Latest research on Coronavirus
Coronavirus, also known as COVID-19, has gripped the world since it was first discovered in Wuhan China in December, 2019. There has been significant amount of research that is being done on this very important topic and more being published or announced almost on a daily basis. In this page, we will summarize all the research studies organized by the role the study plays in our understanding of the disease, pathophysiology, prevention, vaccine, treatment and or cure.
Vaccine development research
Many companies are currently working on a vaccine although it may take up to 18 months before it might complete all research and be available for clinical use.
LATEST COMBINATION OF DRUGS FOR SARS-COV-2 (COVID-19): A COMBINATION OF DRUGS - CHLOROQUINE 200 MG THREE TIMES A DAY ALONG WITH AZITHROMYCIN 500 MG FOLLOWED BY 250 MG FOR 4 DAYS HAS BEEN USED IN A SMALL STUDY IN FRANCE WITH THE FOLLOWING PROMISING RESULTS. NEW
SUMMARY OF RESULTS - FRENCH STUDY ON CHLOROQUINE AND AZITHROMYCIN
- 14 Patients with COVID-19 given Hydroxyhloroquine (57.1% cured)
- 6 patients given combination of Hydroxychloroquine and Azithromycin (100% cured)
- 16 patients given neither of the above for 4 days (12.5% cured)
Link to the French Study - Chloroquine and Azithromycin
Drug re-purposing research
There are many drugs that are previously used in other purposes that are being considered for prevention, and treatment of COVID-19 including the following. Although there are no US FDA-approved drugs specifically for the treatment of patients with COVID-19, many drugs approved for other indications as well as several investigational drugs are being studied in several hundred clinical trials that are underway around the world.
Remdesivir is an investigational intravenous drug with broad antiviral activity that inhibits viral replication through premature termination of RNA transcription and has in-vitro activity against SARS-CoV-2 and in-vitro and in-vivo activity against related betacoronaviruses [1-3].
There are currently four options for obtaining remdesivir for treatment of hospitalized patients with COVID-19 and pneumonia in the United States:
- A National Institutes of Health (NIH)-sponsored adaptive double-blinded, placebo-controlled trial of remdesivir versus placebo in COVID-19 patients with pneumonia and hypoxia is enrolling non-pregnant persons aged 18 years and older with oxygen saturation of ≤94% on room air or requiring supplemental oxygen or mechanical ventilation (https://clinicaltrials.gov/ct2/show/NCT04280705 Clinical trials). Exclusion criteria include alanine aminotransaminase or aspartate aminotransaminase levels >5 times the upper limit of normal, stage 4 severe chronic kidney disease or a requirement for dialysis (i.e., estimated glomerular filtration rate (eGFR) <30);
- Two phase 3 randomized open-label trials of remdesivir (5-days versus 10-days versus standard of care) are open to enrollment in persons aged 18 years and older with COVID-19, radiographic evidence of pneumonia and oxygen saturation of ≤94% on room air (severe disease https://clinicaltrials.gov/ct2/show/NCT04292899external icon) or >94% on room air (moderate disease [https://clinicaltrials.gov/ct2/show/NCT04292730 https://clinicaltrials.gov/ct2/show/NCT04292730 Clinical trials). Exclusion criteria include alanine aminotransaminase or aspartate aminotransaminase levels >5 times the upper limit of normal, participation in another clinical trial of an experimental treatment for COVID-19, requirement for mechanical ventilation, or creatinine clearance <50 mL/min; and
- Finally, in areas without clinical trials, COVID-19 patients in the United States and other countries have been treated with remdesivir on an uncontrolled compassionate use basis. While clinical trials are critical to establish the safety and efficacy of this drug, clinicians without access to a clinical trial may request remdesivir for compassionate use through the manufacturer for patients with clinical pneumonia.
Hydroxychloroquine and Chloroquine
Hydroxychloroquine and chloroquine are oral prescription drugs that have been used for treatment of malaria and certain inflammatory conditions. Chloroquine has been used for malaria treatment and chemoprophylaxis, and hydroxychloroquine is used for treatment of rheumatoid arthritis, systemic lupus erythematosus and porphyria cutanea tarda. Both drugs have in-vitro activity against SARS-CoV, SARS-CoV-2, and other coronaviruses, with hydroxychloroquine having relatively higher potency against SARS-CoV-2 [1,4,5]. A study in China reported that chloroquine treatment of COVID-19 patients had clinical and virologic benefit versus a comparison group, and chloroquine was added as a recommended antiviral for treatment of COVID-19 in China . Based upon limited in-vitro and anecdotal data, chloroquine or hydroxychloroquine are currently recommended for treatment of hospitalized COVID-19 patients in several countries. Both chloroquine and hydroxychloroquine have known safety profiles with the main concerns being cardiotoxicity (prolonged QT syndrome) with prolonged use in patients with hepatic or renal dysfunction and immunosuppression but have been reportedly well-tolerated in COVID-19 patients.
Hydroxychloroquine is preferred
Due to higher in-vitro activity against SARS-CoV-2 and its wider availability in the United States compared with chloroquine, hydroxychloroquine has been administered to hospitalized COVID-19 patients on an uncontrolled basis in multiple countries, including in the United States. One small study reported that hydroxychloroquine alone or in combination with azithromycin reduced detection of SARS-CoV-2 RNA in upper respiratory tract specimens compared with a non-randomized control group but did not assess clinical benefit . Hydroxychloroquine and azithromycin are associated with QT prolongation and caution is advised when considering these drugs in patients with chronic medical conditions (e.g. renal failure, hepatic disease) or who are receiving medications that might interact to cause arrythmias.
