Resources for Doctors

Protocols, Lab findings, Radiology, ICU, PPE, Medications...

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Section edited by Ruth Ann Crystal MD @CatchTheBaby

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Table of Contents:

START HERE for Summaries

Agency Resources

Protocols

General Protocols

Triage Protocols

EMS Medical Director Resources

Findings on Examination

Lab Findings

Radiology Findings

Clinical Course

ICU/Critical Care

Intubation and Airway Management

Critical Care Guidelines

Abnormal clotting in COVID-19 patients

Critical Care for the non-ICU physician

CPR

Prone Positioning

ICU Tips

Ventilators:

Triage in Critical Care:

Personal Protective Equipment (PPE)

Medications

GENERAL INFORMATION

Plasmaphoresis and Convalescent Serum as treatment

Drug Repurposing:

COVID19 Drug and Vaccine development:

LOPINAVIR-RITONAVIR (KALETRA) STUDIES:

Anticoagulants

ACE-INHIBITORS/ARB DEBATE:

IBUPROFEN/ NSAIDS:

RESEARCH:

COVID-19 Diagnostic Tests

Medical Specialties Specific

Telemedicine

Journal Articles

Helpful Tips & Testimonials

Helpful Info for Patients

Medical Blogs on COVID19

Support for Healthcare workers well-being

Money for Medical Research on COVID19

Medical Equipment Hacks

FACE MASK HACKS

COVID19 Databases

Humor to lighten the mood

START HERE for Summaries


Brigham and Women’s Hospital: COVID-19 Critical Care Clinical Guidelines http://covidprotocols.org/

Alibaba Handbook of COVID-19 Prevention and Treatment (3/18/20) https://covid-19.alibabacloud.com/

The Internet Book of Critical Care, an online textbook written by Josh Farkas (@PulmCrit) https://emcrit.org/ibcc/COVID19/

NEW (4/2/20) Physician support line https://doxy.me/physiciansupportline

  • Free confidential peer support for US doctors by volunteer psychiatrists during COVID19 pandemic
  • 8am to 12am EDT, 7 days a week

Coronavirus: Why You Must Act Now | @TomasPueyo https://t.co/D1fbok5jpu 

The only way to prevent this is social distancing today. Not tomorrow. Today.

That means keeping as many people home as possible, starting now.

NEW (3/19/20): The Hammer and the Dance https://bit.ly/3dmIktj 

NEW (3/23/20) Stanford N95 mask decontamination https://buff.ly/33NjUVC

  • Use oven at 70C (158F) for 30 minutes or
  • Use boiling water for 10 min
  • Do not microwave
  • Do not use bleach or alcohol
  • EtO, UVGI, and H2O2 are safe but unknown integrity, takes time & space

◆  NEW (3/28/20) WHO: Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations https://buff.ly/2UqMh8S

NEW (3/28/20) Abbott’s new test that can detect COVID-19 in as little as 5 minutes https://buff.ly/2WMJTuM

NEW (3/28/20): COVID-19 Related Medications |@ASHPOfficial  https://buff.ly/3bD2yNY

  • Great table of important articles on each medication used to treat COVID19

NEW (3/28/20) FDA approves use of convalescent plasma to treat critically ill Covid-19 patients https://buff.ly/3dxSWWt

NEW, RECENTLY ADDED:

NEW (4/1/20) Brief19: Daily news on COVID19 research and policy http://www.brief19.com/ 

NEW (4/1/20) Society for Hospital Medicine Pacific Northwest Chapter Webinar on COVID-19 [Slide Deck]: https://bit.ly/3dNzpkU

  • UW, Evergreen, Swedish, CHI Franciscan experience in Seattle, WA area
  • Protocols, Staffing & Safety considerations, Communication

NEW Joint Commission (3/31/20): Statement supporting use of personal face masks provided from home amid COVID-19 pandemic https://buff.ly/3auFReu

NEW 3/31/20 Rationale for Community Face Mask Program https://www.youtube.com/watch?v=BoDwXwZXsDI

Why we need #masks4all by Jeremy Howard and Rachel Thomas

  • CDC considering recommending general public wear face coverings in public | Washington Post (3/30/20) https://buff.ly/2UHfX0g

NEW (3/26/20) RCOG UK: Updated advice for Pregnant Healthcare Workers in the NHS and other work settings during the Coronavirus outbreak https://buff.ly/3dyWgjW 

NEW (3/31/20) Dr. WenHong Zhang of Shanghai summarises how to fight Coronavirus | KashmirWatch https://buff.ly/2yoDsnH

NEW (3/31/20) Skin reactions related to hand hygiene - WHO Guidelines on Hand Hygiene in Health Care https://buff.ly/2N8i641

NEW (3/31/20) The Italian coronavirus disease 2019 outbreak: Recommendations from clinical practice https://buff.ly/2UT0vOG

        

Agency Resources


WHO: Technical guidance from WHO for COVID-19 https://buff.ly/2TYmhQZ

UK NHS/Public Health England: https://buff.ly/3aLl3Py

Europe ECDC guidelines: https://buff.ly/33bz0UD

US CDC: Coronavirus Disease 2019 (COVID-19) https://buff.ly/2Th67mE 

US Directory of Local Health Departments https://buff.ly/2Sj6zPg

UK Intensive Care Society info for the critical care community https://buff.ly/3aM8cwz

US Society of Critical Care Medicine (SCCM) | COVID-19 https://buff.ly/2W7uwNe

US Joint Commission: https://bit.ly/3dN6jC0 

IDSA resource center https://buff.ly/39X0tMe 

Johns Hopkins live COVID19 map https://buff.ly/2xgcJsD

 Official agency resources for 150 countries: https://bit.ly/covid-info-list 

        I cannot vouch for these links but looks correct.

Spain’s Protocol (03 Mar 2020 - en Español): https://buff.ly/332sgIC

France: Ministère des Solidarités et de la Santé (en Francais) https://buff.ly/2Wk3m5F

Australia and New Zealand Intensive Care Society https://buff.ly/38XrBcN

 Belgium guidelines:  https://buff.ly/3a84ZYs

Protocols

General Protocols

🔸UW Medicine COVID-19 Protocols: https://buff.ly/2xrFYc2

Many helpful protocols for testing, PPE, Triage workflows, special groups guides, room cleaning, telemedicine, etc.

