Published: July 2, 2020; Updated: July 11, 2020
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Immunological and serological studies show that most people develop no symptoms or only mild symptoms when infected with the new coronavirus, while some people may experience a more pronounced or critical course of the disease.
Based on the available scientific evidence and current clinical experience, the SPR Collaboration recommends that physicians and authorities consider the following treatment protocol for early treatment of the Covid-19 disease in high-risk patients (see below for references).
Based on this and very similar protocols, US physicians have been reporting an 84% decrease in hospitalization rates, a 50% decrease in mortality rates among already hospitalized patients, and an improvement in the condition of patients often within hours.
Note: Patients are asked to consult a doctor.
Treatment protocol
- Zinc (100mg per day)
- Hydroxychloroquine (400mg per day)
- Azithromycin (up to 500mg per day)
- Heparin (usual dosage)
- Vitamins C and D3 plus quercetin
Explanatory notes
- Zinc: Antiviral properties (see references below). Zinc may be used prophylactically or immediately when the first typical symptoms appear. For some patients, treatment with high-dose zinc (100mg per day) may already be sufficient to prevent progression of the disease.
- Hydroxychloroquine (HCQ): Support of the cellular uptake of zinc as well as additional antiviral properties. If prescribed by a doctor, HCQ may be used immediately upon the onset of the first typical symptoms or even prophylactically. Contraindications (e.g. favism) must be observed.
- Azithromycin: Antibiotic to prevent a bacterial superinfection in case of viral pneumonia. In patients at risk and as prescribed by a doctor, azithromycin may be used immediately after the first typical symptoms appear. Contraindications must be observed.
- Heparin: Anticoagulation (blood clotting inhibition) for prophylaxis or treatment of infection-related thrombosis and pulmonary embolism in patients at risk and as prescribed by a doctor.
- Vitamins C and D3: Support of the immune system (also prophylactically). These may be supplemented by the antiviral flavonoid quercetin, which supports the absorption of zinc.
Importantly, early treatment as soon as the first symptoms appear and even without a PCR test is crucial to prevent progression of the disease. Zinc and HCQ may also be used prophylactically.
The alleged or actual negative results with HCQ in some studies were based, according to the current state of knowledge, on delayed use (intensive care patients), excessive doses (up to 2400mg per day), manipulated data sets, or ignored contraindications (e.g., favism or heart problems).
Early treatment based on the above protocol is intended to avoid hospitalization. If hospitalization nevertheless is required, experienced ICU doctors recommend avoiding invasive ventilation (intubation) whenever possible and using oxygen therapy (HFNC) instead.
It is conceivable that the above treatment protocol, which is simple, safe and inexpensive, could render more complex medications, vaccinations, and other measures largely obsolete.
References
General
- EVMS Critical Care Covid-19 Management Protocol (Paul Marik, MD, June 2020)
Zinc
- Study: Effect of Zinc Salts on Respiratory Syncytial Virus Replication (Suara & Crowe, AAC, 2004)
- Study: Zinc Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture (Velthuis et al, PLOS Path, 2010)
- Study: Zinc for the common cold (Cochrane Systematic Review, 2013)
- Study: Hydroxychloroquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients (Carlucci et al., MedRxiv, May 2020)
- Review: Does zinc supplementation enhance the clinical efficacy of chloroquine/ hydroxychloroquine to win today’s battle against COVID-19? (Derwand & Scholz, MH, 2020)
- Review: Zinc supplementation to improve treatment outcomes among children diagnosed with respiratory infections (WHO, Technical Report, 2011)
- Article: Can Zinc Lozenges Help with Coronavirus Infections? (McGill University, March 2020)
Hydroxychloroquine
- Studies: Overview of more than 50 international HCQ studies (C19Study.com)
- Study: Chloroquine is a potent inhibitor of SARS coronavirus infection and spread (Vincent et al., Virology Journal, 2005)
- Study: Chloroquine Is a Zinc Ionophore (Xue et al, PLOS One, 2014)
- Study: Clinical Efficacy of Chloroquine derivatives in COVID-19 Infection: Comparative meta-analysis between the Big data and the real world (Million et al, NMNI, June 2020)
- Study: Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19 (Arshad et al, Int. Journal of Infect. Diseases, July 2020)
- Study: COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin (Scholz et al., Preprints, July 2020)
- Article: Using Hydroxychloroquine and Other Drugs to Fight Pandemic (Yale School of Medicine)
- Article: Moroccan Scientist: Morocco’s Chloroquine Success Reveals European Failures (Morocco World News, June 2020) Zemmouri believes 78% of Europe’s coronavirus-related deaths could have been avoided if European states had mirrored Morocco’s chloroquine strategy.
- Article (IT): Covid: none of my patients are dead, and only 5% had to be hospitalized (Italia Oggi, June 2020) Dr. Cavanna treated the affected by the virus by intervening promptly and at home.
Quercetin
- Study: Zinc Ionophore Activity of Quercetin and Epigallocatechin-gallate: From Hepa 1-6 Cells to a Liposome Model (Dabbagh et al., JAFC, 2014)
- Study: Quercetin as an Antiviral Agent Inhibits Influenza A Virus Entry (Wu et al, Viruses, 2016)
- Study: Quercetin and Vitamin C: An Experimental, Synergistic Therapy for the Prevention and Treatment of SARS-CoV-2 Related Disease (Biancatelli et al, Front. in Immun., June 2020)
- Report: EVMS Critical Care Covid-19 Management Protocol (Paul Marik, MD, June 2020)
Heparin
- Commentary: The versatile heparin in COVID‐19 (Thachil, JTH, April 2020)
- Study: Anticoagulant Treatment Is Associated With Decreased Mortality in Severe Coronavirus Disease 2019 Patients With Coagulopathy (Tang et al, JTH, May 2020)
- Study: Autopsy Findings and Venous Thromboembolism in Patients With COVID-19 (Wichmann et al., Annals of Internal Medicine, May 2020)
- Article: Anticoagulation Guidance Emerging for Severe COVID-19 (Medpage Today)
