NantHealth recently hosted a webinar entitled “The Science Behind Emerging Treatments: A COVID-19 Discussion,” with NantHealth Chief Medical Officer, Dr. Sandeep “Bobby” Reddy, ImmunityBio Director of Infectious Diseases, Jeffrey T. Safrit, Ph.D., and NantKwest Senior Vice President of Pediatric and Young Adult Medical Affairs, Leonard Sender, MD. If we were unable to reply to your question during the livestream, our experts answered those questions below. A stream of the complete broadcast is available here.
Does Remdesvir harm pregnant patients?
The FDA currently has this posted on their website for Remdesivir: Remdesivir should be used during pregnancy only if the potential benefit justifies the potential risk for the mother and the fetus. In other words, if the pregnant woman is at risk of dying from COVID-19, the benefit of taking the drug likely outweighs any risks. This type of recommendation is typically given when few or no studies have been done to determine the true risk.
Please discuss the status of clinical trials evaluating the possible role of ACE inhibitors and ARBs, such as Losartan, both in patients with hypertension (who then contract COVID-19) and as a clinical intervention for those with COVID-19.
Retrospective studies show no adverse effects for COVID-19 patients using ACEi or ARBs, the most prominent by Mehra et al. Their role as a potential therapeutic to reduce the risk of infection or decrease severity of infection is still unknown with insufficient data to make a comment.
What are the parameters for determining that a person has “recovered’ from COVID -19? Is it a confirmed negative after a positive test, or is it verification of antibodies?
Confirmed negative means that the person is no longer shedding active virus. Verification of antibodies helps to prove prior infection has occurred, and an immune response has been generated but does not guarantee that viral clearance has occurred.
Are we all going to get COVID-19 regardless to be able to develop immunity?
In the absence of a vaccine, YES. The only way to develop immunity is to have exposure to the pathogen. A vaccine may use an attenuated strain or as similar target so that immunity can be generated. Based on symptomatic and asymptomatic cases around us, if we have not gotten the virus, we need to get sick to be able to fight it off? No, asymptomatic patients have been shown to develop antibodies to the virus.
I have heard the very elderly might have different manifestations. If gastrointestinal, what sort of testing is needed?
Like other diseases, the elderly may manifest with different symptoms because of impaired immune responses and reduced organ function. The classic COVID-19 symptoms of fever and cough may be absent and instead replaced by confusion, weight loss, increased sleep, or simply a subtle sense of “not being all there.”
Why not use a saliva test, rather than the nasal swab?
Saliva testing is still relatively new. On April 13, the U.S. Food and Drug Administration gave emergency use authorization for a saliva-based test for COVID-19 developed by researchers at RUCDR Infinite Biologics, a biorepository backed by Rutgers University. The approved test must be conducted in a healthcare setting under supervision of a qualified professional.
Therefore there is limited availability and experience with this type of testing, whereas millions of nasal swab tests have been performed globally. While the saliva test has certain advantages of convenience, it still requires a bit more formal validation before a uniform recommendation of equivalence to the nasal swab test can be given.
I heard from a friend in NY who got info from a government employee that Pepcid AC, the heartburn drug, is being sought out as a possible drug to help with coronavirus, though I haven’t heard any news or social media talk about this but is there any truth to this?
Limited retrospective data suggest a possible reduction in mortality in COVID-19 patients who took famotidine during their hospitalization. The mechanism of benefit is unknown and it’s too early to assume a causal effect but prospective trials could answer the question and the costs and risks to patients are likely minimal.
I have heard a few doctors referring to Vitamin D and how this will assist in building up the immune system. Is this correct? And if so, how often should a person take this vitamin?
Studies have shown that Vitamin D can help your immune system stay strong. The Office of Dietary Supplements of the National Institutes of Health has recommended dietary allowances (RDAs) of 600-800 International Units (IUs) of vitamin D per day.
For the early infection immune support, have any tests/trials been done with pure essential oils like Rose or Oregano to help the body fight infection?
Essential oils have been found to have antimicrobial effects but few studies have been done to know whether they can boost an immune response and none that we are aware of for COVID or related infections.