Coronavirus (COVID-19) Resources For Pharmacists

This webpage is dedicated towards providing coronavirus (COVID-19) resources for pharmacists.

Maintained By: Timothy P. Gauthier, Pharm.D., BCPS

Supported By: Bassam Ghanem, Pharm.D., MS, BCPS

Created: 14 March 2020

Last updated: 31 May 2021, update #268 – We are no longer updating this webpage. We may resume updating it at some point in the future.

Many pharmacists across the world are working hard to keep up with therapeutic options for coronavirus / SARS-CoV-2 / COVID-19. This webpage was created to provide insights and resources for pharmacists helping to manage this pandemic. Take note that updates to the page will be made periodically as permitted and the content here may not be completely up-to-date as the situation is evolving quickly. Also beware that much of the data identified below is of relatively poor quality in terms of utility for determining what should be done in clinical practice.

Additionally, there are many potential COVID-19 therapies, I list several at the bottom, but do not discuss them in depth. Some of these can potentially lessen the cytokine storm associated with COVID-19 and help with managing acute respiratory distress syndrome (ARDS).

Many randomized controlled trials are ongoing. Remdesivir (Veklury) is the only drug approved by the US Food and Drug Administration to treat COVID-19. Inclusion in this webpage is not an endorsement for use of any of these drugs for COVID-19.

To see what is new look for the ✓ symbol, we will be adding this to new material and removing it from older material as we keep updating the page. Use CTRL+F and search for it to find what is new.

If you have a resource that is helpful and reliable, but not posted here, send it to me: IDstewardship@gmail.com or @IDstewardship on Twitter.

As the pandemic has progressed we have created webpages to house information specific to some items:

For information about remdesivir (Veklury) click here.
For information on bamlanivimab (an Eli Lilly antibody product) click here.
For information on bamlanivimab-etesevimab (an Eli Lilly antibody product) click here.
For information on casirivimab and imdevimab (a Regeneron antibody product) click here.
For information on sotrovimab (a GSK antibody product) click here.
For information on tocilizumab (Actemra) click here.
For information on baricitinib (Olumaint) click here.
For information on COVID-19 vaccines click here.

We have removed information about hydroxychloroquine and chloroquine from this webpage, as there appears to be no role for these medicines in the treatment or prevention of COVID-19.

General COVID-19 Resources

Institutional, Governmental & Society COVID-19 Treatment Guidelines

COVID-19 Resource Centers

COVID-19 Oriented Data Tracking Resources

COVID-19 Symptom Analysis

General Notes on COVID-19

Reducing transmission is key to “flattening the curve”
- CDC Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission
Coronavirus 2019 (aka SARS-CoV-2) causes a disease called COVID-19
Corticosteroids were initially not recommended as part of treatment for COVID-19 unless other indications exist, because it was thought they may prolong viral shedding
- This article did recommend to consider a short course of glucocorticoids
- In June 2020 a press release from the RECOVERY Trial stated a benefit of dexamethasone and the data is now published in NEJM, as of January 2021 dexamethasone is a routinely used therapy for many hospitalized patients with COVID-19
Nebulized bronchodilators may risk spread of the virus, in general meter dose inhalers (MDIs) are preferred
- RE: Transmission of Corona Virus by Nebulizer- a serious, underappreciated risk!
- Revisiting the Need for MDI Common Canister Protocols During the COVID-19 Pandemic
Antibiotics are generally NOT recommended
- Pharmacotherapeutics for the New Coronavirus Pneumonia
Co-infection with influenza and COVID-19 is expected to be generally uncommon
- Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis
- Co-infection with SARS-CoV-2 and Influenza A Virus in Patient with Pneumonia, China
Lymphopenia is a common component of initial COVID-19 presentation
- Clinical Characteristics of Coronavirus Disease 2019 in China
COVID-19 does not appear to increase procalcitonin, but does appear to increase CRP
- Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China
- Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore
Empiric neuraminidase (NMD) inhibitor therapy may be reasonable during flu season, but we are unable to identify any data to support NMD inhibitor use for COVID-19
- Inhibition of SARS Coronavirus Infection In Vitro with Clinically Approved Antiviral Drugs
People who die from COVID-19 usually have ARDS, beware the fluids may exacerbate this so aggressive fluid support is not generally appropriate
COVID-19 commonly causes troponin elevations
Patients with mild disease may not require hospitalization, but they may worsen with progression to lower respiratory tract disease
- Risk factors for progression include: older age and underlying chronic medical conditions such as lung disease, cancer, heart failure, cerebrovascular disease, renal disease, liver disease, diabetes, immunocompromising conditions, and pregnancy
- Infection in pediatrics may not be as common or severe, but it is possible
  - A case report of neonatal COVID-19 infection in China
  - Laboratory Abnormalities in Children With Novel Coronavirus Disease 2019
  - It appears there is a low risk of intrauterine infection by vertical transmission of SARS-CoV-2
    - Perinatal Transmission of COVID-19 Associated SARS-CoV-2: Should We Worry?

