Dr. George Fareed and Colleagues Urge Early Outpatient Treatment for COVID-19

BRAWLEY, Calif., Jan. 11, 2021 /PRNewswire/ --  Widely available outpatient treatments can reduce COVID-19 illness severity, hospitalization and mortality when used early in the disease, according to a new peer-reviewed article co-authored by Dr. George Fareed, MD, Medical Director of Pioneers Health Clinic, and 56 other doctors and academics in a special COVID-19 issue of Reviews in Cardiovascular Medicine. With vaccines taking time to deploy and having only partial success in high-risk patients, these early outpatient therapies can help manage the disease by lowering mortality and reducing the burden on overstretched healthcare systems.

The outpatient therapies include combinations of widely available drugs and nutraceuticals (zinc, vitamin D, vitamin C, quercetin) as well as anti-infectives, steroids and anticoagulants if necessary. The new protocol features FDA-approved antibody infusions manufactured by Lilly and Regeneron, which are available at hospitals and should be available at urgent care centers and nursing homes soon.

For patients who do not receive antibodies, early sequential multidrug therapy (SMDT) calls for combinations of well-known, safe drugs such as ivermectin, hydroxychloroquine, azithromycin, doxycycline, and favipiravir (outside the US), along with inhaled steroids such as budesonide and oral steroids including dexamethasone and prednisone.

The article notes that dozens of countries around the world are already using these drugs for early outpatient treatment of COVID-19, including some like Brazil and India which are widely distributing ivermectin and hydroxychloroquine in at-home treatment kits.

Addressing the debate over drug efficacy, the authors note that trials producing claimed null findings suffer from serious flaws including unblinded protocols, absence of placebo controls, changing endpoints, and truncated sample sizes. By contrast, ongoing reviews and meta-analyses of over 200 studies of hydroxychloroquine and 44 studies of ivermectin suggest early use of these drugs in combination with others results in substantial reductions in disease severity, hospitalization, and mortality. 

The article emphasized the safety of these drugs, which have been safely used by hundreds of millions of people around the world. Regarding hydroxychloroquine for COVID-19 specifically, a study in the European Society of Cardiology's journal, EP Europace, concludes, "HCQ administration is safe for a short-term treatment for patients with COVID-19 infection regardless of the clinical setting of delivery."

Citation:

McCullough, Peter, et al. "Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)." Reviews in Cardiovascular Medicine, 2020, Vol. 21, Issue (4): 517-530.  DOI: 10.31083/j.rcm.2020.04.264

Contact:

Harvey A. Risch, MD, PhD 
Professor of Epidemiology
Yale School of Public Health
Yale School of Medicine
Yale Cancer Center

[email protected]

SOURCE George Fareed