SSF - Grand Rounds 4/20/20 - Clinical Care of COVID-19 Patients

South San Francisco, CA US
April 20, 2020

Clinical Care of COVID-19 Patients

Our knowledge of COVID-19 is rapidly changing. In the past month, our hospital has taken care of many Covid-19 patients.  In this activity, our frontline physicians will give updates on the current practices for COVID-19 care and future therapeutics.

Cultural and Linguistic Competency:

There’s known racial disparity in those infected or at higher risk for infection with COVID-19. Patients who cannot socially distance or essential workers may be at higher risk for COVID-19 infection. 

References:

  1. https://www.massgeneral.org/assets/MGH/pdf/news/coronavirus/treatment-guidance-for-critically-ill-patients-with-COVID-19.pdf
  2. Gattinoni, L., Chiumello, D., Caironi, P. et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes?. Intensive Care Med (2020).
  3. Nishimura, Masaji. High-flow nasal cannula oxygen therapy in adults. Journal of Intensive Care (2015) 3:15
  4. Sun, Q., Qiu, H., Huang, M. et al. Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu Province. Ann. Intensive Care 10, 33 (2020).
  5. Guerin et al. Prone Positioning in Acute Respiratory Distress Syndrome. N Engl J Med 2013; 368:2159-2168
  6. Yang et al. Clinical course and outcomes of cirtically ill patients with CARS-CoV-2 pneumonia in Wuhan, ChinaL A single centered, retrospective, observational study. E-published 2/21/2020.  https://doi.org/10.1016/s2213-2600(20)30079-5
  7. Zhou et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395:1054-62 
  8. Intensive Care Med (2020). https://doi.org/10.1007/s00134-020-06022-5
  9. Bhatraju et al. Covid-19 in Critically Ill Patients in the sEattle Region – Case Series. E-published March 30. 2020. DOI: 10.1056/NEJMoa2004500
  10. Fox et al. Pulmonary and Cardiac Pathlogy in Covid-19: The First Autopsy Series from New Orleans. https://doi.org/10.1101/2020.04.06.20050575 From MedRxIV
  11. J Thromb Haemost. 2020 Mar 27.  doi: 10.1111/jth.14817. [Epub ahead of print]
  12. Thromb Res. 2020 Apr 10. pii: S0049-3848(20)30120-1. doi: 10.1016/j.thromres.2020.04.013. [Epub ahead of print
  13. https://www.hematology.org/covid-19/covid-19-and-vte-anticoagulation
  14. Journal of the American College of Cardiology March 2020 DOI: 10.1016/j.jacc.2020.03.031 
  15. Cao et al. A Trial of Lopinavir-Ritonavir in Adults hospitalized with Severe COVID-19 NEJM 2020 DOI: 10.1056/NEJMoa2001282
  16. Chorin Et al. The QT Interval in Patients with SARS-CoV-2 Infection Treated with Hydroxychloroquine/Azithromycin medRxiv 2020.04.02.20047050; doi: https://doi.org/10.1101/2020.04.02.20047050 
  17. Borba et al. Chloroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study) medRxiv 2020.04.07.20056424; doi: https://doi.org/10.1101/2020.04.07.20056424 
  18. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033–1034.
  19. Huang et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223);497-506.
  20. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;1–3
  21. Luo, P et al. Tocilizumab treatment in COVID-19: A single center experience.  J Medical Virology.  April 2020
  22. Xu, X et al.  Effective Treatment of Severe COVID-19 Patients with Tocilizumab. 2020 [ChinaXiv:202003.00026]
  23. Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet. 2020;395(10223):473–475
  24. Shang L, Zhao J, Hu Y, Du R, Cao B. On the use of corticosteroids for 2019-nCoV pneumonia. Lancet. 2020;395(10225):683–684.
  25. Zhou YH, et al. Effectiveness of glucocorticoid therapy in patients with severe novel coronavirus pneumonia: protocol of a randomized controlled trial Chin Med J (Engl). 2020;10.1097

*Box lunches will be available for pick up at the following locations between 11:30am-12:45pm:*
- Middle and Back Cafeteria, SSF
- Daisy/Daffodil, Daly City (12:00pm-12:30pm pickup)
- 3rd Floor Physical Therapy Conf Room, San Bruno
- 220 Oyster Point, SSF (Josie Garcia to distribute)
- 2001 Junipero Serra Blvd. Daly City (Aurora Gomez to distribute)
- 901 El Camino Real, San Bruno (Dr. Eva Liu’s Office)

Post Presentation Survey: Will be send out in a follow-up email 

 

Target Audience

All physicians, but most importantly primary care physicians.

