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Nurmawati, Thatit

Thatit Nurmawati
Presenter
https://confbeam.org/2020/ishs/kfz | Auth ID: 8EV4kb6x9 | Konfrenzi.com


International Symposium on Health Sciences

O'Horo, John C

English

Azithromycin

 
  
ECG Monitoring for QT Prolongation in  
Hospitalized Patients with COVID-19  
 
Pre-Treatment Assessment 
1. Obtain a QTc using a standard 12-lead ECG, telemetry, or mobile ECG device 
2. Obtain baseline electrolytes, including calcium, magnesium, and potassium; correct abnormalities 
3. Review the patient’s medications; discontinue any QTc prolonging medications that are not 
necessary 
4. Document high-risk cardiovascular and comorbid conditionsa  
5. Assess and adjust for hepatic and renal dysfunction 
 
Patients taking ONE of the following ONLY: azithromycin, hydroxychloroquine, chloroquine, or 
lopinavir; ritonavir1 
 
Baseline QTc is 500 msec or more OR QTc increases by 60 msec or more after drug initiation 
1. Consider withholding treatment 
2. Correct electrolyte abnormalities 
3. Obtain an on-therapy QTc 2 to 4 hours after the first dose and repeat in 48 and 96 hours 
 
Baseline QTc is 460 to 499 msec (prepubertal patients), 470 to 499 msec (postpubertal males), or 480 to 
499 msec (postpubertal females) 
1. Correct electrolyte abnormalities before drug initiation 
2. Obtain an on-therapy QTc at 48 hours and 96 hours after drug initiation 
 
Baseline QTc is less than 460 msec (prepubertal patients), less than 470 msec (postpubertal males), or 
less than 480 msec (postpubertal females) 
1. Measure an on-therapy QTc at 48 and 96 hours after drug initiation 
2. Correct electrolyte abnormalities once known 
 
Patients taking azithromycin WITH hydroxychloroquine OR chloroquine2 
1. In patients with a baseline QTc more than 500 msec or a history of long QT syndrome, the 
combined use of these agents is relatively contraindicated. 
2. Place patient on telemetry before drug initiation. 
3. Monitor and correct electrolytes at baseline and daily thereafter. 
4. Obtain an ECG 2 to 3 hours after the second dose of antimalarial and then daily thereafter. 
5. If QTc is more than 500 msec or increases by 60 msec or more over baseline, discontinue 
azithromycin and/or decrease dose of the antimalarial. Continue to monitor ECG daily. 
6. If QTc continues to be more than 500 msec or increased by 60 msec or more, consider 
discontinuing the antimalarial. 
 
Immediately discontinue all QT prolonging medications in any patient with Torsade de Pointes 
 
 
References 
1. Giudicessi JR, Noseworthy PA, Friedman PA. Ackerman MJ. Urgent guidance for navigating and circumventing the QTc prolonging and 
torsadogenic potential of possible pharmacotherapies for COVID-19 [published online ahead of print, March 25, 2020]. Mayo Clin Proc 
2020; 95. 
2. Simpson TF, Kovacs RJ, Stecker EC. Ventricular arrhythmia risk due to hydroxychloroquine-azithromycin treatment for COVID-19. 
Accessed April 10, 2020. Available at: https://www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-
to-hydroxychloroquine-azithromycin-treatment-for-covid-19  
 
 
aHigh risk conditions include age > 65 years, female patients, bradycardia, heart failure, recent acute coronary syndrome, atrial 
fibrillation, hypertension, heart valve disease, hypocalcemia, hypokalemia, hypomagnesemia, hypothyroidism, systemic 
inflammation (e.g., HIV infection, sepsis, lupus, rheumatoid arthritis), hypothermia, and sleep deprivation 


ECG Monitoring for QT Prolongation in

Hospitalized Patients with COVID-19

Milici, Justin

Mechanical Ventilation (Neonatal)