COVID-19 Therapeutics

Relevant resources:
- The best place for a full list and ongoing studies related to these: clinicaltrials.gov
- A living WHO guideline on drugs for covid-19
- Bringing evidence from press release to the clinic in the era of COVID-1
- Treating COVID-19—Off-Label Drug Use, Compassionate Use, and Randomized Clinical Trials During Pandemics
- COVID‐19: Important Therapy Considerations and Approaches in this Hour of Need
  - Two senior ID pharmacists put things in perspective
- Review of Emerging Pharmacotherapy for the Treatment of Coronavirus Disease 2019
  - Published 7 April 2020
- Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review
  - Published 13 April 2020
We have removed information about hydroxychloroquine and chloroquine from this webpage, as there appears to be no role for these medicines in the treatment or prevention of COVID-19. Refer to NIH guidelines for details.
For information about remdesivir (Veklury) click here.
For information on bamlanivimab (The Eli Lilly antibody product) click here.
For information on casirivimab and imdevimab (the Regeneron antibody product) click here.
For information on sotrovimab (a GSK antibody product) click here.
For information on tocilizumab (Actemra) click here.
For information on baricitinib (Olumaint) click here.
For information on COVID-19 vaccines click here.
Anakinra
- Early Anakinra Treatment for COVID-19 Guided by Urokinase Plasminogen Receptor – Pre-Print
Anti-CD14 Antibody
- NIH trial of anti-CD14 antibody to treat COVID-19 respiratory disease begins
Arbidol
- Arbidol Combined With LPV/r Versus LPV/r Alone Against Corona Virus Disease 2019: a Retrospective Cohort Study
Atazanavir
- Atazanavir, Alone or in Combination with Ritonavir, Inhibits SARS-CoV-2 Replication and Proinflammatory Cytokine Production
Azithromycin
- A randomised clinical trial of azithromycin versus standard care in ambulatory COVID-19 – the ATOMIC2 trial – PrePrint
- Azithromycin for community treatment of suspected COVID-19 in people at increased risk of an adverse clinical course in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial
- Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil (COALITION II): a randomised clinical trial
  - In patients with severe COVID-19, adding azithromycin to standard of care treatment (which included hydroxychloroquine) did not improve clinical outcomes. Our findings do not support the routine use of azithromycin in combination with hydroxychloroquine in patients with severe COVID-19.
Baricitinib
- Baricitinib EUA content from Eli Lilly
- Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19
  - Baricitinib plus remdesivir was superior to remdesivir alone in reducing recovery time and accelerating improvement in clinical status among patients with Covid-19, notably among those receiving high-flow oxygen or noninvasive ventilation. The combination was associated with fewer serious adverse events.
- Baricitinib has Significant Effect on Recovery Time, Most Impactful in COVID-19 Patients Requiring Oxygen
- Baricitinib: A review of pharmacology, safety and emerging clinical experience in COVID‐19
- Use of Baricitinib in Patients with Moderate and Severe COVID-19
Blood purification
- Coronavirus (COVID-19) Update: FDA Authorizes Blood Purification Device to Treat COVID-19
Budesonide:
- Inhaled budesonide for COVID-19 in people at higher risk of adverse outcomes in the community: interim analyses from the PRINCIPLE trial – PREPRINT
- Inhaled budesonide in the treatment of early COVID-19 (STOIC): a phase 2, open-label, randomised controlled trial
Ciclesonide (Zetonna)
- The inhaled corticosteroid ciclesonide blocks coronavirus RNA replication by targeting viral NSP15
Colchicine
- Colchicine in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial – Pre-Print
- Colchicine for community-treated patients with COVID-19 (COLCORONA): a phase 3, randomised, double-blinded, adaptive, placebo-controlled, multicentre trial – LANCET
- RECOVERY trial closes recruitment to colchicine treatment for patients hospitalised with COVID-19
- Efficacy of Colchicine in Non-Hospitalized Patients with COVID-19
Convalescent plasma
- Refer to the NIH COVID-19 Guidelines for information on convalescent plasma for COVID-19
- Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial – LANCET
- Association of Convalescent Plasma Treatment With Clinical Outcomes in Patients With COVID-19A Systematic Review and Meta-analysis
- Convalescent plasma for patients with severe COVID-19: a matched cohort study
- Convalescent Plasma Therapy for COVID-19: State of the Art
  - This review summarizes historical settings of application, with a focus on betacoronaviruses, and surveys current approaches for donor selection and CP collection, pooling technologies, pathogen inactivation systems, and banking of CP
- Antimicrobial Stewardship Programs and Convalescent Plasma for COVID-19: A New Paradigm for Pre-Authorization?
- FDA Issues Emergency Use Authorization for Convalescent Plasma as Potential Promising COVID–19 Treatment, Another Achievement in Administration’s Fight Against Pandemic