 

Learning Objectives

As a result of this activity, participants should be able to:

  1. Apply risk stratification to COVID-29 patients to identify those who are at higher risk for complications.
  2. Discuss clinical management of COVID-19 patients.
  3. Review emerging therapies for treatment of COVID-19.

Additional Information

Location: 
Building: 
South San Francisco Medical Center
Conference room: 
Join Microsoft Teams Meeting +1 213-533-9530 United States, Los Angeles (Toll) Conference ID: 479 611 106#
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit(s)™
Course opens: 
04/20/2020
Course expires: 
04/30/2020
Event starts: 
04/20/2020 - 12:30pm PDT
Event ends: 
04/20/2020 - 1:30pm PDT
Add to calendar: 
Kaiser Permanente
1200 El Camino Real
MS TEAMS
South San Francisco, CA 94080
United States
+1 (650) 742-3074

 

Join Microsoft Teams Meeting

+1 213-533-9530   United States, Los Angeles (Toll)

Conference ID: 479 611 106#

Speaker(s):

Jamila Champsi, MD (ID) 
Dana Clutter, MD (ID)
Tomio Miyai, MD (Critical Care)
Archana Jayakumar, MD (Critical Care)
Doug Zuckermann, MD (Cardiology)
Yiyi Stephanie Gu, MD (Rheumatology)

 

Planning Committee:

  • Jie Zheng, MD, Chief of Medical Education
  • Archana Petkar, MD, CME DLC Grand Round Planner
  • Jennifer A Jones, MD, CME Grand Round Planner
  • Tenisha Jones, MLIS/Library Services
  • Agnes Lau, Sr. Quality Specialist

Kaiser Permanente South San Francisco has determined that the speakers, Dr. Jamila Champsi, Dr. Archana Jayakumar, Dr. Tomio Miyai, Dr. Douglas Zuckermann, Dr. Stephanie Gu and the planning committee, Dr. Jie Zheng, Dr. Jennifer Jones, Dr. Archana Petkar, Tenisha Jones and Agnes Lau, for this activity do not have any relevant financial relationships with commercial interests. 

Speaker Dr. Dana Clutter has disclosed that her husband works for Sutro Biopharma and receives salary and stocks.  The PowerPoint for this activity has been reviewed by the Chief of Education (COE), and the CME Department has determined that there is no bias and/or relevant conflict of interest with this CME activity.

Kaiser Permanente South San Francisco takes responsibility for the content, quality, and scientific integrity of this CME activity.

Kaiser Permanente does not endorse any brand-name products.

Disclosure link: 
2020 CME Disclosure Survey

Accreditation Statement:

Kaiser Permanente South San Francisco is accredited by the California Medical Association (CMA) to provide continuing medical education for physicians.

Credit Statement:

The Kaiser Permanente South San Francisco Medical Center designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses may report up to a maximum total of 1.0 AMA PRA Category 1 Credit(s)™ towards the Continuing Medical Education requirements for license renewal by the California Board of Registered Nurses.

ABIM MOC Recognition Statement:

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1 ABIM Medical Knowledge MOC credit
in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

FOR CME CREDIT: Scan the QR code and claim credit through the link provided or use the link sent with the flyer . A survey will be emailed to all who participate. Please complete the survey. The survey will be open for 10 days.

FOR Maintenance Of Certification (MOC) points: Complete the survey that is provided for this activity, there will be a link within the survey where you will need to provide us with specific information in order to meet the requirements to be awarded MOC points.

Available Credit

  • 1.00 AMA PRA Category 1 Credit(s)™
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