🔸 Brigham and Women’s Hospital Protocols (3/20/20): http://covidprotocols.org

(3/20/20): Brigham and Women’s Hospital: COVID-19 Critical Care Clinical Guidelines http://covidprotocols.org/

(3/23/20) UNMC/ Nebraska Medicine Protocols (updated in real time):  https://www.nebraskamed.com/for-providers/covid19

Protocols including N95 decontamination using UV, inpatient guidance for doctors and for nurses, airway management, airway management in pregnancy, PPE, OR room cleaning, etc.

🔸 UK King’s College (12 Mar 2020): Great educational video Intubation and Rapid Sequence Induction using simulation. Protocols included. https://www.youtube.com/watch?v=pv5A0l3p0zs

◆ COVID-19 Simulation Scenarios & Exercises for system rehearsal and assessment | Simulation Canada https://buff.ly/2WONyZ9

Capacity Planning Tool: CHIME, A tool for COVID-19 capacity planning,  https://pennchime.herokuapp.com/

Converting Operating Rooms to ICU rooms:

Preparing for Overwhelmed ICUs in the US by using existing Operating Rooms, Anesthesia Machines, and Perioperative Personnel by Adam Schlifke, MD, MBA https://docs.google.com/document/d/1eXZbtr9WiUi8hbwQ2UWasZpjrTlPxXIu3spOGqU6TxM/edit

When the supply chain was broken, this Italian hospital used 3D printing to make new valves for ICU machines https://buff.ly/2wXCpu8

Triage Protocols

◆CDC Checklist for transport patients https://buff.ly/3cR3nUE

◆Emory & CEPAR Coronavirus Symptom Checker online: Coronavirus Checker

Triage in Emergency Dept

Triage in Primary Care

Triage remotely (See Telemedicine Section below as well)

  • Scroll to bottom of spreadsheet to see questions for cancer type

Triage for Pregnant Patients with possible COVID-19

  • NEW (3/28/20) Protocol from ACOG and SMFM:

Outpatient Assessment and Management for Pregnant Women With

Suspected or Confirmed Novel Coronavirus (COVID-19) https://buff.ly/3btQLkE

Drive-thru or Tent ideas

One Seoul test center consists of four trailer-like offices with white canopies in front. Put car in park, turn A/C to recirculation. Doctors in full protective suits and goggles take the driver's temperature with an infrared ear thermometer and hand out a questionnaire to fill out. If you're running a fever and, in the doctor's opinion, may be at risk based on where you've been or whom you've contacted, you're eligible for a test. Samples are collected from your nose and throat Only the driver is tested — passengers are not. Results are texted the next day. The test is free.

        

        

Home Care

        WHO on home care: https://buff.ly/2TUjyrt

        CDC: Help prevent the spread of COVID-19 if you are sick https://buff.ly/39EAPvs

◆US: Free Advance Directive Forms by State from AARP https://buff.ly/2KpXRJC

◆ For Specialty Specific protocols (GI, Ob, etc), please scroll down to the “Medical Specialties” section of this document.

EMS Medical Director Resources

CDC: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.html


MN Emergency Suspension of Ambulance Services example

Sample self monitoring log for exposed providers

IEAD Dispatch 911 screen (see EIDS tool for protocol/card download in multiple languages): https://www.emergencydispatch.org/coronavirus-2019-nCoV

Updated NHS Guidelines for PPE (4/2/20)

Findings on Examination


◆ Normal auscultation

◆ Severity in China: 81% mild, 14% severe, 5% critical, 2.3% died https://buff.ly/2Qme6wT

  • Mild cases: without pneumonia or mild pneumonia
  • Severe cases: shortness of breath, respiratory frequency ≥ 30/minute, blood oxygen saturation ≤ 93%, PaO2/FiO2 ratio <300, and/or lung infiltrates >50% within 24-48 hours
  • Critical cases:respiratory failure, septic shock and/or multiple organ dysfunction/failure

◆ Symptoms: Fever, dry cough but no runny nose usually https://buff.ly/2Wfo8Uj

American Journal of Gastroenterology (3/18/20): Diarrhea is a Prominent Symptom of COVID-19 https://buff.ly/3a71Yrg

 Loss of Smell (Ansomia) and Taste

  • Adults who lose their sense of smell (anosmia) should isolate themselves for 7 days, even if they have no other symptoms.
  • Loss of taste and smell is an indication that a person who otherwise seems healthy is in fact carrying the virus and may be spreading it to others.
  • In South Korea, where testing has been widespread, 30% of 2,000 patients who tested positive experienced anosmia as their major presenting symptom (these were mild cases).

◆ Incubation: It takes 2-10 days before infected person shows fever https://buff.ly/2Q8ygKB

Lab Findings


◆ WBC normal, with low Lymphocytes

◆ Mild Thrombocytopenia (> 100K)

◆ Moderate hypoxemia

◆ ABG: Mild acidosis with normal lactate and severe base deficit

◆ Elevated LDH, Very high CRP, Elevated CK

◆ Normal Procalcitonin (If elevated, may mean bacterial involvement)

◆ Glucose ____

◆ D-Dimer may be elevated

◆ LFTs elevated in 30% pts

◆ Low PTT in 30% pts

◆ DO NOT TRUST NEGATIVE COVID19 SWAB if x-ray positive or pneumonia symptoms

(3/18/20): Co-Infection of patients with COVID19 and another Virus

Radiology Findings


Chest Xray

        Bilateral interstitial pneumonia

        Bilateral infiltrates common with gravitational distribution

Asymmetry if bacterial superinfection (secondary bacterial infection is uncommon)

        

Chest CT

        

Relation Between Chest CT Findings and Clinical Conditions of COVID-19 Pneumonia: A Multicenter Study : American Journal of Roentgenology  https://buff.ly/2TK8uhH

  • Ground-glass opacities (GGO) (86.1%)
  • Mixed GGO and consolidation (64.4%)
  • Vascular enlargement in the lesion (71.3%).
  • Peripheral distribution (87.1%)
  • Bilateral involvement (82.2%)
  • Lower lung predominant (54.5%)
  • Multifocal (54.5%)

In patients at high risk for COVID19 infection, chest CT evidence of viral pneumonia may precede positive RT-PCR test results. https://buff.ly/2U1jlmG

Lung Ultrasound (LUS)

◇ How to do a Lung Ultrasound on a COVID19 patient (3/25/20)  https://buff.ly/2ycP8d7

(3/21/20) Lung Ultrasound video gallery and triage flow chart from Dr. Mike Stone of Butterfly: https://buff.ly/33zNAFy

        ◇From GiViTI COVID19 Meeting document (10 March 2020) 

        LUS daily to evaluate the lungs

  • PATTERN 1: Diffuse B-line profile = Responds well to PEEP
  • PATTERN 2: Basal PLAPS points showing consolidation / parapneumonic effusions / atelectasis where front areas ventilated, rear areas atelectatic are responsive to pronation
  • Useful in evaluating the effect of high PEEP and managing recruitment manoeuvres

◇ Findings of lung ultrasonography of novel coronavirus pneumonia during the   2019–2020 epidemic https://buff.ly/2W7huze

  • Characteristic findings included the following:
  • Thickening of the pleural line with pleural line irregularity;
  • B lines in a variety of patterns including focal, multifocal, and confluent;
  • Consolidations in a variety of patterns including multifocal small, non-translobar, and translobar with occasional mobile air bronchograms;
  • Appearance of A lines during recovery phase;
  • Pleural effusions are uncommon.

