The Centers for Disease Control and Prevention (CDC) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in December 2019. The World Health Organization (WHO) characterized the COVID-19 outbreak as a pandemic on March 11, 2020.
Among hospitalized patients, research frequently reports that the signs and symptoms of COVID-19 include:
Some patients have experienced gastrointestinal symptoms, such as diarrhea and nausea, prior to developing fever and lower respiratory tract signs and symptoms.
The American College of Gastroenterology, in partnership with other gastroenterology (GI) organizations, has released a message sharing additional GI-related COVID-19 symptoms:
Reported cases have ranged from very mild, including some with no reported symptoms, to severe cases resulting in death. Those who are at a higher risk of developing serious COVID-19 symptoms include:
In addition to clinical symptoms, nurse practitioners (NPs) may want to consider whether:
The CDC is currently investigating reports of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. Clinicians who have cared or are caring for patients younger than 21 years of age meeting MIS-C criteria should report suspected cases to their local, state or territorial health department.
To keep patients with diabetes and health care providers protected from exposure, the FDA has released answers to frequently asked questions (FAQs) regarding patients' use of home-use glucose meters while hospitalized due to COVID-19.
This association offers two webinars on COVID-19 and its effects on people with autoimmune diseases. One is a nationwide dialogue with leading medical experts, and the second focuses on the impact of stress on autoimmune patients and coping strategies.
ACC's Science and Quality Committee summarized current data on the risk, potential need for hemostasis or coagulation testing, VTE prophylaxis and therapeutic anticoagulation in patients with COVID-19 without confirmed/suspected thrombosis in the form of a useful FAQs sheet.
In addition, a consensus statement from ACC, the Society for Cardiovascular Angiography and Interventions (SCAI) and the American College of Emergency Physicians (ACEP) outlines recommendations for a systematic approach for the care of patients with acute myocardial infarction (AMI) during the COVID-19 pandemic.
ADA has hosted a webinar series for health care providers and people with diabetes during the COVID-19 pandemic, ranging from the impact COVID-19 can have on youth with diabetes and families in quarantine to inpatient care questions.
The AHA has released a new Circulation journal article on the spectrum of cardiac manifestations in COVID-19. The study found that LV systolic function is preserved in the majority of patients, but LV diastolic and RV function are impaired.
The AHA is making adjustments to its quality improvement programs in response to COVID-19. Review how this may impact your facility.
ASMBS has released a webinar on keeping patients engaged and avoiding caregiver burnout and a webinar with considerations for restarting metabolic and bariatric surgery in the context of COVID-19. Both webinars also feature a family nurse practitioner (FNP) as a panelist.
Patients with addiction are a vulnerable population, facing multiple challenges during COVID-19. The ASAM Caring for Patients During the COVID-19 (CPDC) Task Force was started to provide the most up-to-date resources for clinicians regarding addiction medicine treatment.
Learn from diabetes experts from ADCES, who provide insight on topics like telehealth, coping with COVID-19, reducing risk and problem-solving, medication resources, misinformation and disease prevention.
Together with the American College of Sports Medicine®, EIM has created a tool kit of resources and support for keeping your patients active during the COVID-19 pandemic.
A new webinar series from NAM and the American Society of Addiction Medicine is designed to provide insight and targeted guidance for health care providers caring for individuals with substance use disorders.
Many of your patients are no doubt experiencing some level of depression or anxiety due to isolation and stress caused by COVID-19. The NCBH has developed resources to help you provide some comfort during this difficult time.
NORD has on-demand video and webinars, patient assistance programs and weekly state-focused virtual discussion groups, among other resources for vulnerable patient populations.
Neonatologists, obstetricians, midwives, social workers and others have developed comprehensive recommendations for pregnant individuals during the COVID-19 pandemic. The result, Recommendations of the New Jersey Perinatal Care During COVID-19 Work Group, is now being distributed throughout the state to guide clinicians, families and caregivers. The report will be regularly updated.