- Covid-19: FDA approves use of convalescent plasma to treat critically ill patients
- Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma
  - Reports on 5 critically ill patients with COVID-19 and acute respiratory distress syndrome ARDS who were given convalescent plasma containing neutralizing antibody and had an improvement in their clinical status
- New Life for an Old Therapy: Convalescent Plasma
Dapagliflozin
- Update on the DARE-19 Phase III trial for Farxiga in COVID-19
Favipiravir
- Favipiravir, an antiviral for COVID-19?
- Favipiravir as an antiviral agent in COVID-19: same script, different cast?
Fluvoxamine
- Prospective cohort of fluvoxamine for early treatment of COVID-19
Indomethacin
- Indomethacin Has a Potent Antiviral Activity Against SARS Coronavirus
- Inhibition of viral protein translation by indomethacin in vesicular stomatitis virus infection: role of eIF2α kinase PKR
Intravenous Immunoglobulin
- High-dose intravenous immunoglobulin as a therapeutic option for deteriorating patients with Coronavirus Disease 2019
  - This article describes 3 patients with severe COVID-19 disease that had a favorable outcome and received IVIG
- Take note that IVIG shortages have been an issue for many months and it is a ver expensive modality
Ivermectin
- Refer to the NIH COVID-19 Guidelines for information on ivermectin for COVID-19
- Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials – PrePrint
- Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19A Randomized Clinical Trial
- Usefulness of Ivermectin in COVID-19 Illness
  - Caution – this is a pre-print, non-peer reviewed article
- The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro
  - Twitter thread from Caros Chaccour is here on the topic
  - From a peer, unverified: The IC50 value from the ivermectin SARS-CoV-2 study was ~2.2-2.8 microM. The mean serum peaks from ivermectin given as 18-36 mg doses was ~100 nanograms/mL. Ivermectin is ~99% protein bound. The peak concentrations represent ~0.115 microM concentrations (without adjustment for protein binding). The IC50 values are ~20x those that occur from well-studied doses in humans. If you want to factor in free-fraction estimation, that could be many times higher than free fraction ivermectin in vivo concentrations. The IC50 is not even achieved with maximum total concentration in serum.
Leflunamide
- Treatment of COVID-19 Patients with Prolonged Post-Symptomatic Viral Shedding with Leflunomide — a Single-Center, Randomized, Controlled Clinical Trial
  - In COVID-19 patients with prolonged PCR positivity, no benefit in terms of the duration of viral shedding was observed with the combined treatment of leflunomide and IFN α-2a beyond IFN α-2a alone.
Lenzilumab
- LENZILUMAB EFFICACY AND SAFETY IN NEWLY HOSPITALIZED COVID-19 SUBJECTS: RESULTS FROM THE LIVE-AIR PHASE 3 RANDOMIZED DOUBLE-BLIND PLACEBO-CONTROLLED TRIAL – Pre-Print
Leronlimab
- Clinical Characteristics and Outcomes of COVID-19 Patients Receiving Compassionate Use Leronlimab
Molnupiravir
- Merck and Ridgeback Biotherapeutics Provide Update on Progress of Clinical Development Program for Molnupiravir, an Investigational Oral Therapeutic for the Treatment of Mild-to-Moderate COVID-19
Nitazoxanide
- Early treatment with nitazoxanide prevents worsening of mild and moderate COVID-19 and subsequent hospitalization – PREPRINT
Polyclonal Antibody
- Large NIH clinical trial will test polyclonal antibody therapeutic for COVID-19
Progesterone
- Progesterone in Addition to Standard of Care vs Standard of Care Alone in the Treatment of Men Hospitalized With Moderate to Severe COVID-19: A Randomized, Controlled Pilot Trial
Ribavirin
- Stability of Extemporaneous Oral Ribavirin Liquid Preparation
Sarilumab (Kevzara)
- COVID-19 Pneumonia Treated With Sarilumab: A Clinical Series of Eight Patients
Sofosbuvir and daclatasvir, ribavirin
- Sofosbuvir and daclatasvir for the treatment of COVID-19 outpatients: a double-blind, randomized controlled trial
- Sofosbuvir and daclatasvir compared with standard of care in the treatment of patients admitted to hospital with moderate or severe coronavirus infection (COVID-19): a randomized controlled trial
- Evaluation of the efficacy of sofosbuvir plus daclatasvir in combination with ribavirin for hospitalized COVID-19 patients with moderate disease compared with standard care: a single-centre, randomized controlled trial
- The impact of sofosbuvir/daclatasvir or ribavirin in patients with severe COVID-19
Tetracyclines
- Therapeutic Potential for Tetracyclines in the Treatment of COVID‐19
Tissue Plasminogen Activator
- Is There a Role for Tissue Plasminogen Activator (tPA) as a Novel Treatment for Refractory COVID-19 Associated Acute Respiratory Distress Syndrome (ARDS)?
VIR-7831 Monoclonal Antibody
- GSK and Vir Biotechnology announce submission of Emergency Use Authorization request to FDA for VIR-7831 for the early treatment of COVID-19
Vitamin D
- Association of Vitamin D Levels, Race/Ethnicity, and Clinical Characteristics With COVID-19 Test Results
Zinc
- Zn²⁺ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture
- Chloroquine Is a Zinc Ionophore