4/20/2020 Clinical Pharmacology powered by ClinicalKey
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Anakinra Solution for injection
U.S. Trade Names
Kineret
The list of names may not include all products that are available on the market.
What is this medicine?
ANAKINRA (an a KIN ra) is used to treat rheumatoid arthritis and Neonatal-Onset Multisystem Inflammatory
Disease (NOMID).
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have
questions.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
cancer
immune system problems
infection (especially a virus infection such as chickenpox, cold sores, or herpes)
kidney disease
low blood counts, like white cells
lung or breathing disease, like asthma
recently received or scheduled to receive a vaccine
tuberculosis, a positive skin test for tuberculosis or have recently been in close contact with someone who
has tuberculosis
an unusual or allergic reaction to anakinra, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding
How should I use this medicine?
The medicine is for injection under the skin. You will be taught how to prepare and give this medicine. Use
exactly as directed. Take your medicine at regular intervals. Do not take your medicine more often than directed.
It is important that you put your used needles and syringes in a special sharps container. Do not put them in a
trash can. If you do not have a sharps container, call your pharmacist or health care provider to get one.
Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for
selected conditions, precautions do apply.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency
room at once. NOTE: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?
4/20/2020 Clinical Pharmacology powered by ClinicalKey
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If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not
take double or extra doses.
What may interact with this medicine?
Do not take this medicine with any of the following medications:
biologic medicines such as adalimumab, certolizumab, etanercept, golimumab, infliximab
live virus vaccines
This medicine may also interact with the following medications:
abatacept
baricitinib
medicines that lower your chance of fighting an infection
rilonacept
rituximab
sarilumab
tocilizumab
tofactinib
This list may not describe all possible interactions. Give your health care provider a list of all the medicines,
herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use
illegal drugs. Some items may interact with your medicine.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
breathing problems
signs and symptoms of infection like fever or chills; cough; sore throat; pain or trouble passing urine
unusual bleeding or bruising
unusually weak or tired
Side effects that usually do not require medical attention (report to your doctor or health care professional if they
continue or are bothersome):
headache
diarrhea
joint pain
nausea, vomiting
pain, redness, or irritation at site where injected
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You
may report side effects to FDA at 1-800-FDA-1088.
What should I watch for while using this medicine?
4/20/2020 Clinical Pharmacology powered by ClinicalKey
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Your condition will be monitored carefully while you are receiving this medicine. Tell your doctor or health care
professional if your symptoms do not start to get better or if they get worse. You may need blood work done
while you are taking this medicine.
You will be tested for tuberculosis (TB) before you start this medicine. If your doctor prescribed any medicine
for TB, you should start taking the TB medicine before starting this medicine. Make sure to finish the full course
of TB medicine.
This medicine may increase your risk of getting an infection. Call your doctor or health care professional for
advice if you get a fever, chills, or sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to
avoid being around people who are sick.
Where should I keep my medicine?
Keep out of reach of children.
Store the syringes in the refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Do not freeze. Do not
shake. Keep in the original container to protect from light. Do not use the medicine after the expiration date.
NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about
this medicine, talk to your doctor, pharmacist, or health care provider.
[Last revised: 04/15/2020]
Copyright © 2020 Elsevier Inc. All rights reserved.


Anakinra Solution for Injection

4/14/2020 Clinical Pharmacology powered by ClinicalKey
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Baricitinib Oral tablet
U.S. Trade Names
OLUMIANT
The list of names may not include all products that are available on the market.
This medicine can lower your body’s ability to fight infections. You may get more infections while taking this medicine. Any infection
you get could become serious and even deadly. Risk factors for this condition include: getting a lot of infections or have infections that
keep coming back, history of tuberculosis, taking medicine that makes your immune system weak, like methotrexate or corticosteroids.
Report the following side effects to your healthcare provider immediately: blood in phlegm, burning when you urinate or urinate more
often than normal, cough that does not go away, general ill feeling (extreme tiredness, weakness or aches), low grade fever, stomach
symptoms (nausea, vomiting, diarrhea or stomach pain), sweats or chills, trouble breathing, like shortness of breath or wheezing,
warm, red, or painful skin or sores on your body, white patches in your mouth or throat.
This medicine may increase the risk of cancer. Risk factors for this condition include: history of cancer, or currently have cancer.
Report the following side effects to your healthcare provider immediately: a bump or open sore on your skin that doesn’t heal, night
sweats, swollen glands in the neck, armpits, or groin, unexplained fever, unexplained weight loss, weakness or tiredness that does not
go away.
This medicine increases the risk of blood clots. Report the following side effects to your healthcare provider immediately: chest pain,
confusion, trouble speaking, or sudden trouble seeing, coughing up blood, pain in your leg(s), with or without swelling, sudden trouble
walking, dizziness, loss of balance or coordination, swelling of an arm or leg, trouble breathing or shortness of breath.
What is this medicine?
BARICITINIB (BAR i SYE it nib) is a medicine that works on the immune system. This medicine is used to
treat rheumatoid arthritis.
 