The Obesity Society has a number of articles available for free detailing the impact of COVID-19 upon patients with obesity. This includes how school closings may lead to the risk of increased weight gain in children, the impact upon bariatric surgery and more.
The ONS has released interim guidelines for the safe handling of hazardous cancer drugs in the context of personal protective equipment (PPE) shortages.
The CDC recommends health care providers should use their best judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. This includes:
The FDA has released a helpful video explaining the different tests currently available for COVID-19: diagnostic and antibody tests.
As of July 10, the FDA has authorized 173 tests under EUAs, which include 144 molecular tests, 27 antibody tests and two antigen tests. Additionally:
Before you set up or start working at an off-site COVID-19 testing center, review this infographic from the Network for Regional Healthcare Improvement and QUALIDIGM. It lists items you should consider, such as how to determine testing capacity, create a follow-up process for results and get reimbursed for testing.
The CDC currently recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain and especially within areas that are seeing significant community-based transmission.
All health care providers, including NPs, should take steps to prepare for COVID-19 in their practice as well as follow recommended infection control procedures to protect themselves and others:
CMS released guidance on reopening health care facilities to provide non-emergent, non-COVID-19 care. The first phase includes the continued use of telehealth-delivered care, facility considerations and PPE recommendations for clinicians and patients, among other information.
The American College of Gastroenterology, in partnership with other gastroenterology (GI) organizations, has released a message sharing additional guidelines for infection control in for clinicians and GI practices.
WHO has released guidelines offering advice on the use of masks in communities, during home care and in health care settings to prevent the spread of COVID-19.
Currently, COVID-19 transmission is thought to occur mostly from person to person via respiratory droplets among close contacts. If health care providers are in close contact with a patient confirmed to have COVID-19 while not wearing all recommended PPE, they may be at an increased risk of infection.
To limit this risk, health care providers should follow the CDC's recommendations for infection prevention and control:
As a public health reminder, the CDC encourages health care facilities and clinicians to prioritize urgent and emergency visits and procedures in order to preserve staff, personal protective equipment and patient care supplies; ensure staff and patient safety; and expand available hospital capacity during the COVID-19 pandemic.
The Action Collaborative on Clinician Well-Being and Resilience from the National Academy of Medicine (NAM) has released resources to support the health and well-being of clinicians during the COVID-19 pandemic, including roles and responsibilities, coping with traumatic events, managing stress and burnout and much more.
The FDA maintains lists of EUAs issued in response to COVID-19, which include tests and medical devices that serve to reduce patient and health care provider contact and exposure to COVID-19. In addition, the FDA offers information on PPE and other resources relevant to NPs, including:
OSHA has updated guidance and resources available on using, reusing and decontaminating filtering facepiece respirators. OSHA also has guidance protecting workers in nursing home and long-term care facilities.
WHO has expanded its Operational Planning Guidelines to Support Country Preparedness and Response to include new Operational Guidance for Maintaining Essential Health Services During an Outbreak.
Telehealth is suggested by the CDC as an alternative for in-office appointments, as triaging and assessing ill patients by telephone, text monitoring system, video conference or other telehealth methods can reduce the chance of exposure for staff members and minimize a surge on health care facilities.
AANP's COVID-19 Telehealth Updates include several Centers for Medicare and Medicaid (CMS) documents related to telehealth, as well as information on policies and legislation affecting telehealth-delivered care.
This partnership will develop a collaborative framework to prioritize vaccine and drug candidates, streamline clinical trials, coordinate regulatory processes and/or leverage assets among all involved partners to rapidly respond to the COVID-19 pandemic and future pandemics.
The NIH has released COVID-19 Treatment Guidelines, which will be frequently updated as more information on the disease becomes available.