COVID-19 Literature

Comparable environmental stability and disinfection profiles of the currently circulating SARS-CoV-2 variants of concern B.1.1.7 and B.1.351 – JID
SARS-CoV-2 infection induces long-lived bone marrow plasma cells in human – Nature
Bacterial coinfections in coronavirus disease 2019 – Cell
Testing at scale during the COVID-19 pandemic – Nature
Computational epitope map of SARS-CoV-2 spike protein – Plos
Non-steroidal anti-inflammatory drug use and outcomes of COVID-19 in the ISARIC Clinical Characterisation Protocol UK cohort: a matched, prospective cohort study – Lancet Rheum
Perinatal Outcomes During the COVID-19 Pandemic in Ontario, Canada – JAMA
Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China – JAMA
In-Hospital Mortality in a Cohort of Hospitalized Pregnant and Nonpregnant Patients With COVID-19 – Annals Internal Med
Association Between Bitter Taste Receptor Phenotype and Clinical Outcomes Among Patients With COVID-19 – JAMA
Differential Cytokine Signatures of SARS-CoV-2 and Influenza Infection Highlight Key Differences in Pathobiology – CID
An open-label randomized, controlled trial of the effect of lopinavir/ritonavir, lopinavir/ritonavir plus IFN-β-1a and hydroxychloroquine in hospitalized patients with COVID-19 – CMI
The Role of Procalcitonin in Antibiotic Decision-Making in Covid-19 Infection – ICHE
Transmissibility and transmission of respiratory viruses – Nature
Sera neutralizing activities against SARS-CoV-2 and multiple variants six month after hospitalization for COVID-19 – CID
Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study – BMJ
New SARS-CoV-2 Variants — Clinical, Public Health, and Vaccine Implications – NEJM
The first 12 months of COVID-19: a timeline of immunological insights
SARS-CoV-2 infection of the oral cavity and saliva – Nature
How COVID-19 Affects the Brain – JAMA Neurology
Reinfection Rates among Patients who Previously Tested Positive for COVID-19: a Retrospective Cohort Study
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): a Systemic Infection – CMR Review
Confirmed Reinfection with SARS-CoV-2 Variant VOC-202012/01
SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles
When Should Asymptomatic Persons Be Tested for COVID-19?
Who is doing all those COVID-19tests? Why you should care about medical laboratory professionals
Paradoxes and uncertainties of immunomodulatory treatments in the fight against COVID-19
How Could In Vitro Antiviral Activity Be Applied to Optimize the Dosing Regimens of Candidates for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)?
Establishing a New Normal for Hospital Care: A Whole of Hospital Approach to COVID-19
SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis
Dynamic pharmacy leadership during the COVID-19 crisis: Optimizing patient care through formulary and drug shortage management
Lack of antibodies to SARS-CoV-2 in a large cohort of previously infected persons
- In our population with previous RT-PCR confirmed infection, approximately one in 16 persons lacked IgG antibodies. Absence of antibodies varied independently by illness severity, race/ethnicity, obesity, and immunosuppressive drug therapy. The proportion seronegative remained relatively stable among persons tested up to 90 days post symptom onset.
Candidaemia in COVID-19, a link to disease pathology or increased clinical pressures?
Survival analysis of treatment efficacy in comparative COVID-19 studies
- For survival analysis in comparative COVID-19 trials, the routinely used hazard ratio may not provide a meaningful summary of the treatment effect. The mean survival time difference/ratio is an intuitive, assumption-free alternative. However, for short-term studies, landmark mortality rate differences/ratios are more clinically relevant and should be formally analyzed and reported.
Improving Antimicrobial Stewardship in Critically-Ill Patients with COVID-19
Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results – Preprint
- Remdesivir, Hydroxychloroquine, Lopinavir and Interferon regimens appeared to have little or no effect on hospitalized COVID-19, as indicated by overall mortality, initiation of ventilation and duration of hospital stay. The mortality findings contain most of the randomized evidence on Remdesivir and Interferon, and are consistent with meta-analyses of mortality in all major trials.
Characteristics of SARS-CoV-2 and COVID-19 – A Review
Imperfect storm: is interleukin-33 the Achilles heel of COVID-19?
Empiric Antibacterial Therapy and Community-onset Bacterial Co-infection in Patients Hospitalized with COVID-19: A Multi-Hospital Cohort Study
Understanding the role of bacterial and fungal infection in COVID-19
Antimicrobial stewardship challenges and innovative initiatives in the acute hospital setting during the COVID-19 pandemic
Evaluation of Six Commercial Mid- to High-Volume Antibody and Six Point-of-Care Lateral Flow Assays for Detection of SARS-CoV-2 Antibodies
