed and tested, such as hydroxychloroquine, azithromycin, zinc, inhaled steroids, vitamins C and D, and several others. None of these therapies have shown benefit in the treatment of COVID-19.

As the list of proven options is quickly changing, I am proud to say that LifeCare Medical Center is on the cutting edge of providing treatment that many Critical Access Hospitals are not able to utilize.

So what does work, and when do we use them?

Remdesivir:  Remdesivir was approved by the FDA for emergency use earlier this summer and received full FDA approval this fall.  Remdesivir is a direct acting antiviral medication that has been shown to decrease hospitalization and time to recovery in patients with moderate to severe COVID-19. Because this treatment hasn’t shown much benefit in milder cases, it is only offered to patients hospitalized with COVID-19 disease. Remdesivir also cannot be given to patients with severe liver or kidney disease. Our care team at LifeCare Medical Center utilizes remdesivir therapy on the majority of our hospitalized COVID-19 patients.

Dexamethasone:  Dexamethasone (or other equivalent corticosteroids) has been shown to improve survival in severe to critical COVID-19 patients, requiring supplemental oxygen support. Steroids do NOT directly treat the SARS-COV2 virus, but prevent more severe complications of COVID such as respiratory failure. Dexamethasone therapy may actually be harmful in mild to moderate cases of COVID-19, as a result we only used in hospitalized patient requiring supplemental oxygen or ventilation.

Bamlanivimab:  Bamlanivimab (or BAM) is a monoclonal antibody therapy against COVID-19. This medication is approved by the FDA for emergency use for the prevention of hospitalization for high risk COVID-19 patients. BAM essentially gives a patient’s immune system a leg up in fighting off the SARS-COV2 virus, and has a very narrow window where it may be effective. BAM is only effective early in disease (within 10 days of symptom onset), and has not been shown to be effective later in disease, when patients are already needing oxygen. Patients who test positive for COVID-19 and are high risk for severe disease would be eligible for this therapy.  Currently, we are on an allocation from the federal government to only receive so many doses per week. Our patients are therefore screened and randomized to be offered therapy with a one hour infusion. As this therapy becomes more readily available, we at LifeCare will be able to offer more treatment to more patients.

Convalescent plasma:  Convalescent plasma has also received approval by the FDA under emergency usage for hospitalized patients with severe COVID-19. The concept of this therapy is to take blood or plasma from a recovered individual and transfuse it into a sick patient. This plasma of recovered patients is rich in antibodies and other immune boosters that are directed toward their recent COVID-19 infection. Because convalescent plasma is a blood derived product, supply is often limited and will need to be specially ordered based on a patient’s blood type. At LifeCare Medical Center, our team will reserve treatment with convalescent plasma for hospitalized patients that are not improving on remdesivir and steroids.

Oxygen:  Oxygen is often times not thought of as a medication, but essentially it is. When patients are suffering from moderate to severe COVID-19 disease their lungs become damaged and as a result a patient can feel short of breath or have low oxygen levels.  Oxygen therapy is a main course of treatment to help support a patient’s lungs and allow their body to fight off the infection.

Anticoagulation (blood thinners):  Much is unknown of exactly how COVID-19 disease can severely effect some patients.  However, one thing that has been shown, is that patients with more severe disease are often at a much higher risk of diseases caused by blood clots (heart attack, stroke, pulmonary embolism, etc.)  For this reason, high risk patients are often given blood thinners in the hospital, and possibly even sent home on a short course of blood thinning medication. Medications that we use to prevent clots for patients include heparin, enoxaparin (Lovenox®), apixaban (Eliquis®) and rivaroxaban (Xarelto®).  Oftentimes we may suggest low-dose aspirin for lower risk individuals.

I have been diagnosed with COVID-19, what medication can I take to help?  For most patients that get a mild case of COVID-19, the best treatments are getting plenty of rest, drinking plenty of fluids and treating cold/flu symptoms with over the counter medications such as acetaminophen (Tylenol®), ibuprofen (Advil®), decongestants (Sudafed®) and cough suppressants (Robitussin®). If someone is unable to manage at home, or feel their symptoms or shortness of breath is worse, the best course of action would be to call the clinic or emergency room to see if it is appropriate to have their oxygen levels evaluated.

