Five Questions With: Dr. Hadeel Zainah

Dr. Hadeel Zainah is an infectious-disease specialist at Kent County Memorial Hospital. She discusses the potential use of dexamethasone, a steroid, as a treatment for COVID-19. The drug is being tested for its effectiveness against the virus in a study – known as the Randomised Evaluation of COVID-19 Therapy, or RECOVERY study – in the United Kingdom, where more than 11,000 COVID-19 patients are participating.

PBN: Is dexamethasone in use in Rhode Island on COVID-19 patients?

ZAINAH: We expect to have dexamethasone used for select cases of COVID-19 after the results of the RECOVERY study. Dexamethasone will be probably used for mechanically ventilated patients; this category showed the most benefit in the trial. It also may be used in patients on oxygen, but the trial did not specify which group in this category will benefit the most – the patients who require higher amounts of oxygen or the ones who require smaller amounts.

 

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PBN: What is the drug normally used for?

ZAINAH: Dexamethasone is usually used for various conditions, including vasogenic edema, COPD [chronic obstructive pulmonary disease], or asthma attacks, as an antiemetic agent in chemotherapy, meningitis, immune thrombocytopenia and other indications. Overall, it is used to alleviate the effects of inflammation. In COVID-19 patients, dexamethasone would be used to alleviate the inflammation caused by the virus.

PBN: If dexamethasone is found to help COVID-19 patients, could that be a game-changer when it comes to current restrictions on daily life? Could the discovery of a treatment allow a faster return to normal routines?

ZAINAH: Yes. If dexamethasone proves really helpful, it will minimize restrictions on daily life since patients will be discharged quickly and return to work quickly.

PBN: It’s been reported that dexamethasone seems to help people who are seriously ill with COVID-19, but is risky to use in those with milder cases. Please explain why.

ZAINAH: There is always a balance between risk and benefit. Dexamethasone has side effects, like any other steroid. The benefit may outweigh the risk in severely ill patients, but risk may overweight the benefit in less-sick patients, especially where there is no proven benefit. Some of the side effects are hyperglycemia, superinfection and problems with wound healing.

PBN: We know that the National Institutes of Health’s clinical trial on hydroxychloroquine as a treatment for COVID-19 has been called off, but are there other types of drugs being evaluated for effectiveness against the virus?

ZAINAH: There are other drugs being evaluated for effectiveness against the virus, including interleukin 6 blockers such as Tociluzumab, inhaled medications and other antiviral agents.

Elizabeth Graham is a PBN contributing writer.

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