Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19).

Autor:	McCullough PA; Baylor University Medical Center, Baylor Heart and Vascular Institute, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, 75226, TX, USA., Alexander PE; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, L8S 4L8, Ontario, Canada., Armstrong R; Armstrong Medical Group, Texas City, 75510, TX, USA., Arvinte C; North Suburban Medical Center and Vibra Hospital, Thornton, 80229, Colorado, USA., Bain AF; Chicago Health and Wellness Alliance, Chicago, 60603, IL, USA., Bartlett RP; Recipient of the Texas HHS Meritorious Service Award, 78751, Texas, USA., Berkowitz RL; PianoPsych, LLC, Natick, 01760, MA, USA., Berry AC; Division of Gastroenterology, Department of Medicine, Larkin Community Hospital, S. Miami, 33143, FL, USA., Borody TJ; Centre for Digestive Diseases, Five Dock, 2046, NSW, Australia., Brewer JH; Infectious Diseases, St. Luke's Hospital, Kansas City, 64111, MO, USA., Brufsky AM; University of Pittsburgh, Department of Medicine, Pittsburgh, 15213, PA, USA., Clarke T; Clarke Neurology, Newport Beach, 92660, CA, USA., Derwand R; Alexion Pharma Germany GmbH, 80687, Munich, Germany., Eck A; Affordable Health, Inc., Piscataway, 08854, NJ, USA., Eck J; Affordable Health, Inc., Piscataway, 08854, NJ, USA., Eisner RA; Eisner Laser Center, Macon, 31210, GA, USA., Fareed GC; Pioneers Medical Center, Brawley, 92227, CA, USA., Farella A; Privia Medical Group, Webster, 24510, TX, USA., Fonseca SNS; Hapvida HMO, Ribeirão Preto,14015-130, SP, Brazil., Geyer CE Jr; Houston Methodist Cancer Center, Houston, 77030, TX, USA., Gonnering RS; The Medical College Of Wisconsin, Milwaukee, 53226, WI, USA., Graves KE; Personal Healthcare Network, Kansas City, 64116, MO, USA., Gross KBV; Fusion Clinical Multimedia, Inc., Philadelphia, 19019, PA, USA., Hazan S; Ventura Clinical Trials, PROGENABIOME, Malibu Specialty Center, Ventura, 93003, CA, USA., Held KS; Stone Oak Ophthalmology, Immediate Past President, Association of American Physicians and Surgeons, San Antonio, 78258, TX , USA., Hight HT; Cardiosound, Atlanta, 30342, GA, USA., Immanuel S; Rehoboth Medical Center, Houston, 77083, TX, USA., Jacobs MM; Complex Primary Care Medicine, Pensacola, 32507, FL, USA., Ladapo JA; University of California Los Angeles, Los Angeles, 90095, CA, USA., Lee LH; Emergency Medicine, Phoenix, 85016, AZ, USA., Littell J; Family Medicine, Kissimmee, 34741, FL, USA., Lozano I; Lozano Medical Clinic, Dallas, 75218, TX, USA., Mangat HS; Howard University College of Medicine, Mangat and Kaur, Inc., Germantown, 20876, MD, USA., Marble B; President, MyFreeDoctor.com Pensacola Beach, 3256, FL, USA., McKinnon JE; Department of Medicine, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, 48202, MI, USA., Merritt LD; Orthopaedic and Spinal Surgery, Private Practice, Omaha, 68135, NE, USA., Orient JM; Internal Medicine, Executive Director, Association of American Physicians and Surgeons, Tucson, 85716, AZ, USA., Oskoui R; Foxhall Cardiology, PC, Washington, 20016, DC, USA., Pompan DC; Orthopedic Surgery, Salinas, 93907, CA, USA., Procter BC; McKinney Family Medicine, McKinney, 75070, TX, USA., Prodromos C; Illinois Sports Medicine and Orthopaedic Center, Glenville, 60025, IL, USA., Rajter JC; Pulmonary and Sleep Consultants, Ft. Lauderdale, 33316, FL, USA., Rajter JJ; Pulmonary and Sleep Consultants, Ft. Lauderdale, 33316, FL, USA., Ram CVS; MediCiti Medical College, 500005, Hyderabad, India., Rios SS; University of Brasília, Brasilia , 70910-900, DF, Brazil., Risch HA; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, 06510, CT, USA., Robb MJA; Robb Oto-Neurology Clinic, Phoenix, 85012, AZ, USA., Rutherford M; Bluegrass Family Wellness, Crestwood, 40014, KY, USA., Scholz M; Heinrich Heine University, Düsseldorf, 40225, Germany., Singleton MM; Past Pres. Association of American Physicians and Surgeons, Tucson, 85716, AZ, USA., Tumlin JA; NephroNet Clinical Trials Consortium, Buford, 30518, GA, USA., Tyson BM; All Valley Urgent Care, El Centro, 92243, CA, USA., Urso RG; Houston Eye Associates, Houston, 77025, TX, USA., Victory K; Victory Health, LLC., 80487, Colorado, USA., Vliet EL; Vive Life Center, 85728, Arizona & Texas, USA., Wax CM; Family Medicine, Mullica Hill, 08062, NJ, USA., Wolkoff AG; CMO Emergency Hapvida Saude, HMO, Fortaleza, 60140-061, CE, Brazil., Wooll V; National Healthcare Coalition, Family Medicine, Eagle, 83616, ID, USA., Zelenko V; Affiliate Physician, Columbia University Irving Medical Center, New York City, 10032, NY, USA.
Jazyk:	angličtina
Zdroj:	Reviews in cardiovascular medicine [Rev Cardiovasc Med] 2020 Dec 30; Vol. 21 (4), pp. 517-530.
DOI:	10.31083/j.rcm.2020.04.264
Abstrakt:	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. Competing Interests: There is nothing to disclose. Author had access to the data and wrote the manuscript. (© 2020 McCullough et al. Published by IMR Press.)
Databáze:	MEDLINE
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