- Serology assays should not be used for the diagnosis of acute infection but rather in carefully designed serosurveys to facilitate understanding of seroprevalence in a population and to identify previous exposure to SARS-CoV-2.
Implementation of field hospital pharmacy services during the COVID-19 pandemic
Bacterial Co-Infection and Secondary Infection in Patients with COVID-19: A Rapid Systematic Review and Meta-Analysis
Coronavirus Disease 2019–COVID-19 – Clinical Microbiology Review
Invasive Fungal Disease complicating COVID-19: when it rains it pours
COVID-19 and the Path to Immunity
Effect of Recombinant Human Granulocyte Colony–Stimulating Factor for Patients With Coronavirus Disease 2019 (COVID-19) and Lymphopenia
- Preliminary findings from a randomized clinical trial suggest that rhG-CSF treatment should be studied in larger trials and in a broader range of patients with COVID-19.
Emerging Pandemic Diseases: How We Got to COVID-19
- Disease emergence reflects dynamic balances and imbalances, within complex globally distributed ecosystems comprising humans, animals, pathogens, and the environment. Understanding these variables is a necessary step in controlling future devastating disease emergences.
Bacterial and fungal superinfections in critically ill patients with COVID-19
An ID Doctor’s Confrontation with His Own Case of COVID-19 – An Interview with Dr. Michael Saag
Invasive Fungal Disease complicating COVID-19: when it rains it pours
COVID-19 re-infection by a phylogenetically distinct SARS-coronavirus-2 strain confirmed by whole genome sequencing
- Epidemiological, clinical, serological and genomic analyses confirmed that the patient had re-infection instead of persistent viral shedding from first infection. Our results suggest SARS-CoV-2 may continue to circulate among the human populations despite herd immunity due to natural infection or vaccination.
Patient Characteristics and Outcomes of 11,721 Patients with COVID19 Hospitalized Across the United States
- This large observational cohort describes the clinical course and identifies factors associated with outcomes of hospitalized patients with COVID-19 across the US.
Antimicrobial stewardship in a pandemic: picking up the pieces (editorial)
Evaluating the Efficacy of Therapies in COVID-19 Patients
The challenge of managing COVID-19 associated pulmonary aspergillosis
SARS-CoV-2 Infection Among Community Health Workers in India Before and After Use of Face Shields
- Describes transmission in a community setting before and after the use of face shields.
Comparing nasopharyngeal swab and early morning saliva for the identification of SARS-CoV-2
- Our findings demonstrate that saliva is a better alternative specimen for detection of SARS-CoV-2. Taking into consideration, the simplicity of specimen collection, shortage of PPE and the transmissibility of the virus, saliva could enable self-collection for an accurate SARS-CoV-2 surveillance testing.
Does expert opinion trump evidence?
Airborne Transmission of COVID-19
Methylprednisolone as Adjunctive Therapy for Patients Hospitalized With COVID-19 (Metcovid): A Randomised, Double-Blind, Phase IIb, Placebo-Controlled Trial
- The findings of this study suggest that a short course of MP in hospitalized patients with COVID-19 did not reduce mortality in the overall population.
Drug interactions: a review of the unseen danger of experimental COVID-19 therapies
- Aims to assess the risk of drug–drug interactions in the severely ill COVID-19 patient
Drug treatments for covid-19: living systematic review and network meta-analysis
- Compares the effects of treatments for coronavirus disease 2019 (covid-19)
Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients
- Quantitative monitoring of viral load in lower respiratory tract samples helps to evaluate disease progression, especially in cases of low viral load.
A Tool for Early Prediction of Severe Coronavirus Disease 2019 (COVID-19): A Multicenter Study Using the Risk Nomogram in Wuhan and Guangdong, China
- Could help clinicians with early identification of patients who will progress to severe COVID-19
Infectious Diseases Society of America Guidelines on Infection Prevention for Health Care Personnel Caring for Patients with Suspected or Known COVID-19
Treatment of COVID-19 – Evidence-Based or Personalized Medicine?
- Provides a brief summary of the complexities in treating and researching COVID-19
COVID-19 in people with diabetes: understanding the reasons for worse outcomes
- Outlines why diabetic patients may have different outcomes versus non-diabetic patients
Publishing in face of the COVID-19 pandemic
- “Despite the flaws in methodology, we have elected not to withdraw the publication by Gautret et al”
  - IJAA many people are disappointed in you.
Airborne Transmission of SARS-CoV-2Theoretical Considerations and Available Evidence
- “The balance of currently available evidence suggests that long-range aerosol-based transmission is not the dominant mode of SARS-CoV-2 transmission.”