        ◇ Doctor with COVID19 doing #POCUS of his own lungs https://twitter.com/yaletung

Echocardiography 

Watch for dyskinesias (myocarditis?)

COVID19 Radiology databases of patient chest X-ray and CT scans:

Clinical Course

Clinical Characteristics of Patients With 2019 Novel Coronavirus (2019-nCoV)–Infected Pneumonia in Wuhan, China https://buff.ly/37dVZig

◆ Lancet: Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study https://buff.ly/2W63buS

Severe SARS-CoV-2 infections: Practical considerations and management strategy for intensivists | Bouadma L et al https://buff.ly/2QmjOP7

Pediatrics:  Detection of Covid-19 in Children in Early January 2020 in Wuhan, China | NEJM Editorial (3/12/20) https://buff.ly/2WhwRoL

ICU/Critical Care


Intubation and Airway Management

UK King’s College: Great educational video on PPE and intubation (Rapid Sequence Induction) technique using simulation. Protocols included. https://www.youtube.com/watch?v=pv5A0l3p0zs

◆Infographic on Airway Management (mult languages) https://www.aic.cuhk.edu.hk/covid19/

◆ PulmCrit: Some Additional COVID Airway Management Thoughts https://buff.ly/38N15m1

 Infographic on COVID-19 Intubation by @WeAreCanadiEM https://buff.ly/2U4hmOu

APSF: Airway Management in a Patient with Suspected COVID19 https://buff.ly/2xFMZpX

◆ SRLF Intubation simulation video (en Francais 14.3.20) https://buff.ly/2vtIFJK

◆ ICM Anaesthesia COVID-19 Airway management https://buff.ly/2Uy5OmG

◆ SIAARTI (Italy): Airway Management Infographic https://buff.ly/2U89BH9

Critical Care Guidelines

🔸 Brigham and Women’s Hospital: COVID-19 Critical Care Clinical Guidelines http://covidprotocols.org/

 NHS Guide Critical Care (3/16/20): http://bit.ly/3b8hByC

NICE (NHS): COVID-19 rapid guideline: Critical Care in adults https://bit.ly/39kx8tO 

US Society of Critical Care Medicine (SCCM) | COVID-19 https://buff.ly/2W7uwNe

SCCM Surviving Sepsis Campaign Guidelines(3/21/20): https://bit.ly/2Uc0sPb

        COVID-19 ICU Preparedness Checklist

        Preparing Your ICU For Disaster Response

        Educational Videos

Online Training Modules:

🔸The Internet Book of Critical Care, an online textbook written by Josh Farkas (@PulmCrit) https://emcrit.org/ibcc/COVID19/

◆ PulmCrit- WHO guidelines regarding fluid administration for coronavirus are dangerously misguided: https://emcrit.org/pulmcrit/coronavirus/

Kings Critical Care COVID 19 Evidence Summary.pdf https://buff.ly/2IRwglJ

CEMIR (France): Webinar spécial COVID-19: Actualités et prise en charge (en Francais 12.3.20) https://buff.ly/39TC4qV

WHO: Clinical management of severe acute respiratory infection when novel coronavirus (COVID-19) infection is suspected (28 Jan 2020) https://buff.ly/2IyTIE7

OnePagerICU: One page summary of COVID19 available in many languages https://www.onepagericu.com/

Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy:

Early Experience and Forecast During an Emergency Response | JAMA (13 Mar 2020) https://buff.ly/33gFKAj

                Video conference on this via JAMA: https://www.pscp.tv/w/1ZkKzLvQpPNJv

Abnormal clotting in COVID-19 patients

Also see Anticoagulants under Medications section

COVID-19: Abnormal clotting common in more severe disease per Chinese doctors https://buff.ly/2Uzwsf0

  • They recommend anticoagulation if high D-Dimer.
  • Cardiac effects of virus also discussed.

The Internet Book of Critical Care, an online textbook written by Josh Farkas (@PulmCrit) https://emcrit.org/ibcc/COVID19/

NEW (3/31/20) Prophylactic anticoagulation and COVID-19 https://bit.ly/3aKDswB

  • In patients at high risk for thrombosis, prophylactic anticoagulation with LMWH is associated with better prognosis

◆ Beverly Hunt will post weekly updates on this Twitter thread re: anticoagulation in COVID19 https://twitter.com/bhwords/status/1242907152764801026

Critical Care for the non-ICU physician 

🔸 SCCM | Critical Care for the Non-ICU Clinician https://buff.ly/2X12PGa

🔸 NEW (3/27/20) Critical care and COVID-19 Quick refresher sheets | @MDaniyalHashmi1 https://buff.ly/2UDVauP

  • "Cheat sheets" for Non-ICU clinicians who may find themselves taking care of critically ill patients

 NEW (4/2/20) BJHM (Rebecca Linssen) Free to access, refresher articles

Mechanical ventilation for the non-anaesthetist 2: practical tips http://ow.ly/r42Y50yXX1z

Management of hypoxaemia in the critically ill patient http://ow.ly/NeQW50yXX1C

Acute respiratory distress syndrome on the intensive care unit http://ow.ly/CIHo50yXX1B

A survivors' guide to working in the intensive care unit http://ow.ly/GicW50yXX1A

CPR

Queen Mary Hosp HK: CPR in COVID-19 https://buff.ly/2WjX3z1

CPR in COVID-19 patients. Flowcharts, etc. | RESUS UK  https://buff.ly/39l82LD

Prone Positioning

  • Safe prone checklist: construction and implementation of a tool for performing the prone maneuver https://buff.ly/3deqh8H

ICU Tips

  • *** ICU recs from GiViTI Meeting:
  • From GiViTI COVID19 Meeting document (10 March 2020):

Handling Critical CoVid-19 Patients: a Guide from Italian Anesthesiologists https://buff.ly/2QJhthA

Thread by @Chenbariatrics1: (March 10, 2020)

“Isolate, don’t wait for test. The clinical presentation is VERY typical.”

