Special Issue:
Utilizing Technology in the COVID 19 era
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Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) |
Peter A. McCullough1, *( ), Paul E. Alexander2, Robin Armstrong3, Cristian Arvinte4, Alan F. Bain5, Richard P. Bartlett6, Robert L. Berkowitz7, Andrew C. Berry8, Thomas J. Borody9, Joseph H. Brewer10, Adam M. Brufsky11, Teryn Clarke12, Roland Derwand13, Alieta Eck14, John Eck14, Richard A. Eisner15, George C. Fareed16, Angelina Farella17, Silvia N. S. Fonseca18, Charles E. Geyer, Jr.19, Russell S. Gonnering20, Karladine E. Graves21, Kenneth B. V. Gross22, Sabine Hazan23, Kristin S. Held24, H. Thomas Hight25, Stella Immanuel26, Michael M. Jacobs27, Joseph A. Ladapo28, Lionel H. Lee29, John Littell30, Ivette Lozano31, Harpal S. Mangat32, Ben Marble33, John E. McKinnon34, Lee D. Merritt35, Jane M. Orient36, Ramin Oskoui37, Donald C. Pompan38, Brian C. Procter39, Chad Prodromos40, Juliana Cepelowicz Rajter41, Jean-Jacques Rajter41, C. Venkata S. Ram42, Salete S. Rios43 , Harvey A. Risch44, Michael J. A. Robb45, Molly Rutherford46, Martin Scholz47, Marilyn M. Singleton48, James A. Tumlin49, Brian M. Tyson50, Richard G. Urso51, Kelly Victory52, Elizabeth Lee Vliet53, Craig M. Wax54, Alexandre G. Wolkoff55, Vicki Wooll56, Vladimir Zelenko57 |
1Baylor University Medical Center, Baylor Heart and Vascular Institute, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, 75226, TX, USA 2Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, L8S 4L8, Ontario, Canada 3Armstrong Medical Group, Texas City, 75510, TX, USA 4North Suburban Medical Center and Vibra Hospital, Thornton, 80229, Colorado, USA 5Chicago Health and Wellness Alliance, Chicago, 60603, IL, USA 6Recipient of the Texas HHS Meritorious Service Award, 78751, Texas, USA 7PianoPsych, LLC, Natick, 01760, MA, USA 8Division of Gastroenterology, Department of Medicine, Larkin Community Hospital, S. Miami, 33143, FL, USA 9Centre for Digestive Diseases, Five Dock, 2046, NSW, Australia 10Infectious Diseases, St. Luke's Hospital, Kansas City, 64111, MO, USA 11University of Pittsburgh, Department of Medicine, Pittsburgh, 15213, PA, USA 12Clarke Neurology, Newport Beach, 92660, CA, USA 13Alexion Pharma Germany GmbH, 80687, Munich, Germany 14Affordable Health, Inc., Piscataway, 08854, NJ, USA 15Eisner Laser Center, Macon, 31210, GA, USA 16Pioneers Medical Center, Brawley, 92227, CA, USA 17Privia Medical Group, Webster, 24510, TX, USA 18Hapvida HMO, Ribeirão Preto,14015-130, SP, Brazil 19Houston Methodist Cancer Center, Houston, 77030, TX, USA 20The Medical College Of Wisconsin, Milwaukee, 53226, WI, USA 21Personal Healthcare Network, Kansas City, 64116, MO, USA 22Fusion Clinical Multimedia, Inc., Philadelphia, 19019, PA, USA 23Ventura Clinical Trials, PROGENABIOME, Malibu Specialty Center, Ventura, 93003, CA, USA 24Stone Oak Ophthalmology, Immediate Past President, Association of American Physicians and Surgeons, San Antonio, 78258, TX , USA 25Cardiosound, Atlanta, 30342, GA, USA 26Rehoboth Medical Center, Houston, 77083, TX, USA 27Complex Primary Care Medicine, Pensacola, 32507, FL, USA 28University of California Los Angeles, Los Angeles, 90095, CA, USA 29Emergency Medicine, Phoenix, 85016, AZ, USA 30Family Medicine, Kissimmee, 34741, FL, USA 31Lozano Medical Clinic, Dallas, 75218, TX, USA 32Howard University College of Medicine, Mangat and Kaur, Inc., Germantown, 20876, MD, USA 33President, MyFreeDoctor.com Pensacola Beach, 3256, FL, USA 34Department of Medicine, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, 48202, MI, USA 35Orthopaedic and Spinal Surgery, Private Practice, Omaha, 68135, NE, USA 36Internal Medicine, Executive Director, Association of American Physicians and Surgeons, Tucson, 85716, AZ, USA 37Foxhall Cardiology, PC, Washington, 20016, DC, USA 38Orthopedic Surgery, Salinas, 93907, CA, USA 39McKinney Family Medicine, McKinney, 75070, TX, USA 40Illinois Sports Medicine and Orthopaedic Center, Glenville, 60025, IL, USA 41Pulmonary and Sleep Consultants, Ft. Lauderdale, 33316, FL, USA 42MediCiti Medical College, 500005, Hyderabad, India 43University of Brasília, Brasilia , 