Extrapulmonary manifestations of COVID-19
It is Time to Address Airborne Transmission of COVID-19
- Reviews how COVID-19 may be spread by airborne method and advocates precautions
Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19)
- Review article in JAMA
Impact of COVID-19 pandemic on pharmacy learners and preceptors
Is a “Cytokine Storm” Relevant to COVID-19?
- Until new data establish otherwise, the linkage of cytokine storm to COVID-19 may be nothing more than a tempest in a teapot.
SARS-CoV-2 infection in healthcare personnel with high-risk occupational exposure: evaluation of seven-day exclusion from work policy
- HCP with high-risk occupational exposure to COVID-19 had increased probability of serious morbidity, healthcare seeking, hospitalization and absenteeism. Our findings justify the 7-day exclusion from work policy for HCP with high-risk exposure.
Distribution of Transmission Potential during Non-Severe COVID-19 Illness
- Among patients with non-severe COVID-19, viral loads in upper respiratory specimens peak by two or three days from symptom onset and decrease rapidly thereafter. The vast majority of the viral load-time AUC lies within 10 days of symptom onset.
Impact of SARS-CoV-2 Viral Load on Risk of Intubation and Mortality Among Hospitalized Patients with Coronavirus Disease 2019
- Admission SARS-CoV-2 viral load among hospitalized patients with COVID-19 independently correlates with the risk of intubation and in-hospital mortality.
Immune modulation in COVID-19: Strategic considerations for personalized therapeutic intervention
Retraction: Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. N Engl J Med. DOI: 10.1056/NEJMoa2007621.
Laboratory Diagnosis of COVID-19: Current Issues and Challenges
- This commentary covers current issues and challenges for the laboratory diagnosis of infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Updated Approaches against SARS-CoV-2
- Published in the June issues of AAC, this minireview aims to summarize the updated potential approaches against SARS-CoV-2. The authors emphasize that further efforts are warranted to develop the safest and most effective approach.
Early Short Course Corticosteroids in Hospitalized Patients with COVID-19
- Found that an early short course of methylprednisolone in patients with moderate to severe COVID-19 reduced escalation of care and improved clinical outcomes.
Thromboembolism and Anticoagulant Therapy During the COVID-19 Pandemic: Interim clinical Guidance
Lessons from COVID-19 in children: Key hypotheses to guide preventative and therapeutic strategies
AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19
Interpreting a COVID-19 test result
- Provides insights on COVID-19 test interpretation
Assessment of Deaths From COVID-19 and From Seasonal Influenza
Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19
- Presents a risk score based on characteristics of COVID-19 patients at the time of admission to the hospital was developed that may help predict a patient’s risk of developing critical illness.
Clinical and laboratory predictors of in-hospital mortality in patients with COVID-19: a cohort study in Wuhan, China
- Developd two predictive models for the in-hospital mortality of patients with COVID-19 in Wuhan and validated in patients from another center
Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study
- Found a high incidence of thromboembolic events
The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application
- Provides additional evidence for a median incubation period for COVID-19 of approximately 5 days, similar to SARS
Bacterial and fungal co-infection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing
- Explores and describes the current literature surrounding bacterial/fungal co-infection in patients with coronavirus infection
Mild or Moderate COVID-19
- Discusses the topic in the context of a clinical case
COVID-19: towards understanding of pathogenesis
- Includes potentially helpful hypothetical images related to the pathogenesis of COVID-19
Association of Inpatient Use of Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Mortality Among Patients With Hypertension Hospitalized With COVID-19
- Found that among hospitalized COVID-19 patients with hypertension, inpatient use of ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB non-users
COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up
- Reviews the current understanding of the pathogenesis, epidemiology, management and outcomes of patients with COVID-19 who develop venous or arterial thrombosis, and of those with preexisting thrombotic disease who develop COVID-19, or those who need prevention or care for their thrombotic disease during the COVID-19 pandemic
Rates of Co-infection Between SARS-CoV-2 and Other Respiratory Pathogens
- Reports on co-infection rates between SARS-CoV-2 and other respiratory pathogens in Northern California
The duration of viral shedding of discharged patients with severe COVID-19