#COVID19 anecdotal crit care pearls so far:

-Stock up on HUGE doses of sedatives & analgesics

-Pts seem to have gastroparesis + diarrhea (?iatrogenic v. pathophys)

-MSSA is VAP of choice

-DIC/thrombosis while on ppx a real problem; use goal PTT 70-100

Medical Ethics Guidelines from SAMW (Swiss) Intensive Care Medicine (3/21/20):

Triage in case of bottlenecks https://buff.ly/2xc1MZc

Available in English, Francais, Deutsch, Italiano

Nursing Hack: To save on PPE, move iv pumps outside the rooms to the hallway and run tubing extensions to the patients. https://www.facebook.com/groups/opensourcecovid19medicalsupplies/permalink/678144116329317/

Australian COVID-19 Repository – Collating the best resources in COVID-19 research and guidelines https://buff.ly/2WuZcYK

Ventilators:

Ventilator settings

Splitting ventilators to treat multiple patients:

  • NEW (3/27/20): Joint Statement on Multiple Patients per Ventilator (from multiple societies including SCCM, CHEST, ASA)  http://bit.ly/3dxymFE 

Statement Takeaway: Don’t split ventilators

  • NEW (3/29/20) PulmCrit:  Why the SCCM/AARC/ASA/APSF/AACN/CHEST joint statement on split ventilators is wrong. https://buff.ly/3dIyiCY

Allocation of Scarce Resources in Critical Care:

Also see Medical Ethics section under Journal Articles

NEW (4/3/20) Fair Allocation of Scarce Medical Resources in the Time of Covid-19 | NEJM

◆NEJM The Toughest Triage (perspective) https://bit.ly/2UGEy5B 

 NEW (4/3/20) Allocation of Scarce Critical Care Resources During a Public Health Emergency | Univ Pittsburg https://buff.ly/3bQwVR8

Personal Protective Equipment (PPE)

◆ WhatsApp group to discuss PPE https://chat.whatsapp.com/FFaO16rDuQYGVXwWFFVWWi

WHO recommendations for which type of PPE to wear during COVID19 pandemic https://buff.ly/2UgIBGM

 NEW (4/2/20) Updated NHS Guidelines for PPE

CDC (10 Mar 2020) Healthcare PPE FAQs for COVID-19 https://buff.ly/337IxMc

How to don and doff PPE correctly

CDC (March 7, 2020): Recommendations for Healthcare Staff with Potential Exposure in a Healthcare Setting to Patients with COVID-19 https://buff.ly/2VxwJB1

 ◆ (3/23/20)The National COVID-19 N95 Mask and Medical Equipment Clearinghouse | Andy Slavitt https://buff.ly/3bitORq

How to make a reuseable respirator as a replacement for N95 mask | Boston Children's Hospital https://buff.ly/2UtH8LU

Reusable Full-Face Snorkel Mask PPE Project | Stanford Prakash Lab https://buff.ly/2QIo0Jn

NEW (3/21/20) Where to donate PPE:

NEW (3/20/20) JAMA: Conserving Supply of Personal Protective Equipment—

A Call for Ideas https://buff.ly/2vG6Ogf

How to Decontaminate  N95 Masks

Stanford N95 mask decontamination https://bit.ly/2Jh0TkP 

  • Use oven at 70C (158F) for 30 minutes or
  • Use boiling water for 10 min
  • Do not microwave
  • Do not use bleach or alcohol
  • EtO, UVGI, and H2O2 are safe but unknown integrity, takes time & space
  • 3/26 update includes multiple cycles of disinfection and filtering efficiency

◆ University of Nebraska Medical Center Protocol for decontaminating N95 masks with UV light, allowing for multiple re-uses by an individual healthcare worker: https://bit.ly/3afMIsf 

        Good pictures showing how to label masks, etc

Nebraska Medicine guidance on extended use and reuse of PPE  https://bit.ly/3bjJVhM 

◆Open source document on Reuse and Disinfection of PPE https://bit.ly/33lcqc0

Editor note: This document has not been vetted yet but may be of use in low resource and crisis settings.

For homemade face mask patterns, see the Medical Equipment Hacks section as well.  Note, homemade masks do not protect or filter virus like N95 masks but may be of use in a crisis. Homemade sewn masks can be used for patients arriving to the hospital and for families and visitors and home care givers.

NEW 3/31/20 Rationale for Community Face Mask Program https://www.youtube.com/watch?v=BoDwXwZXsDI

Why we need #masks4all by Jeremy Howard and Rachel Thomas

NEW 3/31/20 CDC considering recommending general public wear face coverings in public | Washington Post https://buff.ly/2UHfX0g

NEW 3/31/20 What Are The Best Materials for Making DIY Masks? https://buff.ly/3dc2XbJ

Face Mask Sewing Pattern with insertable filter | Craft Passion  https://buff.ly/393RHKU

        Not tested

Face Mask Sewing Pattern with Insertable Filter designed by two doctors:  https://twitter.com/marklewismd/status/1240850124273672197

'Cosplayers Unite!' Medical officials in Washington state solicit homemade face masks https://buff.ly/2UncW5n

100 Million Masks Project from Providence Hospital (kit with materials to make surgical masks provided)  https://buff.ly/2UCQDc7

Medications

GENERAL INFORMATION

Also see PROTOCOLS above for therapeutic algorithms from various institutions.

NEW (3/27/20): COVID-19 Related Medications |@ASHPOfficial  https://buff.ly/3bD2yNY

  • Great table of important articles on each medication used to treat COVID19

Drug Interactions with experimental COVID19 therapies https://buff.ly/2xM0JQ0

◆ Experiences from GiViTI COVID19 Meeting (10 March 2020) [doc no longer available]-

        Meeting recording (Italian): https://bit.ly/2QHWV8O 

Summary Infographic from Drs. Wilkinson and Lyness: https://buff.ly/2Qk9JlK 

  • Lopinavir / ritonavir (KALETRA) 200/50 mg x2cp BID (Ed note: NEJM article below shows no benefit to Kaletra)
  • Chloroquine 500 mg BID or hydroxychloroquine 200 mg BID
  • Antibiotic prophylaxis (variable depending on the center): pip / tazo, ceftriaxone, bactrim, antifungals ...(abandoned use of azithromycin)
  • Acetylcysteine 300 mg TID (not abundant secretions but, where present, very dense)
  • Steroids? Only in case of signs of fibrosis (not early).
  • Tocilizumab? IL-6 receptor inhibitor. Rationale given by the strong inflammatory picture MA utility to be evaluated in the light of a picture of lymphopenia. At the moment, NO routine indication and NO early use.

