YAFI Online Programming // Disease State Management and Drug Therapy

UConn Update #4: SARS-CoV-2 and COVID-19

Educational Objectives

After participating in this activity pharmacists and pharmacy technicians will be able to:

● List developments related to treatments that  are currently being investigated for COVID-19

● Recognize changes to the CDC’s recommendations and risk criteria

● Describe non-pharmacologic interventions to reduce the spread of SARS-CoV-19

UCONN update #4 COVID-19

Session Offered

Release Date: July 10, 2020

Expiration Date: December 31,2021

Course Fee


Session Codes

20YC59-ATX82 Pharmacist

20YC59-BXF73 Pharmacy Technician

Accreditation Hours

2.0 hours of CE


UConn faculty assembled this homestudy in response to a high demand for reliable education on coronavirus. It answers questions submitted by our learners

Accreditation Statements

The University of Connecticut School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Pharmacists and pharmacy technicians are eligible to participate in this application-based activity and will receive up to 0.2 CEU (2 contact hours) for completing the activity, passing the quiz with a grade of 70% or better, and completing an online evaluation. Statements of credit are available via the CPE Monitor on- line system and your participation will be recorded with CPE Monitor within 72 hours of submission


Grant funding: Merck Sharp & Dohme Corp.

Cost:    $3 for pharmacists
$3 for technicians

Initial Release Date: April 13, 2020
Expiration Date: December 31, 2021

To obtain CPE credit, visit the UConn Online CE Center

Use your NABP E-profile ID and the session code 20YC59-ATX82 for pharmacists or 20YC59-BXF73 for pharmacy technicians to access the online quiz and evaluation.

First- time users must pre-register in the Online CE Center. Test results will be displayed immediately and your participation will be recorded with CPE Mon- it or within 72 hours of completing the requirements.

For questions concerning the online CPE activities, email joanne.nault@uconn.edu


Jeffrey R. Aeschlimann, Pharm.D. Is an Associate Professor, UConn School of Pharmacy, Adjunct Associate Professor, UConn School of Medicine, UConn Health, Division of Infectious Diseases. C. Michael White, Pharm.D., FCP, FCCP; Professor and Chair, Pharmacy Practice, UConn School of Pharmacy, Storrs, CT and Director, HOPES Collaborative Group, University of Connecticut and Hartford Hospital, Hartford, CT. Jennifer Girotto, PharmD, BCPPS, BCIDP, Associate Clinical Professor,
UConn School of Pharmacy, Cassandra Doyno, Pharm.D., BCPS is an Assistant Clinical Professor,Pharmacy Practice, UConn School of Pharmacy, Storrs, CT. Jeannette Y. Wick, R.Ph, MBA, FASCP, is the Assistant Director, Office of Pharmacy Professional Development, UConn School of Pharmacy, Storrs, CT. Ariana Hawkins is a 2021 PharmD candidate at the University of Connecticut.

Faculty Disclosure

All faculty have no actual or potential conflicts of interest associated with this article

Disclosure of Discussions of Off-label and Investigational Drug Use

This activity may contain discussion of off label/unapproved use of drugs. The content and views presented in this educational program are those of the faculty and do not necessarily represent those of the University of Connecticut School of Pharmacy. Please refer to the official prescribing information for each prod-



This is the fourth update to UConn’s running series on SARS-COV-2 and COVID-19. In previous continuing education (CE) activities, we discussed the virus (SARS-CoV-2), the disease it causes (COVID-19), and frequently asked questions.

As noted in our learner survey issues on June 30, 2020, UConn School of Pharmacy was an early responder with continuing education for pharmacists and technicians. We issued frequent updates, but slowed our pace when other CE providers began to issue what appeared to be a tremendous amount of CE on this topic. In our survey, more than 70% of respondents said they were ready for another update from UConn. Here it is, and thank you for your feedback and support.

You can find links to UConn’s previous CE activities on this topic at the end of this activity (page 10).


Full List of References

1. Centers for Disease Control and Prevention. Symptoms of coronavirus. Available at https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html. Accessed July 2, 2020.

