NHLBI's COVID-19 Guidance for Practicing Clinicians

Healthcare providers seeking information about appropriate coronavirus disease 2019 (COVID-19) treatment may now consult treatment guidelines developed by a panel of U.S. physicians, statisticians, and other experts. These guidelines are based on published and preliminary data and the clinical expertise of the panelists, many of whom are frontline clinicians caring for patients during the rapidly evolving pandemic. The guidelines will be updated often as new data are published in peer-reviewed scientific literature and as other authoritative information emerges.

The CDC has also published Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19)external link for clinicians caring for patients with confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). CDC will update this interim guidance as more information becomes available.

This guidance covers clinical presentation, testing, diagnosis, and clinical management and treatment, among other topics. 

In addition, there are a number of clinical trials underway in an effort to inform and optimize the clinical care of patients.  By leveraging current NHLBI-supported clinical trial networks—such as the Prevention and Early Treatment of Acute Lung Injury (PETAL) Clinical Trials Networkexternal link and Strategies to Innovate Emergency Care Clinical Trials Network (SIREN)external link, we have been able to quickly launch COVID-19 clinical trials:

• The ORCHID trial was the first trial to get started, with the first patient enrolled on April 9. It was a randomized, placebo-controlled trial of hydroxychloroquine. The NHLBI closed the trial on June 20, 2020, after researchers found that the drug provided no additional benefit compared to placebo for the treatment of COVID-19 in hospitalized patients.
• The COVID-19 Observational Study (CORAL) is a long-term study of patients hospitalized with COVID-19 that will collect comprehensive data on severe outcomes including respiratory failure, strokes and heart attacks, as well as risk factors and potential mechanisms.
• The COLCORONA trial is looking at the effects of colchicine (an anti-inflammatory drug commonly used to treat gout) on cardiopulmonary complications. NHLBI sponsored the addition of a U.S. site (at New York University) to expand a Canadian Institutes for Health Research-funded trial of colchicine for treating COVID-19 in the outpatient setting.
• The Recipient Epidemiology and Donor Evaluation Study (REDS), with additional funding from NIAID, is examining the presence of SARS-CoV-2 in blood, its potential for transfusion-transmission, and the immune responses of infected individuals, which will help inform vaccine development.
• The C3PO trial is leveraging the NIH-funded Strategies to Innovate Emergency Care Clinical Trials Network (SIREN) to study whether blood plasma from individuals who have recovered from COVID-19 (convalescent plasma) can help reduce the progression of COVID-19 in patients with mild symptoms.