- This study found the median duration of viral shedding in previously hospitalized patients was 31 days from illness onset and the median total time from illness onset to discharge was 40 days
Smell and taste dysfunction in patients with COVID-19
- Discusses the lack of data surrounding this topic
Hypertension, the renin–angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19: European Society of Hypertension COVID-19 Task Force Review of Evidence
- Provides a critical review on the relationship of hypertension, RAS, and risk of lung injury. Also details the molecular mechanisms linking the RAS to lung damage and the potential clinical impact of treatment with RAS blockers in patients with COVID-19 and a high cardiovascular and renal risk. Concludes there is currently no reason to discontinue RAS blockers in stable patients facing the COVID-19 pandemic.
Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission
- A retrospective analysis of over 3,500 cases found obesity is a potential risk factor for hospital admission and need for intensive care
Diagnostic Testing for Severe Acute Respiratory Syndrome–Related Coronavirus-2: A Narrative Review
- Reviews the current array of tests for SARS–CoV-2, highlight gaps in current diagnostic capacity, and proposes potential solutions
The Use of Povidone Iodine Nasal Spray and Mouthwash During the Current COVID-19 Pandemic May Protect Healthcare Workers and Reduce Cross Infection
- Discusses the topic
A War on Two Fronts: Cancer Care in the Time of COVID-19
- Discusses treatment of COVID-19 and gives oncology considerations
Detection of Covid-19 in Children in Early January 2020 in Wuhan, China
- Reports on a retrospective chart review of COVID-19 in children
Self-reported olfactory and taste disorders in SARS-CoV-2 patients: a cross-sectional study
- Discusses olfactory and taste disorders and SARS-CoV-2
Unprecedented Solutions for Extraordinary Times: Helping Long-Term Care Settings Deal with the COVID-19 Pandemic
- Discusses challenges LTCs face with COVID-19
Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019
- Provides results from analysis of 535 plasma samples, providing strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients
Covid-19 in Critically Ill Patients in the Seattle Region — Case Series
- Discusses symptoms and clinical course
A COVID-19 Transmission within a family cluster by presymptomatic infectors in China
- Reports on a family with COVID-19 including symptomatic and asymptomatic people
Understanding COVID-19: what does viral RNA load really mean?
- Discusses limitations and potential role for viral RNA in managing COVID-19 patients
COVID-19 Treatment: A Review of Early and Emerging Options
- This is an outstanding review of the treatment options currently available and emerging
  - **MUST READ**
Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19)
- Suggests evaluating humoral response to SARS-CoV-2 can help diagnose subclinical cases
Learning from the Past: Possible Urgent Prevention and Treatment Options for Severe Acute Respiratory Infections Caused by 2019‐nCoV
- This article discusses drug targets and potential therapies for treating COVID-19
Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2)
- This article suggests that a large amount of undocumented cases is making it hard to control the SARS-CoV-2 pandemic
First 12 patients with coronavirus disease 2019 (COVID-19) in the United States
- This is essentially a case series and given the limited amount of data here it is hard to take much away from it
2019-Novel Coronavirus (2019-nCoV): estimating the case fatality rate – a word of caution
- Case fatality rate may vary by region
Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China
- Found older age is associated with death
Detection of SARS-CoV-2 in Different Types of Clinical Specimens
- Virus may be spread via feces and testing multiple sites of the body may be helpful
Involving Antimicrobial Stewardship Programs in COVID-19 Response Efforts: All Hands on Deck
- Discusses opportunities for antimicrobial stewardship programs to help out, including managing drug shortages, developing treatment guidelines, assisting with acquisition of investigational drugs, and monitoring
On the origin and continuing evolution of SARS-CoV-2
- This article discusses the L type and S type of SARS-CoV-2 and how the frequency of each may be shifting as the pandemic progresses
Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study
- Found severe maternal and neonatal complications were not observed in pregnant women with COVID-19 pneumonia who had vaginal delivery or caesarean section. Also found that mild respiratory symptoms of pregnant women with COVID-19 pneumonia highlight the need of effective screening on admission.
COVID-19 in pregnant women – Authors’ reply
- This article provides a guideline on what to do for pregnant women with 2019-nCoV exposure