On May 1, the FDA issued an EUA for the investigational antiviral drug remdesivir for the treatment of suspected or laboratory-confirmed COVID-19 in adults and children hospitalized with severe disease. On June 15, the FDA informed the public that the use of remdesivir and chloroquine phosphate or hydroxychloroquine sulfate is not recommended.
The FDA offers both a list of diagnostic tests and medical devices and a list of therapeutics that have been approved to treat COVID-19 under EUAs.
Convalescent plasma has the potential to lessen the severity or shorten the length of illness caused by COVID-19. The FDA is currently encouraging people who have fully recovered from COVID-19 for at least two weeks to contact their local blood or plasma collection center to schedule an appointment to donate plasma.
Guidelines on the treatment and management of COVID-19 are available from IDSA. The evidence-based guidelines were developed using the GRADE methodology and are frequently updated. A panel of infectious disease clinicians, pharmacists and methodologists with varied areas of expertise created the guidelines.
NCSBN has released a joint statement with the National Association of Boards of Pharmacy and the Federation of State Medical Boards on the inappropriate prescribing and stockpiling of medications, including chloroquine, hydroxychloroquine and azithromycin, to prevent or treat COVID-19 for themselves or their family members.
NEJM Group has a free, interactive clinical reasoning resource designed to help health care providers navigate the diagnosis and treatment of COVID-19. NEJM Group plans to maintain the free case simulations for a number of months.
The SCCM COVID-19 Rapid Resource Center contains information on medical nutrition therapy, unanticipated consequences of the pandemic and pediatric multisystem inflammatory syndrome. The educational resources are available in a variety of formats, including infographics, podcasts and journal articles.
A new funding opportunity is available through the National Institute on Minority Health and Disparity. Interested researchers can submit applications to the Community Interventions to Address the Consequences of the COVID-19 Pandemic for Health Disparity and Vulnerable Populations funding opportunity until July 2020.
Some health plans are offering clinicians and their primary care practices financial support. If you know of other health plans that are offering prospective or advance payments, please email the Primary Care Collaborative at Communications1@pcpcc.org.
AcademyHealth is supporting a new initiative that aims to build a COVID-19 Patient Data Registry Network. The goal of the network is to provide researchers, policymakers and clinicians with quality information on the impact and progression of COVID-19.
Additionally, the American Association for Public Opinion Research has released guidance for survey researchers and IRBs. The guidance covers risks and benefits for survey participants, informed consent, mandatory reporting and incentives.
The Annals of Internal Medicine journal has released an article titled "Collision of the COVID-19 and Addiction Epidemics," a free resource exploring how COVID-19 is impacting patients who smoke or use vaping devices, patients who have opioid use disorder and patients with other substance use disorders.
AAHRPP has issued guidance how to protect research participants and report any study changes to an Institutional Review Board (IRB). AAHRPP’s suggestions align with the Food and Drug Administration’s guidance on conducting clinical trials during the COVID-19 pandemic.
The Alliance is in the process of creating a secure, de-identified, international case reporting registry in order to help guide rheumatology clinicians in assessing and treating patients with rheumatologic disease and in evaluating the risk of infection in patients on immunosuppression.
EBSCO has created a COVID-19 Information Portal to support the immediate need for trusted health care information during the pandemic. This includes open access resources and research, clinical care information and data maps and visualizations.
The FDA has released guidance for industry, investigators and institutional review boards (IRBs) interested in conducting clinical trials of medical products during the COVID-19 public health emergency.
A collection of preprint journal articles and other resources related to COVID-19 are available from Health Affairs. Additionally, several published journal articles are available at no cost to the public.
IHI offers COVID-19 guidance and resources for health care providers, including a free weekly learning hour on COVID-19, a data dashboard on the trajectory of COVID-19 reported deaths and a daily call for health care providers working in nursing homes.
To assist researchers and clinicians, The Lancet has established a COVID-19 Resource Centre. Articles and podcasts on the effects of the virus on prisoners, misinformation and vaccine development are available for free.