Overall, medical practices and scientific study have provided us with some answers on how to best offer treatment to severely ill COVID-19 patients. As a result, our nation’s mortality rate has reduced significantly, thanks to advances in care. Here at LifeCare Medical Center, our care team has been continuously researching and pushing for the latest and most effective therapies for the communities we serve. We have worked hard to make sure the diagnostics and therapies we offer at our small rural facilities are on par with the major medical centers of the area. By doing this, we can offer high level of care to our communities throughout Roseau County.

By David Simmons, Pharm.D, BCPS, BCIDP

Quit Partner: New, FREE quit-tobacco programs available online, by phone, and by mail!

Tobacco use is still the leading preventable cause of death, disease and disability in Minnesota.  People can help protect their health and their lungs by quitting smoking, chewing and vaping.

With Quit Partner being available online, by phone and by mail, Minnesotans looking to quit nicotine and improve their health during the COVID-19 outbreak don’t have to go at it alone.  According to the CDC, smoking can compromise the immune system, which makes people at higher risk for severe illness from COVID-19. People can use as many of the support resources as they would like and can access them from home. Using coaching and medication together can more than double a person’s chance of successfully quitting.

“Our goal is to provide free quitting help to Minnesota residents when they want it and in the way that best meets their quitting needs. Most people who smoke want to quit, and we’re here to help,” said Minnesota Commissioner of Health Jan Malcolm.  Free support includes phone and web coaching, text and email programs, and free nicotine replacement therapy (NRT), like patches, gum or lozenges delivered to your door.

While fewer adults are using tobacco overall, some populations have higher than average rates of tobacco use. To help address these differences and to help people most at risk of nicotine use, Quit Partner offers specialized programs for people living with mental illnesses or substance use disorders, American Indian communities (American Indian Quitline), pregnant and post-partum women, and youth ages 13-17 (My Life, My Quit).

How can I promote or refer teens to My Life, My Quit?
Many young people know they need to stop smoking or vaping and may not know how to ask for help.  While the decision to quit tobacco is always one teens must make themselves, here are several ways parents or other adults can help promote the My Life, My Quit program:

  • Let teens know you are concerned about the impact of tobacco use, including vaping, on their current and long-term health.
  • Tell them you want to support their plan to stop and ask if they will sign up for the My Life, My Quit program. Be sure to mention it is free and confidential.
  • If they are not willing to enroll right then, provide them with information about how to enroll and let them know they have support to help them quit.
  • If a teen is ready to get started, they can text, call or enroll online. It’s fast and simple.
  • Some teens may want your help taking the first step of calling or sending the text. But remember, they need to do the work in order to be successful.


QUIT PARTNER  http://www.quitpartnermn.com/  or CALL 1-800-QUIT-NOW (784-8669)

MY LIFE, MY QUIT for teens  https://mylifemyquit.com/index.html

THE AMERICAN INDIAN QUITLINE  http://www.quitpartnermn.com/american-indian-quitline/


Smokefree Teen
Smokefree Teen helps teens stop using tobacco by providing information grounded in scientific evidence and offering free tools that meet teens where they are – on their mobile phones.  Program includes: text messaging program, quitSTART mobile app, and live help online chat.  Visit Teen.Smokefree.gov.

Truth Initiative® e-cigarette quit program
A free text message program created with input from teens, college students and young adults who have attempted to, or successfully, quit e-cigarettes. It’s tailored by age group to give teens and young adults appropriate recommendations about quitting. The program also serves as a resource for parents looking to help their children who now vape.

To access the new e-cigarette quit program, users can text “QUIT” to (202) 804-9884. Users can also enroll in This is Quitting or BecomeAnEX®, free digital quit programs from Truth Initiative that integrate the text program.

Health plan quitlines
Health insurance companies have their own options. Youth and parents should check with their health plan. Call the number on the back of your insurance card to see what is available.

Additional Services:

Asian Smokers Quitline  https://www.asiansmokersquitline.org/

Smokefree Español  https://espanol.smokefree.gov

Smokefree Veterans  https://veterans.smokefree.gov/

Smokefree Women  https://women.smokefree.gov/

Smokefree 60+  https://60plus.smokefree.gov/

LifeCare Medical Center also offers the American Lung Association’s, Freedom From Smoking, group classes.
For more information, contact Paula at 463-4301.

Source:  Minnesota Department of Health

Contributor: Paula Hedlund, RN, LifeCare Wellness Coordinator