Twitter thread on use of drugs for #COVID19 

Hydroxychloroquine (Lupus, RA) Lopinavir/Ritonavir (HIV/AIDS) Remdisivir and Favipiravir (Ebola) and Camostat (Pancreatitis, Japan) are drugs that seem to have activity against SARSCov2 https://twitter.com/abledoc/status/1240148729317011458

Plasmapheresis and Convalescent Serum as treatment

◆ Mount Sinai in NYC to begin transfer of COVID-19 Antibodies into Critically Ill patients via Plasmapheresis https://buff.ly/3anehjd

If you would like to help, recently recovered COVID19 patients please email  COVIDSerumTesting@mountsinai.org

 (3/28/20) FDA approves use of convalescent plasma to treat critically ill Covid-19 patients https://buff.ly/3dxSWWt

Drug Repurposing:

CURE ID (sign up for free) https://bit.ly/33HgPWQ 

Allows providers to report novel uses of existing drugs to treat infectious diseases lacking adequate treatments as well as disseminate treatment information more quickly than traditional publications

Submit case reports

Coronavirus puts drug repurposing on the fast track (2/27/20) | @Nature https://buff.ly/2vE3CSl

Rx: Remdesivir, Chloroquine, Kaletra

See Table 1

Could an old malaria drug help fight the new coronavirus? https://buff.ly/3cGsBVJ

Both Chloroquine and the antiviral Remdesivir were, individually, “highly effective” at inhibiting replication of the novel coronavirus in cell culture.

Drug treatment options for patients admitted with COVID-19 https://buff.ly/2TPoKgj

Translate from Dutch to English

Datapunk | Covid2019/SARSCoV2 Antivirals tested https://buff.ly/2vukVFp

 Review of Potential Medications  for Novel Coronavirus (3/11/20): https://buff.ly/2wdsIHK

COVID19 Drug and Vaccine development:

  • (3/23/20) A SARS-CoV-2-Human Protein-Protein Interaction Map Reveals Drug Targets and Potential Drug-Repurposing To Treat COVID19 https://buff.ly/3a98s90

  • Updated guide to the coronavirus vaccines and drugs in development | @STAT (3/19/20) https://buff.ly/2vy7O5S
  •  A human monoclonal 1 antibody blocking SARS-CoV-2 infection. New study, not peer-reviewed (3/12/20) https://buff.ly/2TNVtUo

LOPINAVIR-RITONAVIR (KALETRA) STUDIES:

◆ NEJM (3/18/20): A Trial of Lopinavir-Ritonavir (Kaletra) in Adults Hospitalized with Severe COVID-19 https://buff.ly/3dk5Ua1

No benefit was observed with Lopinavir-Ritonavir (Kaletra) treatment beyond standard care.

◆JAMA: Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore https://buff.ly/38r55IX

        Kaletra (Lopinavir-Ritonavir)

◆PulmCrit – Preview of Lopinavir/Ritonavir efficacy in COVID-19:

https://emcrit.org/pulmcrit/lopinavir/

ANTICOAGULANTS 

◆ NEW (3/31/20) Prophylactic anticoagulation and COVID-19 https://bit.ly/3aKDswB

  • In patients at high risk for thrombosis, prophylactic anticoagulation with LMWH is associated with better prognosis

NEW (3/26/20) COVID-19: Abnormal clotting common in more severe disease per Chinese doctors https://buff.ly/2Uzwsf0

  • They recommend anticoagulation if high D-Dimer.
  • Cardiac effects of virus also discussed.

◆ Beverly Hunt will post weekly updates on this Twitter thread re: anticoagulation in COVID19 https://twitter.com/bhwords/status/1242907152764801026

Steroids

◆ Emory: COVID-19 Immune Response and Steroids:

https://twitter.com/HanCardiomd/status/1245369075280175104/photo/1

ACE-INHIBITORS/ARB DEBATE:

IBUPROFEN/ NSAIDS:

UPDATED  (3/19/20): WHO does not recommend against the use of ibuprofen for COVID-19 Symptoms https://buff.ly/2IZ3u2B

  • COVID-19 : l’ANSM prend des mesures pour favoriser le bon usage du paracétamol (en francais) https://buff.ly/2U9g9oY
  • UK experts discuss the French Health Minister recommended use of paracetamol for fever from COVID-19 rather than ibuprofen or cortisone | Science Media Centre https://buff.ly/2TVB9AB

For SARS I, ibuprofen but not acetaminophen was shown to exacerbate pneumonia in their discussion.

  • Non-steroidal Anti-inflammatory Drugs may Worsen the Course of Community-Acquired Pneumonia: A Cohort Study (2017) - PubMed - NCBI https://buff.ly/2WlktEj
  • Thanks Loren Looger!

RESEARCH:

Clinical Trials.gov database: all listed COVID-19 trials https://bit.ly/2xEqSQs

Trials for Remdesivir

Gilead Trials

Expanded Access to Remdesivir: Limited to pregnant women and children https://bit.ly/2URrp9K 

Hydroxychloroquine trial for exposed healthcare workers: http://trialcovid.com/ 

COVID-19 Diagnostic Tests

🔸 In patients at high risk for COVID19 infection, chest CT evidence of viral pneumonia may precede positive RT-PCR test results. Don’t rely on PCR swab results if the patient has symptoms and CT findings consistent with COVID19! https://buff.ly/2U1jlmG

 

(3/27/20) Abbott launches new test that can detect COVID-19 in as little as 5 minutes https://buff.ly/2WMJTuM

◆WHO: National laboratory testing https://buff.ly/2TFKrkg

◆NHS PHE UK: Guidance for sampling and for diagnostic laboratories https://buff.ly/2Q4uhOV

◆CDC: https://bit.ly/2QUoqw2 

MGH: How to collect Coronavirus NP and OP Swab (video) https://buff.ly/3375Upe

◆UW: 1a - Sample Collection for COVID19 Testing_Nasopharyngeal 3/8/2020

◆ U.S. swab testing capacity (March 11, 2020): https://twitter.com/ScottGottliebMD/status/1237745451174105094

University of Washington https://twitter.com/UWVirology/status/1235675168074129408

◆Stanford- rapid test. Now in drive through clinic https://buff.ly/2TROQ3p

◆LabCorp- takes 3-4 days. Doctor’s office only.