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have
questions.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
cancer
diabetes
high cholesterol
history of blood clots
HIV or AIDs
immune system problems
infection (especially a virus infection such as chickenpox, cold sores, hepatitis B or herpes)
kidney disease
liver disease
lung or breathing disease, like asthma
low blood counts, like low white cell, platelet, or red cell counts
organ transplant
tuberculosis
stomach or intestine problems
an unusual or allergic reaction to baricitinib, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
breast-feeding
4/14/2020 Clinical Pharmacology powered by ClinicalKey
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How should I use this medicine?
Take this medicine by mouth with a full glass of water. Follow the directions on the prescription label. You can
take it with or without food. If it upsets your stomach, take it with food. Take your medicine at regular intervals.
Do not take it more often than directed. Do not stop taking except on your doctor's advice.
 
A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this
information carefully each time.
 
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
 
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency
room at once. NOTE: This medicine is only for you. Do not share this medicine with others.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not
take double or extra doses.
What may interact with this medicine?
azathioprine
biologic medicines such as abatacept, adalimumab, anakinra, certolizumab, etanercept, golimumab,
infliximab, ofatumumab, rituximab, sarilumab, secukinumab, tocilizumab, ustekinumab
cyclosporine
live vaccines
medicines that lower your chance of fighting infection
probenecid
 
This list may not describe all possible interactions. Give your health care provider a list of all the medicines,
herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use
illegal drugs. Some items may interact with your medicine.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
signs and symptoms of a blood clot such as breathing problems; changes in vision; chest pain; severe,
sudden headache; pain, swelling, warmth in the leg; trouble speaking; sudden numbness or weakness of
the face, arm, or leg
signs and symptoms of infection like fever or chills; cough; sore throat; pain or trouble passing urine
signs and symptoms of liver injury like dark yellow or brown urine; general ill feeling or flu-like
symptoms; light-colored stools; loss of appetite; nausea; right upper belly pain; unusually weak or tired;
yellowing of the eyes or skin
signs and symptoms of low blood cells or anemia, such as unusually weak or tired; feeling faint or
lightheaded; falls; breathing problems
stomach pain or a sudden change in bowel habits
 
4/14/2020 Clinical Pharmacology powered by ClinicalKey
https://www.clinicalkey.com/pharmacology/education/print 3/3
Side effects that usually do not require medical attention (report these to your doctor or health care professional
if they continue or are bothersome):
nausea
runny nose
sinus trouble
 
This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You
may report side effects to FDA at 1-800-FDA-1088.
What should I watch for while using this medicine?
Visit your healthcare professional for regular checks on your progress. Tell your healthcare professional if your
symptoms do not start to get better or if they get worse. You may need blood work done while you are taking
this medicine.
 
Avoid taking products that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed
by your doctor. These medicines may hide a fever.
 
Call your doctor or healthcare professional for advice if you get a fever, chills or sore throat, or other symptoms
of a cold or flu. Do not treat yourself. This drug decreases your body's ability to fight infections. Try to avoid
being around people who are sick.
 
Women should inform their doctor if they wish to become pregnant or think they might be pregnant. There is a
potential for serious side effects to an unborn child. Talk to your health care professional or pharmacist for more
information.
 
Do not breast-feed an infant while taking this medicine.
Where should I keep my medicine?
Keep out of the reach of children.
 
Store between 20 and 25 degrees C (68 and 77 degrees F). Throw away any unused medicine after the expiration
date.
NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about
this medicine, talk to your doctor, pharmacist, or health care provider.
[Last revised: 04/10/2020]
Copyright © 2017 Elsevier Inc. All rights reserved.


