While much about SARS-CoV-2 virus and coronavirus disease 2019 (COVID-19) remain unknown, it is important to crowdsource knowledge and information on how to respond to this novel threat.
On Wednesday, March 25th
partnered with sister company Physicians’ Education Resource® to host a live CME-certified webinar that focused on what clinicians need to know about COVID-19.
The discussion was moderated by Jason C. Gallagher,
PharmD, FCCP, FIDP, FIDSA, BCPS. Dr. Gallagher, the editor-in-chief of Contagion
®, is a Clinical Professor at Temple University School of Pharmacy and Clinical Pharmacy Specialist in Infectious Diseases at Temple University Hospital.
Featured speakers were Helen W. Boucher
, MD, FACP, FIDSA, chief, division of geographic medicine and infectious diseases, Tufts Medical Center; Carlos del Rio
, MD, director, clinical sciences and international research, Emory Center for AIDS Research; and Stanley Deresinski
, MD, clinical professor of medicine, infectious diseases, Stanford University.
The discussion began with Boucher presenting several case studies of patients with COVID-19. Boucher discussed a range of clinical information from symptoms to underlying conditions, and featured images of chest X-rays from the patients.
Interestingly, the second case presented featured a dual infection of an adenovirus in addition to SARS-CoV-2.
Most patients have mild illness and may not need to seek medical care, Boucher noted, but there is a range of illness which includes severe and fatal infections.
Boucher also pointed out that the disease has a biphasic nature, meaning there is potential for patients to get sicker during second week of illness.
Boucher noted that secondary bacterial infections have occurred, and highlighted that a larger proportion of patients in Wuhan, China, who died of COVID-19 had secondary bacterial infections.
Key risk factors for severe disease are older age
, underlying lung disease, a history of smoking, cardiovascular
disease, and immunocompromising conditions.
The second speaker, del Rio, refreshed viewers on the history of the outbreak. He provided an overview of the virus from December 2019 to the present, emphasizing the exponential spread of COVID-19 around the world.
New York city, del Rio pointed out, is now the epicenter of the outbreak in the United States. But other states are likely to see a growth in numbers del Rio explained.
Based on current projections, del Rio pointed out that hospitalizations and mortality will outpace those of influenza.
If we decrease transmission by social distancing, del Rio concluded, the worst-case scenarios can be avoided. The practice is not intended to stop the spread entirely, he clarified, but to even out the burden on health systems over time.
The final presenter, Stanley Deresinski, presented information on the genetics of the virus and potential treatment options. Deresinski pointed out the close genetic relation of SARS-CoV-2 to SARS-CoV-1.
“Similar to the original SARS virus, it uses the same host cell receptor for entry, for attaching to human cells and infecting them,” Deresinski said.
Deresinski then transitioned into discussing experimental treatment options for COVID-19. Currently, there is no treatment that has been proved effective for the novel coronavirus.
Deresinski noted that there are at least 6 remdesivir clinical trials ongoing worldwide. This is a potential treatment option that many are hopeful about, Deresinski explained, but we won’t know until more about its effectiveness until data are available.
With respect to hydroxychloroquine, Deresinski pointed to mixed results in published studies, but also pointed to an ongoing phase 3 clinical trial in China.
Deresinski also described results of a study concerning lopinavir/ritonavir
which has ruled the treatment out for many clinicians. The treatment worked against SARS, but had little impact against COVID-19 compared with standard care.
Corticosteroids should be avoided, Deresinski noted, unless there is a separate indication for something other than COVID-19 which warrants them.
Overall, there are a myriad of approaches
in development, including monoclonal antibodies.
The presentations were followed by a Q&A with live viewer submitting questions. Some topics included the “flattening the curve” concept and which potential treatments the presenters are most optimistic about.
“We need data, not anecdotes,” del Rio said of the treatments under study.
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