Cartersville Medical Center was one of nearly 85 hospitals across the state to obtain remdesivir from the Georgia Department of Public Health.
According to a press release from Georgia DPH, the distributed medication was “enough to treat about 1,676 patients with COVID-19 infection, depending on the duration of an individual’s illness and treatment needs. Remdesivir is an antiviral medicine being used to treat hospitalized patients with serious symptoms caused by COVID-19, like low oxygen levels or pneumonia. It has been found to shorten the duration of disease in patients being treated in inpatient hospital settings. Remdesivir is given intravenously (IV) and decreases the amount of coronavirus in the body, helping patients recover faster.
“Georgia hospitals receiving remdesivir had patients who met the federal criteria for treatment, including COVID-19 positive patients on ventilators, in addition to patients currently being treated with extracorporeal membrane oxygenation (ECMO), a machine that takes over the work of the heart and lungs."
On May 23, CMC received 40 vials of the antiviral medication from the Georgia DPH.
“SARS-CoV-2 — the cause of COVID-19 — is a RNA (ribonucleic acid=genetic material) virus,” said EeJay Enekwa, clinical coordinator of CMC’s pharmacy. “The virus uses an enzyme called a polymerase to replicate itself once inside a cell.
“The polymerase enzyme strings together new strands of RNA using four bases: adenine, cytosine, guanine and uracil. In its active form, remdesivir mimics the structure of adenine. When the drug (remdesivir), instead of a nucleoside (adenine), is added to a new RNA molecule it blocks further synthesis of viral RNA — delayed chain termination.”
Comprised of about 770 full-time workers, CMC’s staff started caring for COVID-19 patients March 11.
“As of 5/28/2020, we have had a total of 142 patients test positive for COVID-19,” CMC Chief Medical Officer Mark Senger said. “Of the 142 patients, 119 required admission to the hospital. In total, we have tested a total of 870 patients, with 728 patients testing negative.
“The most common symptoms seen at CMC have been fever and respiratory — cough, shortness of breath, tachypnea and respiratory failure. However, we have seen GI symptoms — nausea, vomiting, diarrhea and abdominal pain — as well as cardiac symptoms (chest pain, new heart failure, arrhythmias and cardiac arrest) and hypercoagulable issues (PEs and DVTs) and neurological symptoms (delirium).”
Since late March, Senger shared CMC’s staff has administered a variety of treatment methods.
“Under the guidance of our infectious disease specialist, Dr. Aman Mongia,” he said, “we have used hydroxychloroquine and azithromycin (only at the beginning of the pandemic), remdesivir (we received approval through Gilead before GPH was able to supply but never used due to circumstances beyond our control), convalescent plasma — through a trial with Mayo Clinic; has shown the biggest benefit at CMC, proning of patients, ARDS protocol for ventilation, and we transferred a couple of patients for ECMO (extracorporeal membrane oxygenation) at an outside hospital.
“Remdesivir has been difficult to obtain, especially at the beginning of the pandemic, due to limited supply through Gilead. Receiving remdesivir, especially given the results of the recently published trial, will allow Dr. Mongia to have all treatment options available at CMC to care for our COVID-19 patients.”