2. Butowt R, Bilinska K. SARS-CoV-2: Olfaction, Brain Infection, and the Urgent Need for Clinical Samples Allowing Earlier Virus Detection. ACS Chem Neurosci. 2020;11(9):1200-1203.doi:10.1021/acschemneuro.0c00172

3. Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the Treatment of Covid-19 - Preliminary Report [published online ahead of print, 2020 May 22]. N Engl J Med. 2020;NEJMoa2007764.doi:10.1056/NEJMoa2007764

4. Goldman JD, Lye DCB, Hui DS, et al. Remdesivir for 5 or 10 Days in Patients with Severe Covid-19 [published online ahead of print, 2020 May 27]. N Engl J Med. 2020;10.1056/NEJMoa2015301.doi:10.1056/NEJMoa2015301

5. Gilead. Gilead announces results from phase 3 trial of remdesivir in patients with moderate COVID-19. June 1, 2020. Available at https://www.gilead.com/news-and-press/press-room/press-releases/2020/6/gilead-announces-results-from-phase-3-trial-ofremdesivir-in-patients-with-moderate-covid-19. Accessed July 4, 2010.

6. Herber M. Gilead announces long-awaited price for Covid-19 drug remdesivir. Available at https://www.statnews.com/2020/06/29/gilead-announces-remdesivir-price-covid-19/. Accessed July 4, 2020.

7. U.S. Department of Health and Human Services. Trump administration secures new supplies of remdesivir for the United States. Available at https://www.hhs.gov/about/news/2020/06/29/trump-administration-secures-new-supplies-remdesivir-united-states.html. Accessed July 4, 2020.

8. Lupkin S. Remdesivir priced at more than $3,100 for a course of treatment. NPR. June 29, 2020. Available at
for-a-course-of-treatment. Accessed July 7, 2020.

9. Oxford University. Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19. Available at https://www.recoverytrial.net/files/recovery_dexamethasone_statem
ent_160620_final.pdf. Accessed July 4, 2020.

10. Horby P, Lim WS, Emberson J, et al. Effect of Dexamethasone in Hospitalized Patients with COVID-19: Preliminary Report. Available at https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1. Accessed July 4, 2020.

11. National Institutes ofHealth. COVID-19 Treatment Guidelines Panel. Coronavirus disease 2019 (COVID-19) treatment guidelines. Available at https://www.covid19treatmentguidelines.nih.gov/. Accessed July 5, 2020.

12. RECOVERY Trial Investigators. No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19;2020. Available at https://www.recoverytrial.net/news/statement-from-the-chiefinvestigators-of-the-randomised-evaluation-of-covid-19-therapyrecovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefitfrom-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid19. Accessed July 5, 2020.

13. White CM, Hernandez AV. Why your patients’ believing hydroxychloroquine and chloroquine are 90% effective for COVID-19 Is 100% dangerous [published online ahead of print, 2020 Jun 12]. J Clin Pharmacol. 2020;10.1002/jcph.1687. doi:10.1002/jcph.1687

14. U.S. Food and Drug Administration. Development and licensure of vaccines to prevent COVID-19; Guidance for industry. Available at https://www.fda.gov/media/139638/download. Accessed July 5, 2020.

15. World Health Organization. Draft landscape of COVID-19 candidate vaccines. July 2, 2020. Available at
https://www.who.int/publications/m/item/draft-landscape-of-covid19-candidate-vaccines. Accessed July 5, 2020.

16. Craven J. COVID-19 vaccine tracker. Regulatory Focus. July 2, 2020. Available at https://www.raps.org/news-and-articles/newsarticles/2020/3/covid-19-vaccine-tracker. Accessed July 7, 2020.
17. Clinical questions about COVID-19: Questions and answers. Updated July 28, 2020. Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html. Accessed July 5, 2020.

18. Leaf RK, Al-Samgari H, Brenner SK, et al. ABO phenotype and death in critically ill patients with COVID-19. Available at https://onlinelibrarywiley-com.ezproxy.lib.uconn.edu/doi/pdfdirect/10.1111/bjh.16984. Accessed July 7, 2020.

19. Ellinghaus D, Degenhardt F, Bujanda L, et al. Genomewide Association Study of Severe Covid-19 with Respiratory Failure [published online ahead of print, 2020 Jun 17]. N Engl J Med. 2020;NEJMoa2020283.doi:10.1056/NEJMoa2020283

20. Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet.2020;395(10242):1973-1987. doi:10.1016/S0140-6736(20)31142-9

21. Dave DH, Friedson AI, Matsuzawa, et al; National Bureau of Economic Research. Black lives matter protests, social distancing, and COVID-19. Available at https://www.nber.org/papers/w27408.pdf. Accessed July 7, 2020.

