As challenging as this year has been, Dr. Shefali Mahesh says we shouldn’t overlook the amazing advances in medicine during the COVID-19 pandemic.
Case in point is her patient, Ahmad Amiri, who had a kidney transplant in 2017, putting him at high risk should he contract the coronavirus.
Ahmad Amiri, 18, was one of the first patients in Northeast Ohio to receive a monoclonal antibody therapy for COVID-19.
Just before Thanksgiving, Amad, 18, noticed he lost his sense of smell. He was visiting a primary care doctor, who encouraged him to be tested for SARS-CoV-2. When he learned the following day that he was, in fact, positive, he immediately called Akron Children’s Nephrology Department, where he receives care.
Dr. Mahesh, director of Pediatric Nephrology, and her team were ready for that call.
Akron Children’s received a limited number of doses of bamlanivimab, a monoclonal antibody therapy that had recently received emergency use authorization for the treatment of mild-to-moderate COVID-19 disease in adults and pediatric patients over the age of 12 years.
Dr. Shefali Mahesh and her team in Nephrology had identified Ahmad as a good candidate for the therapy should he test positive for COVID-19.
Dr. Mahesh immediately contacted Dr. Eric Robinette, a pediatric infectious disease specialist, to confirm Ahmad qualified for the therapy. He did, and they were able set him up for the infusion on the day after Thanksgiving.
“There is a rather narrow criteria for eligibility for this therapy,” said Dr. Mahesh. “It is for patients just showing initial symptoms of COVID-19. The goal is to prevent hospitalization.”
In fact, patients who are hospitalized and on oxygen would not qualify to receive this therapy, so timing is everything.
Ahmad is one of the first patients in Northeast Ohio to receive this particular monoclonal antibody therapy.
Ahmad Amiri is doing well, and most likely avoided hospitalization because the monoclonal antibody therapy was available to him through FDA emergency use.
“We are extremely impressed with how hard and fast the researchers, the FDA, Operation Warp Speed, and the State of Ohio worked to develop this therapy and to get it to us in an extremely short timeline,” said Dr. Robinette. “Given that, we felt it was our responsibility to develop a safe, accessible process to get our eligible patients access to the medication as quickly as we could too. Ahmad was a perfect candidate for this treatment, and we were very excited to be able to offer it to him and are extremely happy he has done so well.”
Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful antigens such as viruses. Bamlanivimab is specifically directed against the spike protein of SARS-CoV-2, designed to block the virus’ attachment and entry into human cells.
The infusion Ahmad received on Nov. 27 most likely prevented his COVID-19 symptoms from worsening and kept him from being hospitalized. He said by the Monday after his infusion, he was feeling 100 percent better, and he could smell again.
Dr. Eric Robinette worked closely with Dr. Mahesh to get Ahmad quickly scheduled for his infusion the day after Thanksgiving.
Ahmad, a senior at St. Vincent/St. Mary High School, was born in Afghanistan and began having kidney problems early in life.
“When I was 3 years old, I started getting sick and lost lots of energy,” he said. “I wasn’t playing a lot like normal kids.”
His parents traveled around the Middle East – to Iran and Turkey – and back to his native country trying to get the specialized care he needed. For 3 years, he spent hours a day on dialysis and at one point said he was in a coma and close to death. In addition to their son’s serious medical concerns, the family had to deal with the stress of not having passports renewed and unsure of where they could get the help he needed.
Eventually, the family arrived in the United States. Their first stop from Akron Canton Airport was Akron Children’s Hospital. The nephrology team assumed his care and after another year on dialysis and extensive testing was able to coordinate a kidney transplant for Ahmad at the Cleveland Clinic in 2017. The family has settled into Akron and Ahmad continues to receive his follow-up kidney transplant care through Akron Children’s.
Ahmad has learned English very quickly and plans to study computer science at Stark State Community College after he graduates high school.
“I’m so grateful for all the doctors and medical care I have received here,” said Ahmad. “I am really thankful for everything.”
Ahmad Amiri with pediatric nephrologist Dr. Stephen Cha in 2018.
Dr. Mahesh is hopeful that Akron Children’s will receive more doses of this therapy even as the COVID-19 vaccinations roll out.
“When you stop to think about this, we’re seeing the relentless pursuit of better medicine evolving in front of our eyes and benefiting patients with Covid,” she said. “This pandemic has been disruptive, with so many lives lost – but these new treatments bring hope and solutions for patients affected by COVID. We are seeing innovation moving at lightning speed from discovery to patient; it’s an exciting time to be in healthcare.”
