Updated summary of all current #COVID19 clinical trials. Incredibly, 102 trials were posted last week! #coronavirus #SARSCoV2 /1

China, USA, Italy, France leading, but this is a global effort. I'm inspired by the unprecedented pace of this scientific inquiry. @V2019N @DrEricDing @mlipsitch @neil_ferguson @TDivala @SusanDavisNY /2

Most trials Phase 2 or 3, so we should see efficacy data. Number of randomized trials doubled; most are unblinded (127 of 197 interventional trials). /3

Median enrollment target 213 (IQR 80-553), but some large global trials. Still relatively few pediatric trials. @martinoffringa /4

Regarding therapies, I'm struck by the "see what sticks" shotgun approach; while some therapies plausible against SARS-CoV-2, others less so. @Dereklowe @DavidJuurlink @DrJudyStone /5

Hydroxychloroquine, protease inhibitors, IL-6 inhibitors, convalescent plasma, RAAS blockade, JAK inhibitors, and complement inhibitors all increasingly being studied. @FranciscoMarty_ @angie_rasmussen /6

Many new approaches: hyperbaric oxygen ( @NYUWinthropHosp), angiotensin (1,7), ciclesonide, serum iron binding, anti-parasitics, and various immune modulators that I frankly don't fully understand! /7

Early PEEP and proning being studied; anecdotally can say they both improve sats but unclear if changes outcomes. Hopefully we will find out. @DocSteveTaylor @CritCareMed @emcrit @PulmCrit /8

Combination therapy proposed to block various stages of viral entry, replication, and late cytokine effects. Seems promising. @AlisonBLowndes /9

Interventions I'm curious about that are missing: zinc therapy, therapeutic anticoagulation. Any upcoming trials out there #MedTwitter? @thecurbsiders /10

Most trials focus on specific time of illness (PrEP vs early vs late) and severity of disease (mild vs ARDS). /11

Cursory review of trial timing suggests most results will be after the US "surge" in cases. We need thoughtful interim analyses. /12

We need to take care with groupthink (or "grouptreat") as weak data emerges. I've seen HCQ toxicity and it's scary. How did HCQ become standard of care? @EricTopol /13

Ok, I'm back to Bellevue Hospital to work with an inspiring group of nurses and residents caring for very sick #COVID19 patients. @mike_natter @colleenmfarrell /14

Limited armamentarium against #COVID19 but these trials give me hope. See you in a week #MedTwitter and stay safe! #Meded #FOAMed /end