Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection
Procter et al.
, Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection
, Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm.2020.04.260
Retrospective 922 outpatients, with 320 treated early due to age>50 or comorbidities, showing 2.2% hospitalization and 0.3% death, which authors note is considerably lower than reported in other studies in their region.
At least two of zinc, HCQ, and ivermectin were used, along with one antibiotic, and budesonide and/or dexamethasone.
Procter et al., 30 Dec 2020, peer-reviewed, 6 authors.
Abstract: Published online: December 30, 2020
Clinical outcomes after early ambulatory multidrug therapy
for high-risk SARS-CoV-2 (COVID-19) infection
Reviews in Cardiovascular Medicine
Brian C. Procter1 , Casey Ross1 , Vanessa Pickard1 , Erica Smith1 , Cortney Hanson1 and Peter A. McCullough2,3,4, *
McKinney Family Medicine, McKinney, 75070, TX, USA
Baylor University Medical Center, Dallas, 75226, TX, USA
Baylor Heart and Vascular Institute, Dallas, 75226, TX, USA
Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, 75226, TX, USA
*Correspondence: firstname.lastname@example.org (Peter A. McCullough)
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
There is an emergency need for early ambulatory treatment of Coronavirus Disease 2019 (COVID-19) in acutely
ill patients in an attempt to reduce disease progression
and the risks of hospitalization and death. Such management should be applied in high-risk patients age >
50 years or with one or more medical problems including cardiovascular disease. We evaluated a total of 922
outpatients from March to September 2020. All patients
underwent contemporary real-time polymerase chain reaction (PCR) assay tests from anterior nasal swab samples.
Patients age 50.5 ± 13.7 years (range 12 to 89), 61.6%
women, at moderate or high risk for COVID-19 received
empiric management via telemedicine. At least two agents
with antiviral activity against SARS-CoV-2 (zinc, hydroxychloroquine, ivermectin) and one antibiotic (azithromycin,
doxycycline, ceftriaxone) were used along with inhaled
budesonide and/or intramuscular dexamethasone consistent with the emergent science on early COVID-19 treatment. For patients with high severity of symptoms, urgent in-clinic administration of albuterol nebulizer, inhaled
budesonide, and intravenous volume expansion with supplemental parenteral thiamine 500 mg, magnesium sulfate
4 grams, folic acid 1 gram, vitamin B12 1 mg. A total of 320/922 (34.7%) were treated resulting in 6/320
(1.9%) and 1/320 (0.3%) patients that were hospitalized
and died, respectively. We conclude that early ambulatory (not hospitalized, treated at home), multidrug therapy
is safe, feasible, and associated with low rates of hospitalization and death. Early treatment should be considered for high-risk patients as an emergency measure while
we await randomized trials and guidelines for ambulatory
SARS-CoV-2; COVID-19; multidrug; hospitalization; mortality; ambulatory; antiviral; zinc; hydroxychloroquine; ivermectin; doxycycline;
azithromycin; vitamin; corticosteroid
Rev. Cardiovasc. Med. 2020 vol. 21(4), 611–614
©2020 Procter et al. Published by IMR Press.
The epidemic viral outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection Coronavirus Disease 2019 (COVID-19) is advancing across the United States unabated despite public policy measures focussed on contagion control (McCullough et al., 2020). The United States has a current 877
deaths per million inhabitants despite having technically advanced
hospitals and to date sufficient capacity to handle the surges of patients requiring hospitalization (Worldometer, 2020). Conversely
India, a country with broad implementation of early COVID-19
treatment has 102 deaths per million (Worldometer, 2020). The
regulatory agencies as well as the National Institutes of..
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