Third year doctor of pharmacy students Anika Patel ’21 and Edward Liang ’21 conducted research focused on COVID-19 treatment methods during their Advanced Pharmacy Practice Experience rotations. They shared their experiences during the Research Tuesday series hosted by the Graduate School. 

Patel conducted a retrospective descriptive analysis of 30 patients at Veteran Affairs Palo Alto Health Care System under the guidance of Nancy N. Nguyen, PharmD, BCPS, AAHIVP, FCSHP, clinical professor of pharmacy practice and regional coordinator for Palo Alto. Patel’s research focused on what portion of hospitalized patients received pharmacotherapy and what COVID-19 treatments they received. The data she reviewed included demographics, comorbidities, medications, hospital length of stay and intensive care unit length of stay, mortality, symptoms at admission, pharmacotherapy and clinical status. 

A number of the patients received Remdesivir, the first FDA approved treatment for COVID-19, which is recommended for patients who require supplemental oxygen. In Patel’s study, patients fell into three major treatment groups: patients that received standard of care only, such as antibiotics or oxygen support but no COVID-19-specific therapies; patients that received Remdesivir; and patients that received Remdesivir plus other COVID-19 treatments. 

“It is really interesting to work on a disease state that is so relevant right now,” said Patel. She emphasized that health care professionals are learning about COVID-19 on a daily basis. 

Two factors created an added challenge to the research, the lack of existing research and the rapid evolution of treatment recommendations. Liang originally planned to study hydroxychloroquine, but pivoted his research after the National Institutes of Health (NIH) announced it did not recommend its use.

Liang contributed to a study co-authored by Jered Arquiette ’08, PharmD, BCPS-AQ ID, Regine Padilla ’08, PharmD and Yvonne Mai ’13, ’15, PharmD, MS, BCGP, BCACP, assistant professor of pharmacy practice and regional coordinator for Stockton. The study conducted at San Joaquin General Hospital focused on COVID-19 patients who received convalescent plasma and patients who received convalescent plasma plus Remdesivir. 

Plasma, the liquid portion of blood, transports nutrients, hormones and proteins throughout the body. “Convalescent plasma comes from donors who have recovered from COVID-19 and have created antibodies to the virus,” said Liang. “Someone else’s immune system already learned how to fight the virus. It is believed that these antibodies from recovered individuals directly neutralize the virus.”

Convalescent plasma has been available under an expanded access program, also known as compassionate use, which provides patients with treatment options outside of clinical guidelines when no satisfactory alternative therapies exist.

“Currently, the NIH does not recommend either for or against the use of convalescent plasma as treatment for COVID-19,” Liang said. “However, other medical societies have come to different conclusions. The Infectious Disease Society of America only recommend the use of convalescent plasma as part of clinical trials.” 

The researchers studied mortality, days on mechanical ventilation, hospitalization length of stay and ICU length of stay. The study highlighted the need for further studies focused on the effectiveness of convalescent plasma to treat COVID-19. 

Despite the challenges of researching a novel virus, Patel and Liang agree it was a valuable learning experience. Liang added that since so little is known about COVID-19 it presented a unique opportunity for students and seasoned health care professionals to learn together the best way to treat the virus.