Fundamental Principles
Treat patients based on clinical suspicion as soon as possible, preferably within the first 5 days of symptoms. Perform PCR testing, but do not withhold treatment pending results.
Risk Stratify Patients
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Low risk patient - Younger than 45, no comorbidities, and clinically stable
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High risk patient - Older than 45, younger than 45 with comorbidities, or clinically unstable
Treatment Options
Low risk patients
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Supportive care with fluids, fever control, and rest
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Elemental Zinc 50mg 1 time a day for 7 days
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Vitamin C 1000mg 1 time a day for 7 days
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Vitamin D3 5000iu 1 time a day for 7 days
Optional over the counter options
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Quercetin 500mg 2 times a day for 7 days or
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Epigallocatechin-gallate (EGCG) 400mg 1 time a day for 7 days
Moderate / High risk patients
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Elemental Zinc 50-100mg once a day for 7 days
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Vitamin C 1000mg 1 time a day for 7 days
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Vitamin D3 10000iu once a day for 7 days or 50000iu once a day for 1-2 days
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Azithromycin 500mg 1 time a day for 5 days or
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Doxycycline 100mg 2 times a day for 7 days
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Hydroxychloroquine (HCQ) 200mg 2 times a day for 5-7 days and/or
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Ivermectin 0.4-0.5mg/kg/day for 5-7 days Either or both HCQ and IVM can be used, and if one only, the second agent may be added after about 2 days of treatment if obvious recovery has not yet been observed etc.
Treatment Options
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Dexamethasone 6-12mg 1 time a day for 7 days or
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Prednisone 20mg twice a day for 7 days, taper as needed
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Budesonide 1mg/2cc solution via nebulizer twice a day for 7 days
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Blood thinners (i.e. Lovenox, Eliquis, Xarelto, Pradaxa, Aspirin)
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Colchicine 0.6mg 2-3 times a day for 5-7 days
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Monoclonal antibodies
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Home IV fluids and oxygen
TRY TO KEEP PATIENTS OUT OF THE HOSPITAL
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https://www.sciencedirect.com/science/article/pii/S0924857920304258
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/
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https://pubs.acs.org/doi/10.1021/jf5014633
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https://vdmeta.com/
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/
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https://pubs.acs.org/doi/10.1021/jf5014633
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https://www.sciencedirect.com/science/article/pii/S0924857920304258
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https://ivmmeta.com/
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https://www.nejm.org/doi/full/10.1056/NEJMoa2021436
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392554/
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https://www.medrxiv.org/content/10.1101/2021.01.26.21250494v1