Re: Preventing a covid-19 pandemic: ACE inhibitors as a potential risk factor for fatal Covid-19
- This article suggests use of ACE-inhibitors (ACE-Is)/ angiotensin-receptor blockers (ARBs) may increase the risk for severe COVID-19 disease and increase transmissibility, due to increased expression of ACE2 receptor
  - However, this article suggests the opposite in that ARBs may be protective against COVID-19:
    - Angiotensin receptor blockers as tentative SARS‐CoV‐2 therapeutics
- On the topic: Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?
  - This article suggests patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs.
    - However, the European Society of Cardiology notes: “speculation about the safety of ACE-i or ARB treatment in relation to COVID-19 does not have a sound scientific basis or evidence to support it.” HFSA, ACC, and AHA essentially agree.
      - Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers
      - HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19
  - Is There an Association Between COVID-19 Mortality and the Renin-Angiotensin System—a Call for Epidemiologic Investigations
    - Proposes key clinical research priorities necessary to clarify the role of RAS inhibition in COVID-19 mortality that could be rapidly addressed by the international research community.
- Also on the topic: SARS-CoV2: should inhibitors of the renin–angiotensin system be withdrawn in patients with COVID-19?
  - Does not advise preemptive switch
- More on the topic: Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19
  - Assessing nearly 6,000 COVID-19 positive patients they found no substantial increase in the likelihood of a positive test for COVID-19 or in the risk of severe COVID-19 among patients who tested positive in association with five common classes of antihypertensive medications
- This article also notes that ibuprofen and thiazolidinediones can increase ACE2 – but what that means clinically is not understood
  - On the topic: The French Minister suggested to avoid NSAIDs, take acetaminophen instead
    - Anti-inflammatories may aggravate Covid-19, France advises
  - There were reports recommending against use of NSAIDs for COVID-19
    - Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists
  - HOWEVER: As of 18 March the WHO did not recommend against the use of ibuprofen as per the statement in this tweet
    - In addition: EMA gives advice on the use of non-steroidal anti-inflammatories for COVID-19
Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents
- Reviews the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities
Aerosol and surface stability of HCoV-19 (SARS-CoV-2) compared to SARS-CoV-1
- This article found SARS-CoV-2 (HCoV-19) could be found in aerosols up to 3 hours post-aerosolation, on cardboard up to 24 hours, and on plastic or stainless steel for 2-3 days
- The inoculum required to cause infection is an important factor to consider when reading this article
How will country-based mitigation measures influence the course of the COVID-19 epidemic?
- This article has the famous figure showing how flattening the initial wave can help the healthcare systems cope with the influx of COVID-19 cases
COVID-19: An Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease
Under the Epidemic Situation of COVID-19, Should Special Attention to Pregnant Women Be Given?
- Provides considerations for pregnant patients
Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy
- Provides a summary of the response of the COVID-19 Lombardy ICU network and a forecast of estimated ICU demand over the coming weeks
A Novel Approach for a Novel Pathogen: using a home assessment team to evaluate patients for 2019 novel coronavirus (SARS-CoV-2)
- Describes an effective mechanism for testing outside of the healthcare setting
Clinical Features of 69 Cases with Coronavirus Disease 2019 in Wuhan, China
- Found COVID-19 appears to show frequent fever, dry cough, and increase of inflammatory cytokines, and induced a mortality rate of 7.5%. Older patients or those with underlying comorbidities are at higher risk of death.
A comparative study on the clinical features of COVID-19 pneumonia to other pneumonias
- Suggests CT scan may be a reliable test for screening NCOVID-19 cases, liver function damage is more frequent in NCOVID-19 than NON-NCOVID-19 patients, and LDH as well as α-HBDH may be considerable markers for evaluation of NCOVID-19
Dysregulation of immune response in patients with COVID-19 in Wuhan, China
- Suggests surveillance of neutrophil-lymphocyte-ratio and lymphocyte subsets can be helpful in the early screening of critical illness, diagnosis and treatment of COVID-19

Other COVID-19 Webpages & Resources

DISCLAIMER: The views expressed in this article represent that of the author and do not necessarily reflect the position or policy of any previous, current, or potential future employers or other organizations in which he serves.

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