Baricitinib Oral Tablet

Fleming, Loraine

Depression: Adolescent Patients

Casey, Suzanne M

Liddy, Mary Ann

Postmortem Care

Pregnancy and COVID-19 
Coronavirus disease, also called COVID-19, is an infection of the lungs and airways (respiratory 
tract). It is unclear at this time if pregnancy makes it more likely for you to get COVID-19, or what 
effects the infection may have on your unborn baby. However, pregnancy causes changes to your heart, 
lungs, and the body's disease-fighting system (immune system). Some of these changes make it more 
likely for you to get sick and have more serious illness. Therefore, it is important for you to take 
precautions in order to protect yourself and your unborn baby. 
Work with your health care team to develop a plan to protect yourself from all infections, including 
COVID-19. This is one way for you to stay healthy during your pregnancy and to keep your baby 
healthy as well. 
How does this affect me? 
If you get COVID-19, there is a risk that you may: 
• Get a respiratory illness that can lead to pneumonia.  
• Give birth to your baby before 37 weeks of pregnancy (premature birth). 
If you have or may have COVID-19, your health care provider may recommend special precautions 
around your pregnancy. This may affect how you: 
• Receive care before delivery (prenatal care). How you visit your health care provider may 
change. Tests and scans may need to be performed differently. 
• Receive care during labor and delivery. This may affect your birth plan, including who may be 
with you during labor and delivery. 
• Receive care after you deliver your baby (postpartum care). You may stay longer in the 
hospital, and in a special room. Your baby may also need to stay away from you. 
• Feed your baby after he or she is born. 
Pregnancy can be an especially stressful time because of the changes in your body and the preparation 
involved in becoming a parent. In addition, you may be feeling especially fearful, anxious, or stressed 
because of COVID-19 and how it is affecting you. 
How does this affect my baby? 
It is not known whether a mother will transmit the virus to her unborn baby. There is a risk that if you 
get COVID-19: 
• The virus that causes COVID-19 can pass to your baby. 
• You may have premature birth. Your baby may require more 
medical care if this happens. 
What can I do to lower my risk? 
There is no vaccine to help prevent COVID-19. However, there are actions 
that you can take to protect yourself and others from this virus. 
Cleaning and personal hygiene 
• Wash your hands often with soap and water for at least 20 seconds. 
If soap and water are not available, use alcohol-based hand 
sanitizer. 
• Avoid touching your mouth, face, eyes, or nose. 
 
