Residents of the Caribbean know that between a tropical storm and a major hurricane, there is a world of difference. Both bring rain and winds, but weathering and surviving a hurricane requires much greater response and resilience.
Dr. Javier Perez Fernandez, a specialist in critical care medicine and pulmonology at Baptist Health South Florida, views COVID-19 infections in a similar way. While some hospitalised patients face a tropical storm, others are battling a category five hurricane.
Through a new stem-cell treatment, Perez says doctors at Baptist Health and Miami Cancer Institute hope to control the magnitude of COVID-19 ‘storms’ and mitigate the virus’s effects in the most severely affected patients.
As researchers worldwide work against the clock to fight the novel coronavirus, Perez views the stem-cell treatment as one with potential for widespread adoption, including in the Cayman Islands.
“It converts this category five hurricane that you have inside into a tropical storm,” Perez said, explaining that while the treatment cannot cure the virus, it may save lives.
The investigational drug, developed from sentinel or original cells attached to the umbilical cord, takes aim at another kind of storm, produced when the body’s immune system goes into overdrive.
A cytokine storm, seen in fatal COVID-19 cases, occurs when cytokine molecules are released by the body as an immune system response to fight infection. An excessive release of these molecules can result in hyperinflammation, organ failure and death.
With a stem cell injection, however, Perez says doctors have been able to control this cytokine storm and reduce COVID-19 impacts, such as respiratory distress.
“As the cytokine storms really affect the lungs, mostly we’ve seen significant changes on oxygenation of people while we are delivering the cells,” Perez said.
“We’ve seen very good responses on the patients that we have infused, and we have seen responses that lead to a reduction in the oxygen level [administered] by 50% of what they were using.”
The study’s results are still not ready to disclose, and Perez said the rate of research is contingent on the number of patients admitted to critical care units at partner facilities.
In that sense, he hopes the study will remain unfinished, due to a lack of severely ill patients.
“I think the main limitation for faster development has been the lower number of patients that we have on intensive care units,” he said.
The stem cell study has incorporated partners from several US universities, including Florida International University and University of South Dakota, and RESTEM, a California biotechnology company that develops treatments for degenerative and immune-system disorders.
Once the treatment has gone through the full development and approval process, Perez sees Cayman as one of the locations that could benefit from its use.
“We’ll be absolutely happy [to bring] not only that treatment but any other form of treatment, to be there for the people of Cayman,” Perez said.
COVID-19 steroid treatment
During the 17 June press briefing, Cayman’s Chief Medical Officer Dr. John Lee mentioned another novel COVID-19 treatment, a steroid called dexamethasone, that is showing promise in the United Kingdom.
“It’s been shown to reduce deaths by up to a third and has already received approval for emergency use in the United Kingdom,” Lee said, adding that he anticipates the drug will be approved and made available elsewhere.
The drug, developed by scientists at the University of Oxford, is the first treatment shown to aid severely ill COVID-19 patients. Similar to the stem-cell treatment being studied by Baptist Health, dexamethasone treatment aims to reduce the effects of cytokine storms and mitigate the potentially deadly impact of an uncontrolled immune-system response.