◆Quest Diagnostics https://www.questdiagnostics.com/home/Covid-19/

◆Home Testing  

Everlywell.com to start shipping out home Coronavirus (COVID-19) tests on Monday March 23, 2020 https://buff.ly/3dbktwG

$135. Takes 3 days for results once you send in the kit.
Update 3/24/20: Everlywell not sending kits to individuals yet - prioritizing healthcare organizations first

3/24/20 There may be a new 10 minute test for COVID-19 IgM/IgG antibodies from Sugentech according to this reporter: https://twitter.com/vaitor/status/1241337295606657033

  • It’s impossible to get on the Sugentech website right now because of all of the web traffic but this is what it is purported to say:

SGTi-flex COVID-19 IgM/IgG is a gold nanoparticle-based immunochromatographic test kit for qualitative determination of COVID-19’s IgM and IgG antibodies in human whole blood (finger prick or venous), serum or plasma. The kits are accurate and easy to use and results can be observed with the naked eye within 10 minutes.”

Eric Feigl-Ding in NPR article  https://buff.ly/33gnwiB 

      Testing capacity depends on:

  • Get enough test kits
  • Invest in HC infrastructure- CLIA labs, lab hardware, technicians
  • Logistics of moving goods and providing services
  • Information technology- for supply chain, for data

Medical Specialties Specific

Anaesthesia : 

Emergency Department:

Hospitalist:

ENT Otolaryngology

Nephrology:

Pediatrics: 

Neonatal Protocols, see below

Obstetrics: 

Findings suggest NO evidence for intrauterine infections or vertical transmission in women w/COVID-19 pneumonia in late pregnancy.

Scroll to end of article to see Protocols for Obstetrics Units in “Figures”

New coronavirus leaves pregnant women with wrenching choices—but little data to guide them https://buff.ly/2QSKjMe

Obstetric Anesthesia

Neonatal Protocols from UW: https://covid-19.uwmedicine.org/Pages/default.aspx

Delivery Logistics Infant of a COVID Mother Who Admitted to NICU 2020-03-19

Handling of breast milk from COVID-19 mothers_2020-03-12

Newborn Nursery COVID Guideline Update 2020-03-20

Newborn Nursery COVID-19 Talking Points 2020-03-20

Performing sterile procedures in an infant with COVID-19_2020-03-13

UWMC NICU Visitor Restrictions 2020-03-20

◆  Immunocompromised Patients 

Rheumatology

◆  Diabetes: 

Cardiology:

  • NEW (3/26/20) COVID-19: Abnormal clotting common in more severe disease per Chinese doctors https://buff.ly/2Uzwsf0

They recommend anticoagulation if high D-Dimer.

Cardiac effects of virus also discussed.

◆  Gastroenterology:

        Virus found in fecal sample for up to 47 days

◆  Cancer: 

  • Scroll to bottom of spreadsheet to see questions for cancer type

◆  Ophthalmology 

Dr. Glaucomflecken: https://twitter.com/DGlaucomflecken/status/1240480768410845184

AAO.org (3/12//20): https://buff.ly/2TR2Lab

        COVID19 is contagious through conjunctivitis.

  • Several reports suggest the virus can cause conjunctivitis and possibly be transmitted by aerosol contact with conjunctiva.
  • Patients who present to ophthalmologists for conjunctivitis who also have fever and respiratory symptoms including cough and shortness of breath could represent cases of COVID-19.
  • PPE: The Academy and federal officials recommend protection for the mouth, nose and eyes when caring for patients potentially infected with SARS-CoV-2.

◆  Psychiatry:

◆  Urology:

◆  Geriatrics and Nursing Homes:

◆  Substance Use Disorder:

“SAMHSA will consider approving COVID -19 exceptions to permit dispensing of take- home opioid pharmacotherapy for up to 14 days for those with exposure to COVID-19 or symptomatic for infection when documented by the patient’s healthcare provider.”

◆  Surgery:

In laparoscopy, release of CO2 may release virus. Use filters.

◆  Burn Unit:

◆  Non-Coronavirus Patients:

  Medical Ethics

  •  Medical Ethics Guidelines from SAMW (Swiss) Intensive Care Medicine:

  Communication/Code Status/ POLST

  Discharge Planning

Telemedicine

Telehealth changes: Medicare expands visits to the home; Non-encrypted software is allowed

◆ HHS.gov (3/17/20): Telehealth remote communications no longer have to use HIPAA compliant platforms https://buff.ly/2Wmhk72

Health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth.

Public facing apps like Facebook Live, Twitch, TikTok, and similar video communication applications should not be used in telehealth by covered health care providers.

◆ CMA: US President suspends HIPAA penalties to facilitate telehealth, effective immediately https://buff.ly/3916XbN

AMA quick guide to telemedicine in practice https://buff.ly/38XKP1T

  • CMS has issued the following waiver for Medicare patients: Temporarily waive requirements that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state.
  • Medicaid waivers must be requested by the individual state that wants to use them.

HHS Discretion for telehealth remote communications: https://buff.ly/2Wmhk72

Medicare Telemedicine Health Care Provider Sheet | CMS https://buff.ly/2Qq27yh

BMJ: Covid-19: Remote (Telemedicine) Assessment in Primary Care (3/25/20)  https://buff.ly/2UiE2M3 

        Great infographic

Telemedicine EPIC smartphrase note from Sade Khorami, NP: https://buff.ly/38TxDLx

◆ ACP: Telehealth Coding and Billing Practice Management Tips https://buff.ly/2U5Zzrh

Bright.MD: Pt fills in questionnaire online. App uses CDC guidelines and AI for care automation technology. Patient’s own doctor responds and treats patient all online. https://www.bright.md/

◆ Cambridge Health Alliance: Sample workflow for how to rapidly change from in person visits to televisits https://buff.ly/3avXs61 

Some COVID19 Telehealth options

Journal Articles


Journal Collections

Collections of articles and other resources, often includes clinical reports, management guidelines, commentary, videos, and other content.

