With special presenters from NYC Health + Hospitals. May 13, 2020

1. COVID-19
Clinical Presentations and Lessons
Learned from the Front Lines
May 13, 2020

2. CME Credit
• Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State
Medical Society to sponsor continuing medical education for physicians. The
Bridgeport Hospital Yale New Haven Health designates this live activity for a
maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only
credits commensurate with the extent of their participation in the various
activities.
• This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education
through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and
the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited
by the Connecticut State Medical Society to provide continuing medical education
for physicians.
• The content of this activity is not related to products or services of an ACCME-
defined commercial interest; therefore, no one in control of content has a relevant
financial relationship to disclose and there is no potential for conflicts of interest.

4. Objectives
- Update on epidemiology (SARS-CoV-2,
COVID-19)
- Review any good news?
- Continue team efforts to fight the virus

5. COVID-19 in the United States
1,367,491 cases on 5/12/20 – up from 1,203,673 cases last week (5/5/20) -
https://coronavirus.jhu.edu/map.html

6. Any good news?
• Remdesivir:
–Gilead to allow wide-spread generic
development
• Continuing the fight:
–10,000th COVID-19
discharge

8. Stay safe -- Stay up to date
• https://www.cdc.gov/coronavirus/2019-
ncov/index.html
https://emergency.cdc.gov/coca/calls/2020/
• https://www.who.int/emergencies/disea
ses/novel-coronavirus-2019
• https://covidactnow.org/
• https://coronavirus.jhu.edu/map.html

9. COVID-19:
Clinical Presentations and Lessons
Learned from the Front Lines
Joseph Masci, MD
Chairman of Global Health, Elmhurst Hospital Center
Professor of Medicine, Infectious Disease
&
Emma Kaplan-Lewis, MD
HIV Clinical Quality Director, NYC Health and Hospitals
Assistant Professor of Medicine, Infectious Disease

10. Outline
• Unexpected Findings
• Demographics of COVID-19 in NYC
• Indicators used to inform policy (ie.
Social distancing)
• Clinical takeaways

11. Unexpected Findings
• Pulmonary disease
• Renal disease
• Heart disease
• Liver disease
• Hypercoagulable
state
• Strokes
• Kawasaki-like
syndrome
• Changing strains of
the virus

12. NYC COVID-19 Cases- as of 5/3

13. NYC COVID-19 Hospitalizations-
as of 5/3

14. NYC COVID-19 Deaths- as of 5/4

15. Rates by Borough

16. Cases by Age and Gender

17. Hospitalizations and Deaths by Gender

18. Hospitalizations and Deaths by
Race/Ethnicity

19. Milestones Used to Guide Social Distancing Policies

20. Clinical Takeaways
• This is truly unlikely anything our modern day healthcare system
has ever experienced
• Approach embodies art > science of medicine
• Many experimental treatments tried in absence of good
evidence/guidance on who/when to treat
– Hydroxychloroquine +/- Azithromycin
– Remdesivir
– Convalescent plasma
– Tocilizumab/Sarilumab
– Anticoagulation
– Steroids
• A collaborative healthcare system can work wonders to offload
surge and save lives

21. 21

22. Thank You!
www.weitzmaninstitute.org/coronavirus