• Clean and disinfect objects and surfaces that are frequently touched every day. This may 
include: 
◦ Counters and tables. 
◦ Doorknobs and light switches. 
◦ Sinks and faucets. 
◦ Electronics such as phones, remote controls, keyboards, computers, and tablets. 
Stay away from others 
• Stay away from people who are sick, if possible. 
• Avoid social gatherings and travel. 
• Stay home as much as possible. 
Follow these instructions: 
Breastfeeding 
It is not known if the virus that causes COVID-19 can pass through breast milk to your baby. You 
should make a plan for feeding your infant with your family and your health care team. 
If you have or may have COVID-19, your health care provider may recommend that you take 
precautions while breastfeeding, such as: 
• Washing your hands before feeding your baby. 
• Wearing a mask while feeding your baby. 
• Pumping or expressing breast milk to feed to your baby. If possible, ask someone in your 
household who is not sick to feed your baby the expressed breast milk. 
◦ Wash your hands before touching pump parts. 
◦ Wash and disinfect all pump parts after expressing milk. Follow the manufacturer's 
instructions to clean and disinfect all pump parts. 
General instructions 
• If you think you have a COVID-19 infection, contact your health care provider right away. Tell 
your health care provider that you think you may have a COVID-19 infection. 
• Follow your health care provider's instructions on taking medicines. Some medicines may be 
unsafe to take during pregnancy. 
• Cover your mouth and nose by wearing a mask or other cloth covering over your face when you 
go out in public. 
• Find ways to manage stress. These may include: 
◦ Using relaxation techniques like meditation and deep breathing. 
◦ Getting regular exercise. Most women can continue their usual exercise routine during 
pregnancy. Ask your health care provider what activities are safe for you. 
◦ Seeking support from family, friends, or spiritual resources. If you cannot be together in 
person, you can still connect by phone calls, texts, video calls, or online messaging. 
◦ Spending time doing relaxing activities that you enjoy, like listening to music or reading a 
good book. 
• Ask for help if you have counseling or nutritional needs during pregnancy. Your health care 
provider can offer advice or refer you to resources or specialists who can help you with various 
needs. 
• Keep all follow-up visits as told by your health care provider. This is important. 
Where to find more information 
 Centers for Disease Control and Prevention (CDC): www.cdc.gov/coronavirus/2019-ncov/ 
 World Health Organization (WHO): 
www.who.int/news-room/q-a-detail/q-a-on-covid-19-pregnancy-childbirth-and-breastfeeding 
 American College of Obstetricians and Gynecologists (ACOG): 
www.acog.org/patient-resources/faqs/pregnancy/coronavirus-pregnancy-and-breastfeeding 
Questions to ask your health care team 
• What should I do if I have COVID-19 symptoms? 
• How will COVID-19 affect my prenatal care visits, tests and scans, labor and delivery, and 
postpartum care? 
• Should I plan to breastfeed my baby? 
• Where can I find mental health resources? 
• Where can I find support if I have financial concerns? 
Contact a health care provider if: 
• You have signs and symptoms of infection, including a fever or cough. Tell your health care 
team that you think you may have a COVID-19 infection. 
• You have strong emotions, such as sadness or anxiety. 
• You feel unsafe in your home and need help finding a safe place to live. 
• You have bloody or watery vaginal discharge or vaginal bleeding. 
Get help right away if: 
• You have signs or symptoms of labor before 37 weeks of pregnancy. These include: 
◦ Contractions that are 5 minutes or less apart, or that increase in frequency, intensity, or 
length. 
◦ Sudden, sharp pain in the abdomen or in the lower back. 
◦ A gush or trickle of fluid from your vagina. 
• You have difficulty breathing. 
• You have chest pain. 
These symptoms may represent a serious problem that is an emergency. Do not wait to see if the 
symptoms will go away. Get medical help right away. Call your local emergency services (911 in 
the U.S.). Do not drive yourself to the hospital. 
Summary 
• Coronavirus disease, also called COVID-19, is an infection of the lungs and airways 
(respiratory tract). It is unclear at this time if pregnancy makes you more susceptible to 
COVID-19 and what effects it may have on unborn babies. 
• It is important to take precautions to protect yourself and your developing baby. This includes 
washing your hands often, avoiding touching your mouth, face, eyes, or nose, avoiding social 
gatherings and travel, and staying away from people who are sick. 
• If you think you have a COVID-19 infection, contact your health care provider right away. Tell 
your health care provider that you think you may have a COVID-19 infection. 
• If you have or may have COVID-19, your health care provider may recommend special 
precautions during your pregnancy, labor and delivery, and after your baby is born. 
This information is not intended to replace advice given to you by your health care provider. Make sure 
you discuss any questions you have with your health care provider. 
Document Released: 04/14/2020 Document Revised: 04/14/2020 Document Reviewed: 04/14/2020 
Elsevier Patient Education © 2020 Elsevier Inc. 