Pre and post exposure prophylaxis
Hydroxychloroquine is currently under investigation in clinical trials for pre-exposure or post-exposure prophylaxis of SARS-CoV-2 infection, and treatment of patients with mild, moderate, and severe COVID-19. In the United States, several clinical trials of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection are planned or will be enrolling soon. More information on trials can be found at: https://clinicaltrials.gov/ Clinical trials.
Other drugs being considered
Umifenovir has been recommended for COVID-19 treatment according to Chinese 7th edition guidelines
Drugs originally developed for SARS-coV-2 protect against future infections?
Although there were some initial reports of possible re-infection ever after one is infected with SARS-coV-2, according to a research study, getting infected does provide protection against future infections.
- APN01 (ACE2 protein decoy)
Some antibiotics that have been identified as potentially repurposable as COVID-19 Treatments
== Does getting infected with SARS-2-Co
Current protocols for treatment of COVID-19
This is a rapidly changing area as new research comes almost daily.
External resources on COVID-19 research
The Lancet COVID resource center
- COVID-19 and the liver: little cause for concern
- Coronavirus Disease 2019 (COVID-19): Emerging and Future Challenges for Dental and Oral Medicine
- Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment–Elevation Myocardial Infarction Care in Hong Kong, China
- Lancet COVID resource center
NIH on COVID-19
- New coronavirus stable for hours on surfaces (National Institute of Allergy and Infectious Diseases)
- NIH clinical trial of investigational vaccine for COVID-19 begins (National Institute of Allergy and Infectious Diseases)
- NIH clinical trial of remdesivir to treat COVID-19 begins (National Institute of Allergy and Infectious Diseases)
COVID-19 genome sequence
Work and COVID-19
- Guidance on preparing workplaces for Covid 19
- Preparing your clinic for Covid 19
- Preparing dialysis facilities for Covid 19
Telemedicine and COVID-19
Treatment of COVID-19
- INTERIM CLINICAL GUIDANCE FOR PATIENTS SUSPECTED OF/CONFIRMED WITH COVID-19 IN BELGIUM
- COVID-19 Drug Therapy – Potential Options
- COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission
- Care for Critically Ill Patients With COVID-19
- Corona viruses
- First known person-to-person transmission of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) in the USA
Facts and Myths
- Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome corona virus 2 (SARS-CoV-2): Facts and myths
- ACP: Telemedicine: A Practical Guide for Incorporation into your Practice
- CPT® releases new corona virus (COVID-19) code & description for testing
- 6 ways to prepare your medical practice for corona virus COVID-19:
- Corona virus SARS-CoV-2 disease COVID-19: Infection, prevention and clinical advances of the prospective chemical drug therapeutics
Post exposure prophylaxis
Medical Journal Articles
ACC Clinical Guidance and Practice
- ACC Clinical Bulletin
- CardioSmart patient summary
- Telehealth: Rapid Implementation For Your Cardiology Clinic
- HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19
- CardioSmart patient summary
- ACC Interventional Council, SCAI Address Cath Lab Considerations During COVID-19
- Troponin and BNP Use in COVID-19
- Is There a Role For Statin Therapy in Acute Viral Infections?
- Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the Coronavirus Disease 2019 (COVID-19) Pandemic NEW!
- COVID-19 Operational Considerations NEW
Clinical Perspectives and Front-Line Experience
- COVID-19 Provides Potent Reminder of the Risk of Infectious Agents
- Cardiologist's Insights From Treating COVID-19 Patients in China
- Chinese Clinical Guidance For COVID-19 Pneumonia Diagnosis and Treatment
- Coronavirus Fulminant Myocarditis Case ReviewNEW!
- Clinical Course and Risk Factors for Mortality of Inpatients With COVID-19NEW!
- Poll: COVID-19 and Interventional CardiologyNEW!
- Adopting Telemedicine During the COVID-19 Pandemic: A Return to Patient-Focused CareNEW!
- Coronaviruses and the Cardiovascular SystemNEW!
- The Novel Coronavirus Disease (COVID-19) Threat for Patients with Cardiovascular Disease and CancerNEW!
Case mortality - China and Italy compared
Latest dataset on COVID-19
Latest release contains papers up until 2020-03-27 with over 33,000 full text articles. (Changelog from previous release.)
- Commercial use subset (includes PMC content) -- 9315 full text (new: 210, removed: 13) 186Mb
- Non-commercial use subset (includes PMC content) -- 2350 full text (new: 6, removed: 9), 41Mb
- Custom license subset (includes PMC, Elsevier content) -- 20657 full text (new: 4218, removed: 520), 414Mb
- bioRxiv/medRxiv subset (pre-prints that are not peer reviewed) -- 1053 full text (new: 194, removed: 26), 15Mb
- Metadata file -- 67Mb (with Microsoft Academic ID mapping)
- CAS COVID-19 Anti-Viral Candidate Compounds (description - dataset provided by CAS, a division of the American Chemical Society)
Specialty specific COVID-19 recommendations
Latest COVID-19 research articles list
- COVID-19 articles (WHO)
- phttps://www.nejm.org/coronavirus NEJM]
- The lancet
- Cell Press
- CDC publications list