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CME: The changing landscape of acute COVID‑19 treatment

Activity Description / Statement of Need:

In this online, self-learning activity:

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has upended life as humankind knows it, leading to over 668 million cases and more than 6.7 million deaths worldwide at the time of this writing. SARS-CoV-2 invades the nasal epithelium and lungs, leading to a variety of clinical presentations and outcomes during the acute infectious process, including asymptomatic disease; milder symptoms such as fever, cough, abdominal pain, anosmia, and ageusia; and, in severe cases, hypoxemia, acute respiratory stress disease, and death. Complications are not limited to the respiratory tract and may present as multi-organ involvement varying from acute cardiac injury, coagulopathies, and multisystem inflammatory syndrome. Some survivors of the disease must also grapple with post-COVID conditions (or “long COVID”), which can include a constellation of manifestations, such as fatigue and impaired cognitive function, and impair patient quality of life.

Target Audience:

HCPs including: hospitalists and other primary care physicians, infectious disease physicians, pulmonologists, and critical care physicians; physician assistants, nurse practitioners, and pharmacists in those areas of specialty; and any other healthcare professionals with an interest in or who clinically encounter patients with acute COVID-19 infection.


Commercial Support Disclosure: This program is supported by an educational grant from Gilead.

This activity is free of charge.


Release Date: June 07, 2023 -- Expiration Date: June 07, 2024

Faculty: Michael Niederman, M.D., MACP, FCCP, FCCM, FERS

Agenda

Faculty introduction and disclosures

Overview of Acute COVID‑19

· Brief primer on SARS CoV-2 

o    Shifting viral antigenicity

o    Effects of variants and subvariants on therapeutic options

o    Barrier to resistance for small molecules vs monoclonal antibodies

· COVID‑19 diagnosis and risk assessment 

o  CDC testing recommendations

- Advantages and disadvantages of at-home tests

o  Assessing disease severity

o  Risk factors for progression to severe disease, including hospitalization and death

Acute COVID-19 Treatment

· NIH recommendations for COVID‑19 clinical management

o    Symptomatic management

o    Treatment for nonhospitalized patients

o    Treatment for hospitalized patients

o    Determining appropriate treatment setting

o    Patient counseling

-  CDC isolation recommendations

-  Symptoms to monitor

-  Promoting uptake and adherence to antivirals

· Drugs for nonhospitalized patients

o    Shift from monoclonal antibodies to small molecules

o    Ritonavir-boosted nirmatrelvir

o    Remdesivir

o    Molnupiravir

o    Considerations for prescribing

-  Patient age and health status

-  Comorbidities

-  Polypharmacy and drug-drug interactions

-  Pregnancy

-  Time since COVID‑19 infection

-  Reproductive status and intentions

o    Emerging treatments

· Drugs for hospitalized patients

o    Antivirals

o    Immunomodulatory agents

o    Supportive care, including antithrombotics

o    Emerging treatments

· Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Explain the shifting virology of SARS-CoV-2 and its impact  on COVID19 treatment options.
  • Identify optimal treatment approaches for patients with COVID19 according to disease severity and risk factors, for inpatients and outpatients. 
  • Develop a treatment plan for a patient with mild or moderate COVID19 based on patient factors, comorbidities, and concomitant medications.
  • Review approved, authorized, and investigational treatment options for eligible hospitalized and non-hospitalized patients with COVID19.

Accreditation

ACCME Activity #202523147

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.25 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.25 contact hours (0.125 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-23-021-H01-P. This is an Application (A)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosures of Faculty: Michael S. Niederman, MD, Professor of Clinical Medicine, Weill Cornell Medical College, has received financial compensation for consulting work from: Gilead, Abbvie, Dompe, Merck, Shionogi and Pfizer.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty WILL discuss off-label uses of a commercial product.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Gilead.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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