22. Rebmann T, Carrico R, Wang J. Physiologic and other effects and compliance with long-term respirator use among medical intensive care unit nurses. Am J Infect Control. 2013;41(12):1218-1223. doi:10.1016/j.ajic.2013.02.017

23. Roberge RJ, Coca A, Williams WJ, Palmiero AJ, Powell JB. Surgical mask placement over N95 filtering facepiece respirators: physiological effects on healthcare workers. Respirology. 2010;15(3):516-521. doi:10.1111/j.1440-1843.2010.01713.x

24. Hua W, Zuo Y, Wan R, et al. Short-term skin reactions following use of N95 respirators and medical masks [published online ahead of print, 2020 May 13]. Contact Dermatitis. 2020;10.1111/cod.13601.doi:10.1111/cod.13601

25. Scarano A, Inchingolo F, Lorusso F. Facial Skin Temperature and Discomfort When Wearing Protective Face Masks: Thermal Infrared Imaging Evaluation and Hands Moving the Mask. Int J Environ Res Public Health. 2020;17(13):E4624. Published 2020 Jun 27.doi:10.3390/ijerph17134624

26. Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020;395(10242):1973-1987. doi:10.1016/S0140-6736(20)31142-9

27. Perencevich EN, Diekema DJ, Edmond MB. Moving Personal Protective Equipment Into the Community: Face Shields and Containment of COVID-19 [published online ahead of print, 2020 Apr 29]. JAMA. 2020;10.1001/jama.2020.7477. doi:10.1001/jama.2020.7477

28. Snopes. Is coronavirus spreading faster than SARS, Ebola, and Swine Flu? Available at https://www.snopes.com/fact-check/coronavirus-graph-spreading-faster/. Accessed July 5, 2020.

29. [No author.] COVID-19 Open Innovation Efforts. Available at https://my.usgs.gov/confluence/display/cdi/COVID-19+Open+Innovation+Efforts. Accessed July 5, 2020.

30. World Health Organization. Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003. Available at https://www.who.int/csr/sars/country/table2004_04_21/en/. Accessed July 5, 2020.

31. Centers for Disease Control and Prevention. Countries with widespread transmission and other countries affected during the epidemic. Available at https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html. Accessed July 5, 2020.

32. Centers for Disease Control and Prevention. 2009 H1N1 Pandemic (H1N1pdm09 virus). Available at https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html. Accessed July 5, 2020.

33. Centers for Disease Control and Prevention. Available at https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/pandemic-timeline-1918.htm. Accessed July 5, 2020.

34. U.S. Food and Drug Administration. Coronavirus testing basics.
Available at https://www.fda.gov/consumers/consumer-updates/coronavirus-testing-basics. Accessed July 5, 2020.

35. Centers for Disease Control and Prevention. How to protect yourself & others. Available at https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Accessed July 5, 2020.

36. Congress.gov. H.R. 6201 - Families First Coronavirus Response Act. Available at https://www.congress.gov/bill/116th-congress/housebill/6201. Accessed July 5, 2020.
37. Farmer B. Insurers may only pay for coronavirus tests when they're 'medically necessary.’ June 19, 2020. Available at
https://www.npr.org/sections/health-shots/2020/06/19/880543755/insurers-may-only-pay-for-coronavirus-tests-when-theyre-medically-necessary. Accessed July 5, 2020.

38. CDC COVID-19 Response Team. Coronavirus disease 2019 in children - United States, February 12-April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(14):422-426. doi:10.15585/mmwr.mm6914e4

39. Hoang A, Chorath K, Moreira A, et al. COVID-19 in 7780 pediatric patients: a systematic review. EClinicalMedicine 2020:

40. Gilead. Fact sheet for health care providers. Emergency use authorization (EUC) of remdesivir (GS-5734). Available at
https://www.gilead.com/-/media/files/pdfs/remdesivir/eua-fact-sheetfor-hcps_01may2020.pdf. Accessed July 4, 2020.
41. Centers for Disease Control and Prevention. Health alert: multisystem inflammatory syndrome in children (MIS-C) associated with Coronavirus Disease 2019 (COVID-19). May 14, 2020. Available at https://emergency.cdc.gov/han/2020/han00432.asp. Accessed July 2, 2020.

42. Feldstein LR, Rose EB, Horwitz SM, et al. Multisystem InflammatorySyndrome in U.S. Children and Adolescents [published online ahead of print, 2020 Jun 29]. N Engl J Med. 2020;10.1056/NEJMoa2021680. doi:10.1056/NEJMoa2021680

43. Centers for Disease Control and Prevention, Clinical Outreach and Communication Activity Webinar, May 19, 2020 available at https://emergency.cdc.gov/coca/ppt/2020/COCA_Call_Slides_05_19_2020.pdf. Accessed July 2, 2020.