NEJM: https://buff.ly/33ptfCI

The Lancet: https://bit.ly/2xi6Rz1

◆JAMA:  https://bit.ly/3adWBXu 

◆BMJ: https://bit.ly/2U59a1y

Annals of Internal Medicine:  https://bit.ly/2U9wmfa   

◆Dynamed: https://bit.ly/396oVcU 

◆American College of Physicians:https://bit.ly/2QABhDL

◆Elsevier Information Center: https://bit.ly/39ie3Zm 

NEW 4/1/20: US CDC collection of journal articles: https://bit.ly/343mMNZ 

 Collection of best COVID19 journal articles selected by Sachin Shah of UCSF https://buff.ly/2QKfysK

Topics in Critical Care/ Anesthesia, Epidemiology, ID, PPE, Peds, Ethics, Radiology

Chest CT for Typical 2019-nCoV Pneumonia: Relationship to Negative RT-PCR Testing | Radiology https://buff.ly/2U1jlmG

Care for Critically Ill Patients With COVID-19 | @JAMA March 11,2020 https://buff.ly/33bP48F

◆WHO database of latest scientific finds and knowledge on COVID-19, compiled from daily searches of bibliographic databases: Global research on coronavirus disease (COVID-19)

 A human monoclonal 1 antibody blocking SARS-CoV-2 infection. New study, not peer-reviewed (3/12/20) https://buff.ly/2TNVtUo

 WHO declares Global Emergency: Review of the 2019 novel coronavirus (COVID-19) | Int J Surg (April 2020 issue) https://buff.ly/33jTb2x

 Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19 | Nature (3/16/20)  https://buff.ly/2TSmWED

Analysis of 25,000 Lab-Confirmed COVID-19 Cases in Wuhan: Epidemiological Characteristics and Non-Pharmaceutical Intervention Effects  https://buff.ly/2UpcH9J

Twitter thread summarizing findings: https://twitter.com/CatchTheBaby/status/1241203480053735424


Allen Institute for AI: COVID-19 Open Research Dataset (CORD-19)
https://pages.semanticscholar.org/coronavirus-research 

Helpful Tips & Testimonials

🔸 GiViTI COVID19 Meeting document (10 March 2020) 

◆Great related infographic by M. Velia Antonini : Tweet

Very helpful summary of all that is COVID19 infection including lab values, medications used, lab findings and clinical course:

For Doctors and Clinical People on COVID19 by Dr. Jordan Shlain https://buff.ly/2wOUKtl

NEW (4/1/20) Society for Hospital Medicine Pacific Northwest Chapter Webinar on COVID-19 [Slide Deck]: https://bit.ly/3dNzpkU 

Preparing for COVID-19 - Msg from ESICM President & colleagues https://buff.ly/2TF0Khb

ESICM COVID-19 March 9th Webinar with Prof Yaseen Arabi  https://buff.ly/2W5cj2T

◆WHO database of latest scientific finds and knowledge on COVID-19, compiled from daily searches of bibliographic databases: Global research on coronavirus disease (COVID-19)

◆What ER doctors want (Twitter thread:  https://twitter.com/grahamwalker/status/1238150836242370560

Helpful Info for Patients

◆ SF Public Health: Stay home, wash hands https://buff.ly/337Li02

◆ Flatten the Curve: https://buff.ly/3aN0SAK

◆ Wash your hands lyrics generator: https://washyourlyrics.com/

◆ Can I Kiss My Dog and Other Patient Questions | Dr. Lustbader https://buff.ly/33v0a92

◆ BMC: Great visual info for patients, low literacy poster https://twitter.com/EpiEllie/status/1238824669404368902

Poster translated into multiple languages. Download here: https://github.com/eleanormurray/COVID_19

Patient Info in Multiple languages:

King County (Seattle) COVID19 recommendations https://buff.ly/2RvZOdX

NHS simple patient advice in many languages:

https://drive.google.com/drive/folders/193qQN9l04Dvf0N9L5zeWTiXK_DRbrAxg

◆ BMC: Great visual info for patients, low literacy poster translated into multiple languages. Download here: https://github.com/eleanormurray/COVID_19

NEW (4/1/20) Patient Fact Sheets in 30+ Languages.  COVID-19 Health Literacy Project in association with Harvard Health https://covid19healthliteracyproject.com/

CDC: Checklist for Elderly at home https://buff.ly/2UaVmCL

◆ NHS: Advice for patients with Diabetes: https://www.diabetes.org.uk/about_us/news/coronavirus

Kidney Care UK: Guidance for patients with Kidney Disease https://buff.ly/3bpdxdL

Patient information/discharge handouts:

◆ BJC discharge instructions: Home isolation for patients with mild COVID19 infection

◆ CDC: What to do if you are sick with Coronavirus COVID19 https://buff.ly/2TENRCu

CDC: 10 things to manage your health at home

If you know of anyone in the UK who is currently lonely and would appreciate a friendly letter in the post, I’d really like to help. http://lettersinneed.com

◆US: Free Advance Directive Forms by State from AARP https://buff.ly/2KpXRJC

Medical Blogs on COVID19

🔸 The Internet Book of Critical Care, an online textbook by Josh Farkas (@PulmCrit) https://emcrit.org/ibcc/COVID19/

Sanford Guide: COVID-19 https://buff.ly/2w2nezt

CriticalCareNorthampton.com https://buff.ly/2TYTkEg

◆ TheAnaesthesia.blog https://buff.ly/3cN5Pvb

◆ Propofology.com https://buff.ly/39IhsSe 

Support for Healthcare workers well-being

NEW (4/2/20) Physician support line https://doxy.me/physiciansupportline

  • Free confidential peer support for US doctors by volunteer psychiatrists during COVID19 pandemic
  • 8am to 12am EDT, 7 days a week

GREAT LIST: Resources About Healthcare Worker Wellbeing During COVID-19 https://buff.ly/3a7r4Gk

Annals of Internal Medicine - Supporting Clinicians during the COVID-19 Pandemic https://bit.ly/2WEfnmM

Mayo Clinic “Buddy System” for Internal Medicine Residents https://twitter.com/AmyOxentenkoMD/status/1243896091130511362

NEW (3/30/20) Free DAILY online mindfulness and compassion sessions from Center for Mindfulness and Compassion (Cambridge Health Alliance/Harvard Medical School teaching hospital). https://www.chacmc.org/connect

  • For healthcare workers but also sessions for general public
  • Also has Portuguese and Spanish sessions

◆ NEW (3/26/20): FACS: Assistance and Well-Being of Healthcare Workers https://buff.ly/2WKbkoQ

        Very helpful suggestions for physicians and for hospital administration

◆ NEW (3/26/20): Airbnb will provide housing for 100,000 COVID-19 responders around the world https://buff.ly/2WJ5Yuc

All housing will be free or subsidized for healthcare providers, relief workers, and first responders.