70910-900, DF, Brazil 44Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, 06510, CT, USA 45Robb Oto-Neurology Clinic, Phoenix, 85012, AZ, USA 46Bluegrass Family Wellness, Crestwood, 40014, KY, USA 47Heinrich Heine University, Düsseldorf, 40225, Germany 48Past Pres. Association of American Physicians and Surgeons, Tucson, 85716, AZ, USA 49NephroNet Clinical Trials Consortium, Buford, 30518, GA, USA 50All Valley Urgent Care, El Centro, 92243, CA, USA 51Houston Eye Associates, Houston, 77025, TX, USA 52Victory Health, LLC., 80487, Colorado, USA 53Vive Life Center, 85728, Arizona & Texas, USA 54Family Medicine, Mullica Hill, 08062, NJ, USA 55CMO Emergency Hapvida Saude, HMO, Fortaleza, 60140-061, CE, Brazil 56National Healthcare Coalition, Family Medicine, Eagle, 83616, ID, USA 57Affiliate Physician, Columbia University Irving Medical Center, New York City, 10032, NY, USA |
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Abstract:
The SARS-CoV-2 virus spreading across the world has led to surges of COVID-19 illness, hospitalizations, and death. The complex and multifaceted pathophysiology of life-threatening COVID-19 illness including viral mediated organ damage, cytokine storm, and thrombosis warrants early interventions to address all components of the devastating illness. In countries where therapeutic nihilism is prevalent, patients endure escalating symptoms and without early treatment can succumb to delayed in-hospital care and death. Prompt early initiation of sequenced multidrug therapy (SMDT) is a widely and currently available solution to stem the tide of hospitalizations and death. A multipronged therapeutic approach includes 1) adjuvant nutraceuticals, 2) combination intracellular anti-infective therapy, 3) inhaled/oral corticosteroids, 4) antiplatelet agents/anticoagulants, 5) supportive care including supplemental oxygen, monitoring, and telemedicine. Randomized trials of individual, novel oral therapies have not delivered tools for physicians to combat the pandemic in practice. No single therapeutic option thus far has been entirely effective and therefore a combination is required at this time. An urgent immediate pivot from single drug to SMDT regimens should be employed as a critical strategy to deal with the large numbers of acute COVID-19 patients with the aim of reducing the intensity and duration of symptoms and avoiding hospitalization and death.
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Submitted: 28 November 2020
Revised: 08 December 2020
Accepted: 15 December 2020
Published: 30 December 2020
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Fund: None related.
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*Corresponding Author(s):
Peter A. McCullough
E-mail: peteramccullough@gmail.com
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Cite this article:
Peter A. McCullough, Paul E. Alexander, Robin Armstrong, Cristian Arvinte, Alan F. Bain, Richard P. Bartlett, Robert L. Berkowitz, Andrew C. Berry, Thomas J. Borody, Joseph H. Brewer, Adam M. Brufsky, Teryn Clarke, Roland Derwand, Alieta Eck, John Eck, Richard A. Eisner, George C. Fareed, Angelina Farella, Silvia N. S. Fonseca, Charles E. Geyer Jr., Russell S. Gonnering, Karladine E. Graves, Kenneth B. V. Gross, Sabine Hazan, Kristin S. Held, H. Thomas Hight, Stella Immanuel, Michael M. Jacobs, Joseph A. Ladapo, Lionel H. Lee, John Littell, Ivette Lozano, Harpal S. Mangat, Ben Marble, John E. McKinnon, Lee D. Merritt, Jane M. Orient, Ramin Oskoui, Donald C. Pompan, Brian C. Procter, Chad Prodromos, Juliana Cepelowicz Rajter, Jean-Jacques Rajter, C. Venkata S. Ram, Salete S. Rios , Harvey A. Risch, Michael J. A. Robb, Molly Rutherford, Martin Scholz, Marilyn M. Singleton, James A. Tumlin, Brian M. Tyson, Richard G. Urso, Kelly Victory, Elizabeth Lee Vliet, Craig M. Wax, Alexandre G. Wolkoff, Vicki Wooll, Vladimir Zelenko. Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19). Reviews in Cardiovascular Medicine, 2020, 21(4): 517-530.
URL:
https://rcm.imrpress.com/EN/10.31083/j.rcm.2020.04.264 OR https://rcm.imrpress.com/EN/Y2020/V21/I4/517
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