44. Verdoni L, Mazza A, Gervasoni A, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet. 2020;395(10239):1771-1778.doi:10.1016/S0140-6736(20)31103-X

45. Riphagen S, Gomez X, Gonzalez-Martinez C, et al. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet.2020;395(10237):1607-1608. doi:10.1016/S0140-6736(20)31094-1

46. Young TK, Zampella JG. Supplements for COVID-19: A modifiable environmental risk [published online ahead of print, 2020 May 15]. ClinImmunol. 2020;216:108465. doi:10.1016/j.clim.2020.108465

47. U.S. Food and Drug Administration. Coronavirus update: FDA and FTC warn seven companies selling fraudulent products that claim to treat or prevent COVID-19. March 9, 2020. Available at https://www.fda.gov/news-events/press-announcements/coronavirus-update-fda-and-ftc-warn-seven-companies-selling-fraudulent-products-claim-treat-or. Accessed July 3, 2020.

48. Adams KK, Baker WL, Sobieraj DM. Myth Busters: Dietary Supplements and COVID-19 [published online ahead of print, 2020 May 12]. Ann Pharmacother. 2020;1060028020928052.doi:10.1177/1060028020928052

49. Young TK, Zampella JG. Supplements for COVID-19: A modifiable environmental risk [published online ahead of print, 2020 May 15]. Clin Immunol. 2020;216:108465. doi:10.1016/j.clim.2020.108465

50. Burger RA, Torres AR, Warren RP, et al. Echinacea-induced cytokine production by human macrophages, Int. J. Immunopharmacol.1997;19:371–379.

51. Ulbricht C, Basch E, Cheung L, et al. An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration. J Diet Suppl. 2014;11:80-120.doi:10.3109/19390211.2013.859852

52. Tiralongo E, Wee SS, Lea RA. Elderberry supplementation reduces cold duration and symptoms in air-travellers: a randomized, doubleblind placebo-controlled clinical trial. Nutrients. 2016;8(4):182.. doi:10.3390/nu8040182

53. Biancatelli RMLC, Berrill M, Marik PE. The antiviral properties of vitamin C. Expert Rev Anti Infect Ther. 2020;18:99-101.doi:10.1080/14787210.2020.1706483

54. Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;(1):CD00980.doi:10.1002/14651858.CD000980.pub4

55. Caruso TJ, Prober CG, Gwaltney JM Jr. Treatment of naturally acquired common colds with zinc: a structured review. Clin Infect Dis.2007;45:569-574. doi:10.1086/520031

56. Elmowalid GA, Abd El-Hamid MI, Abd El-Wahab AM, et al. Garlic and ginger extracts modulated broiler chicks innate immune responsesand enhanced multidrug resistant Escherichia coli O78 clearance.Comp Immunol Microbiol Infect Dis. 2019;66:101334.

57. Cinatl J, Morgenstern B, Bauer G, et al.Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. Lancet 2003;361:2045-2046.

58. U.S. Centers for Disease Control and Prevention. Food and coronavirus disease 2019 (COVID-19). Updated June 25, 2020. Available at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/food-and-COVID-19.html. Accessed July 3, 2020.

59. World Health Organization. #HealthyAtHome: Healthy Diet. Available at https://www.who.int/campaigns/connecting-the-world-tocombat-coronavirus/healthyathome/healthyathome---healthy-diet. Accessed July 3, 2020.

60. Fan Y, Zhang Y, Tariq A, et al. Food as medicine: a possible preventive measure against coronavirus disease (COVID-19) [published online ahead of print, 2020 May 28]. Phytother Res. 2020;10.1002/ptr.6770.doi:10.1002/ptr.6770

61. Morais AHA, Passos TS, Maciel BLL, et al. Can probiotics and diet promote beneficial immune modulation and purine control in coronavi-rus infection? Nutrients. 2020;12(6):E1737. doi:10.3390/nu12061737

62. Dinesh S, Shikha G, Gangwar B, et al. Biological activities of purine analogues: A review. J. Pharm. Sci. Innov. 2012, 1, 29–34.

63. Wu B, Roseland JM, Haytowitz DB, et al. Availability and quality of published data on the purine content of foods, alcoholic beverages, and dietary supplements. J Food Compos Anal. 2019;84:103281.