Health Workers: While You Combat COVID-19, We Support You | Supportiv https://buff.ly/2W8UGiA

        Peer-support chat for HC workers to vent about what is going on

Philadelphia medical students organize to provide childcare for healthcare workers’ children https://buff.ly/2xEJGiO

        Medical students also doing this at Yale, Northwestern, UCSF, Stanford, etc.

SweetGreen to deliver free salads and bowls to hospital workers: https://buff.ly/2Uh3QHk

(3/27/20): Krispy Kreme to give out free dozens of Original Glazed donuts to healthcare workers (with hospital badge) on Mondays through May 12 https://bit.ly/2QOU7qw 

Intensive Care Society: Staff wellbeing and self-care posters https://bit.ly/2W8QXBK

COVID-19 Women Physicians’ Emotional Well-Being Facebook group (@PoojaLakshmin): https://www.facebook.com/groups/235295047624227/

Headspace App: Free subscription Headspace Plus for US & NHS healthcare professionals. Enroll using your NPI. https://www.headspace.com/health-covid-19

◆ President Obama’s tweet 3.17.20: https://twitter.com/BarackObama/status/1239957076211834881

Managing Healthcare Workers' Stress Associated with the COVID-19 Virus Outbreak - PTSD https://buff.ly/3d7w4Nf

 (3/24/20): FREE ONLINE RESOURCES FOR CLINICIANS OR PATIENTS

◆(3/24/20) Yale's most popular class ever is available free online “The Science of Wellbeing”  — and the topic is how to be happier in your daily life https://buff.ly/2QW9mhN 

Money for Medical Research on COVID19

◆ US: NSF https://www.nsf.gov/publications/pub_summ.jsp?ods_key=pappg or email rapid-covid19@nsf.gov

◆ Gates Foundation: Announcing the COVID-19 Therapeutics Accelerator https://buff.ly/3cKTk3l

◆ Submit treatment ideas to CDC via BARDA: https://buff.ly/2W0HtZ9

 American Heart Association (AHA) Rapid Response Grant: COVID-19 and its Cardiovascular Impact https://buff.ly/2UhtA7o  (proposal due April 6)

Medical Equipment Hacks

NEW (3/27/20): Joint Statement on Multiple Patients per Ventilator (from multiple societies including SCCM, CHEST, ASA)  http://bit.ly/3dxymFE 

Takeaway: don’t do it.

  • NEW (3/29/20) PulmCrit:  Why the SCCM/AARC/ASA/APSF/AACN/CHEST joint statement on split ventilators is wrong. https://buff.ly/3dIyiCY

Converting Operating Rooms' equipment & staff to ICU Ventilators & staff by Adam Schlifke, MD, MBA A Call to Action and Guide: Converting Operating Rooms to ICUs in the United States ( http://tinyurl.com/moreVents )

Nursing Hack: To save on PPE, move iv pumps outside the rooms to the hallway and run tubing extensions to the patients. https://www.facebook.com/groups/opensourcecovid19medicalsupplies/permalink/678144116329317/

JAMA (3/20/20): Conserving Supply of Personal Protective Equipment—A Call for Ideas https://buff.ly/2vG6Ogf

NEW 4/3/20 Medtronic makes their PB560 ventilator open-source 

The following links have not been vetted yet but may be of use in low resource and crisis settings:

NEW 4/3/20 Auburn design adapts CPAP machines into emergency ventilators

Open source document on Reuse and Disinfection of PPE 

Use of Non-Invasive Ventilators (eg BiPAP) in invasive ventilation 

FACE MASK HACKS

◆NEW (3/21/20) How to make a reuseable respirator as a replacement for N95 mask | Boston Children's Hospital https://buff.ly/2UtH8LU

◆ Reusable Full-Face Snorkel Mask PPE Project | Stanford Prakash Lab https://buff.ly/2QIo0Jn

Face Mask Sewing Pattern with insertable filter | Craft Passion  https://buff.ly/393RHKU

        Not tested

Face Mask Sewing Pattern with Insertable Filter designed by two doctors:  https://twitter.com/marklewismd/status/1240850124273672197

'Cosplayers Unite!' Medical officials in Washington state solicit homemade face masks https://buff.ly/2UncW5n

100 Million Masks Project from Providence Hospital (kit with materials to make surgical masks provided)  https://buff.ly/2UCQDc7

COVID19 Databases

COVID19 datasets on:

S. Korea: https://buff.ly/2QbgVQW

Italy:  https://buff.ly/338zIBO

U.S. spread: https://buff.ly/3aR8VfV

Harvard Dataverse: https://buff.ly/2vmszBA

Our World in Data: https://ourworldindata.org/coronavirus

WHO: Database of publications updated daily https://buff.ly/388a01l

COVID-19 Open Research Dataset (CORD-19) by Allen Institute for AI https://buff.ly/38QLAtn

>29,000 scholarly articles,  >13,000 with full text, about COVID-19 and the coronavirus family of viruses for use by the global research community

COVID19 Radiology databases of patient chest X-ray and CT scans:

Clinicaltrials.gov Database on Coronavirus trials: https://bit.ly/2UA08ss 

The COVID-19 Testing Tracking Project https://buff.ly/3da0r5M

Humor to lighten the mood

Ben Phillips on Twitter: "❤️❤️❤️ To beat #Covid19, listen to this Italian grandma.… "

◆ Tom Hanks https://twitter.com/BetootaAdvocate/status/1238013005624819718

◆ Quarantine day 6 https://twitter.com/gnuman1979/status/1239523796542992387

◆ Quarantine day 69 https://twitter.com/PadmaLakshmi/status/1239985294897745922

Dr. Glaucomflecken: https://twitter.com/DGlaucomflecken/status/1240480768410845184

◆ Wash your hands lyrics generator: https://washyourlyrics.com/

https://twitter.com/CatchTheBaby/status/1238652535193337856

https://twitter.com/YoYo_Ma/status/1238572657278431234

◆ Leo AR app to entertain while in quarantine https://leoapp.com/website

https://twitter.com/BrennanSpiegel/status/1239972097985662978

https://www.youtube.com/watch?v=nSXIetP5iak

https://twitter.com/Bumble6671/status/1240734289425301506

https://twitter.com/YoniFreedhoff/status/1240990471675154432

🔸I Will Survive (dance video) https://twitter.com/ghost_wales/status/1242467534059626497

🔸“One Day More” video https://twitter.com/BBCBreakfast/status/1244990078952321028

Coronavirus Dank Meme Stash

🔗 https://www.facebook.com/groups/coronavirus.memes