Pregnancy and COVID-19

COVID-19 
COVID-19, also known as coronavirus disease or novel coronavirus, is caused by a type of virus that 
causes respiratory illness. This may lead to inflammation and the buildup of mucus and fluids in the 
airway of the lungs (pneumonia). There are many different coronaviruses. Most of these viruses only 
affect animals, but sometimes these viruses can change and infect people. 
What are the causes? 
This illness is caused by a virus. You may catch the virus by: 
• Breathing in droplets from an infected person's cough or sneeze. 
• Touching something, like a table or a doorknob, that was exposed to the virus (contaminated) 
and then touching your mouth, nose, or eyes. 
• Being around animals that carry the virus, or eating uncooked or undercooked meat or animal 
products that contain the virus. 
What increases the risk? 
You are more likely to develop this condition if you: 
• Live in or travel to an area with a COVID-19 outbreak. 
• Come in contact with a sick person who recently traveled to an area with a COVID-19 
outbreak. 
• Provide care for or live with a person who is infected with COVID-19. 
What are the signs or symptoms? 
COVID-19 causes respiratory illness that can lead to pneumonia. Symptoms of pneumonia may 
include: 
• A fever. 
• A cough. 
• Difficulty breathing. 
How is this diagnosed? 
This condition may be diagnosed based on: 
• Your signs and symptoms, especially if: 
◦ You live in an area with a COVID-19 outbreak. 
◦ You recently traveled to or from an area where the virus is common. 
◦ You provide care for or live with a person who was diagnosed with COVID-19. 
• A physical exam. 
• Lab tests, which may include: 
◦ A nasal swab to take a sample of fluid from your nose. 
◦ A throat swab to take a sample of fluid from your throat. 
◦ A sample of mucus from your lungs (sputum). 
◦ Blood tests. 
How is this treated? 
There is no medicine to treat COVID-19. Your health care provider will talk with you about ways to 
treat your symptoms. This may include rest, fluids, and over-the-counter medicines. 
Follow these instructions at home: 
Lifestyle 
• Use a cool-mist humidifier to add moisture to the air. This can help you breathe more easily. 
• Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and 
chewing tobacco. If you need help quitting, ask your health care provider. 
• Rest at home as told by your health care provider. 
• Return to your normal activities as told by your health care provider. Ask your health care 
provider what activities are safe for you. 
General instructions 
• Take over-the-counter and prescription medicines only as told by your health care provider. 
• Drink enough fluid to keep your urine pale yellow. 
• Keep all follow-up visits as told by your health care provider. This is important. 
How is this prevented? 
There is no vaccine to help prevent COVID-19 infection. However, there are steps you can take to 
protect yourself and others from this virus. 
To protect yourself: 
• Do not travel to areas where COVID-19 is a risk. The areas where 
the coronavirus is reported change often. To identify high-risk 
areas, check the CDC travel website: 
wwwnc.cdc.gov/travel/notices 
• If you live in, or must travel to, an area where the coronavirus is a 
risk, take precautions to avoid infection. 
◦ Stay away from people who are sick. 
◦ Stay away from places where there are animals that may carry 
the virus. This includes places where animals and animal 
products are sold. Note that both living and dead animals can 
carry the virus. 
◦ Do not eat meat or fish in areas of a coronavirus outbreak. If you must eat fish or meat, 
make sure that it is cooked very well. 
◦ Wash your hands often with soap and water. If soap and water are not available, use an 
alcohol-based hand sanitizer. 
◦ Avoid touching your mouth, face, eyes, or nose. 
To protect others: 
If you have symptoms, take steps to prevent the virus from spreading to others. 
• If you think you have a coronavirus infection, contact your health care provider right away. Tell 
your health care team that you think you may have a COVID-19 infection. 
• Stay home. Leave your house only to seek medical care. 
• Do not travel while you are sick. 
• Wash your hands often with soap and water. If soap and water are not available, use 
alcohol-based hand sanitizer. 
• Stay away from other members of your household. If possible, stay in your own room, separate 
from others. Use a different bathroom. 
• Make sure that all people in your household wash their hands well and often. 
• Cough or sneeze into a tissue or your sleeve or elbow. Do not cough or sneeze into your hand 
or into the air. 
• Wear a face mask.   
Where to find more information 
• Centers for Disease Control and Prevention: www.cdc.gov/coronavirus/2019-ncov/index.html 
• World Health Organization: www.who.int/health-topics/coronavirus 
Contact a health care provider if: 
• You have traveled to an area where COVID-19 is a risk and you have symptoms of the 
infection. 
• You have contact with someone who has traveled to an area where COVID-19 is a risk and you 
have symptoms of the infection. 
Get help right away if: 
• You have trouble breathing. 
• You have chest pain. 
Summary 
• COVID-19 is caused by a type of virus that causes respiratory illness. This may lead to 
inflammation and the buildup of mucus and fluids in the airway of the lungs (pneumonia). 
• You are more likely to develop this condition if you live in or travel to an area with a 
COVID-19 outbreak. 
• There is no medicine to treat COVID-19. Your health care provider will talk with you about 
ways to treat your symptoms. 
• Take steps to protect yourself and others from infection. Wash your hands often. Stay away 
from other people who are sick and wear a mask if you are sick. 
This information is not intended to replace advice given to you by your health care provider. Make sure 
you discuss any questions you have with your health care provider. 
Document Released: 01/23/2020 Document Revised: 03/12/2020 Document Reviewed: 01/23/2020 
Elsevier Interactive Patient Education © 2020 Elsevier Inc. 


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