COVID-19 Questions
Loren Bonner
COVID-19 is on everyone’s minds. As frontline health care providers, pharmacists are fielding all sorts of questions. Here is a top ten list of what pharmacists are hearing most from patients. The information in this article is current as of press time, but the COVID-19 situation continues to evolve rapidly.
1. Will a vaccine for COVID-19 be safe?
Recent polls have found that many Americans might be reluctant to receive a COVID-19 vaccine, even if the vaccine were FDA-approved and available at no cost. Pharmacists are hearing the same hesitancy from their patients—concerns that a vaccine is being rushed through to approval and fears of being possible test subjects for it.
Pharmacists can remind patients how vaccines and drugs get approved in the United States to help allay any worries patients have.
2. What role do supplements play in preventing COVID-19?
Pharmacists are getting a lot of questions about vitamin C, vitamin D, zinc, and even melatonin, and how they might affect COVID-19. Limited to no data exist on how these supplements prevent viral infection, alleviate clinical symptoms, or alter how COVID-19 presents itself in the body.
Vitamin D, in particular, has seemed to generate the most interest during this time for its possible role in preventing COVID-19. Some studies show that vitamin D supplements can enhance immune response and that vitamin D deficiency can harm immune function and increase the risk of developing respiratory illnesses. To date, limited data exist on this and pharmacists should caution patients from taking high doses of vitamin D—or any supplements—as a way to protect against COVID-19.
3. Does hydroxychloroquine work and what drugs are available to treat COVID-19?
One minute hydroxychloroquine (HCQ) is all the rage; FDA even approves it for emergency use authorization (EUA) in late March for COVID-19 treatment without much evidence to back it up. But by June, the agency revokes HCQ’s EUA for COVID-19. No wonder patients are confused.
The short answer is that there are currently no FDA-approved medications specifically meant for COVID-19. FDA has granted EUA for some medicines to be used for certain patients hospitalized with COVID-19, however. The National Institutes of Health has more information about treatment options at https://www.covid19treatmentguidelines.nih.gov/. FDA says that people with COVID-19 should receive supportive care to help relieve symptoms, and those with mild symptoms should be able to recover at home.
4. Can a pharmacist test for COVID-19 and when do results come back?
Yes, they can! Pharmacies can either partner with a lab to conduct COVID-19 testing or perform a COVID-19 test at point of care. Pharmacists must take into account federal, state, and local testing considerations.
Results for molecular or diagnostic tests can come back the same day at some locations or can take up to a week. Antigen tests take one hour or less, and antibody test results can come back the same day—again at some locations—or take 1 to 3 days.
5. What’s the difference between molecular tests, antigen tests, and antibody tests?
Molecular tests (also known as diagnostic tests, viral tests, or RT-PCR tests) diagnose active coronavirus infection.
Antigen tests (or rapid diagnostic tests) diagnose active coronavirus infection.
Antibody tests show if an individual has been infected by coronavirus in the past.
6. Does having diabetes alone increase a person’s risk for COVID-19 or are outcomes worse if someone with diabetes contracts COVID-19?
Diabetes alone does not seem to increase the risk of contracting COVID-19. However, the risk of complications from COVID-19 can be higher for patients with poor glycemic control.
A question like this presents an opportunity for a pharmacist to reeducate patients on risk mitigation strategies.
7. Does blood type have anything to do with the severity of COVID-19?
Theories have circulated about a possible association between people with blood type A being at a greater risk for COVID-19 infection and mortality. However, new research published in the Annals of Hematology seems to dispel any previous reports of a correlation between blood type and COVID-19.
Harvard Medical School researchers based at Massachusetts General Hospital performed a statistical analysis on a study population of 1,289 symptomatic adult patients who tested positive for COVID-19 and had their blood group documented. They found no connection between blood type and the severity of COVID-19 or a need for hospitalization or intubation.
However, the study did find that symptomatic patients with blood types B and AB who were Rh positive were more likely to test positive for COVID-19, while those with blood type O were less likely to test positive.
8. Can I give blood if I have tested positive for COVID-19 antibodies?
The Red Cross began testing convalescent plasma for antibodies from prequalified donors as part of a new initiative involving what researchers hope is a potential treatment for critically ill COVID-19 patients. An automated test screens the donated convalescent plasma for the presence of COVID-19 antibodies, allowing the Red Cross to simplify the eligibility process and qualify more potential donors.
More information can be found on the Red Cross website.
9. What if drug shortages affect the supply of my maintenance medication?
FDA is monitoring the drug supply chain closely and has been in regular contact with drug manufacturers. According to the Pharmaceutical Care Management Association, “If a shortage for a specific medication does occur, PBMs will work with the patient, their prescriber, and their health plan to identify a covered therapeutic substitute and help minimize patient impact caused by a shortage.”
10. What OTCs should I be purchasing?
Pharmacists should have these conversations with their patients early since catching the virus will prevent someone from being able to get to the pharmacy for supplies. Pharmacists can also answer questions patients have about how COVID-19 affects other chronic conditions and how to best manage those conditions.