To promote open access and share key information on COVID-19 research, medRxiv is preprinting research articles. The articles should not be used to guide clinical practice or health-related behavior since they have not yet been peer reviewed. They can, however, be used to start a dialogue on current and future COVID-19 research.
The National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH, has launched a COVID-19 Prevention Trials Network (COVPN) for vaccines, and other prevention tools, with the aim of enrolling in thousands of volunteers in large-scale clinical trials testing. Individuals can securely volunteer for studies on the NIH website.
A number of drugs are under investigation in clinical trials or are being considered for clinical trials to treat COVID-19.
The PCORI Healthcare Worker Exposure Response & Outcomes (HERO) Registry is a large, national clinical research community. It invites health care workers from across the U.S. to share clinical and life experiences to understand the perspectives and problems they face on the COVID-19 pandemic front lines. HERO Registry participants could have the opportunity to participate in future research studies to improve our understanding of COVID-19 and beyond, generating evidence to help keep healthcare workers safe and healthy. The first study, the HERO-HCQ Trial, will invite 15,000 health care workers from the registry to evaluate whether hydroxychloroquine can prevent COVID-19 infections.
Results from the Primary Care Collaborative and The Larry A. Green Center survey indicate that many clinicians do not have adequate testing capabilities and personal protective equipment. The results also reflect that lack of information on the prevalence of COVID-19 in the U.S.
Public opinion research on COVID-19 is being conducted all over the world. Reports from those studies have been collected by WAPOR from Gallup Pakistan, Kstat, Taiwan Public Opinion Foundation, Pew Research Center and other research institutes. The list is publicly available and still accepting research studies.
AANPCB, alongside a number of additional NP and nursing organizations and accrediting bodies, has released a statement regarding NP students and direct care clinical hours.
New guidelines are available from the American College Health Association on how to safely reopen college campuses. The guidelines are broad so that small and large institutions can easily modify them to fit their campuses.
Mumps is a viral infectious disease that historically was a common childhood illness. The mumps vaccine, first licensed in 1967, has successfully decreased the number of cases to the point that mumps is no longer a frequently encountered disease. Prior to the mumps vaccine program, approximately 186,000 cases of mumps were reported each year in the United States (U.S.). Even with the sporadic clusters of re-emergence, there has been a 99% decrease in the number of reported cases since the inception of the vaccination program. As of July 15, 2017, there have been 3,886 cases of mumps reported this year in 45 states, making it a clinically relevant, though not prevalent, illness. Although not a new illness, many health care providers may not have diagnosed or treated patients diagnosed with mumps. Here, we provide vital information to NPs, so they may adequately diagnose and treat mumps as well as remain vigilant in their surveillance of such an old virus that continues to infect individuals today.
The CDC estimates that there were 37,600 new HIV infections in 2014. Pre-exposure prophylaxis (PrEP) is a highly effective tool for the prevention of new HIV infections that was approved by the FDA in 2012. PrEP is largely under utilized by primary care providers. This clinical feature addresses provider barriers that impede prescribing PrEP to high-risk patients and provides a straightforward approach for NPs to offer PrEP in the primary care setting.
Meningococcal Vaccine Information Tent
To increase awareness of the MenB vaccine, AANP developed a colorful 7” x 5” trifold informational tent with a concise review of meningococcal disease, signs/symptoms, and prevention through MenACWY and MenBvaccines. This tent can be printed, folded, taped and placed in the waiting room or exam rooms where patients and parents of adolescents will read it to initiate questions and conversations about meningococcal disease prevention with their health care provider
Hepatitis C HALO Patient Tool
Download, print and distribute this self-care guide to your patients after they are cured to give them easy to reference answers to common questions and tips for keeping their liver healthy long-term.
There are many resources available for both patients and providers and we have listed some of them below for your convenience. Inclusion of these links does not imply AANP endorsement.