{"id":166340,"date":"2020-08-10T12:01:29","date_gmt":"2020-08-10T11:01:29","guid":{"rendered":"https:\/\/www.transcend.org\/tms\/?p=166340"},"modified":"2020-12-02T10:01:55","modified_gmt":"2020-12-02T10:01:55","slug":"update-on-the-treatment-of-covid-19","status":"publish","type":"post","link":"https:\/\/www.transcend.org\/tms\/2020\/08\/update-on-the-treatment-of-covid-19\/","title":{"rendered":"Update on the Treatment of Covid-19"},"content":{"rendered":"

Please note<\/em><\/strong>: This is a recommendation to authorities and physicians. Patients are asked to consult a doctor.<\/em><\/p><\/blockquote>\n

4 Aug 2020 – <\/em>SPR has updated its Covid-19 early treatment protocol<\/a> and has added bromhexine<\/strong>. Bromhexine is a simple over-the-counter mucolytic cough medication that inhibits cellular TMPRSS2 protease and thus blocks SARS-CoV-2 cell entry via ACE2 cell receptors.<\/p>\n

Several groups have already proposed<\/a> bromhexine as an early or prophylactic treatment for Covid-19. An Iranian group recently reported a decrease<\/a> in intensive care treatments of 82%, a decrease in intubations of 89%, and a decrease in deaths of 100% in a trial with 78 patients.<\/p>\n

For further information on bromhexine see the reference section<\/strong> on the protocol page.<\/p>\n

In view of a possible renewed increase in infection rates, early or prophylactic treatment<\/strong> of people at high risk or high exposure (including health care workers) should be of paramount importance to reduce hospitalizations and deaths.<\/p>\n

********<\/p>\n

Immunological and serological studies show that<\/a> 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.<\/p>\n

Based on the available scientific evidence and current clinical experience, the SPR Collaboration recommends that physicians and authorities consider the following Covid-19 treatment protocol for the early treatment<\/strong> of people at high risk or high exposure (see references below).<\/p>\n

Treatment protocol<\/h4>\n
    \n
  1. Zinc (50mg to 100mg per day)\u00ba<\/li>\n
  2. Hydroxychloroquine (400mg per day)*\u00ba<\/li>\n
  3. Quercetin (500mg to 1000mg per day)\u00ba<\/li>\n
  4. Bromhexine (50mg to 100mg per day)\u00ba<\/li>\n
  5. Azithromycin (up to 500mg per day)*<\/li>\n
  6. Heparin (usual dosage)*<\/li>\n<\/ol>\n

    *) Prescription only (in most countries)
    \n\u00ba) Also prophylactically (for high-risk persons)<\/p>\n

    Note<\/strong>: Quercetin may be used in addition to or as a replacement of hydroxychloroquine (HCQ). Contraindications for HCQ (e.g. favism or heart problems) and azithromycin must be observed.<\/p>\n

    Treatment successes<\/h4>\n

    Zinc\/HCQ\/AZ<\/strong>: US physicians reported an 84% decrease<\/a> in hospitalization rates, a 50% decrease<\/a> in mortality rates among already hospitalized patients (if treated early), and an improvement in the condition of patients within 8 to 12 hours<\/a>. Italian doctors reported a decrease in deaths\u00a0of 66%<\/a>.<\/p>\n

    Bromhexine<\/strong>: Iranian doctors reported in a study with 78 patients<\/a> a decrease in intensive care treatments of 82%, a decrease in intubations of 89%, and a decrease in deaths of 100%. Chinese doctors reported a 50% reduction<\/a> in intubations.<\/p>\n

    Mechanisms of action<\/h4>\n

    Zinc<\/strong> inhibits<\/a> RNA polymerase activity of coronaviruses and thus blocks virus replication. Hydroxychloroquine <\/strong>and quercetin <\/strong>support<\/a> the cellular absorption<\/a> of zinc and have additional anti-viral properties<\/a>. Bromhexine<\/strong> inhibits<\/a> the expression of the cellular TMPRSS2 protease and thus the entry of the virus into the cell. Azithromycin<\/strong> prevents bacterial superinfections. Heparin <\/strong>prevents infection-related thromboses and embolisms in patients at risk. (See scientific references below).<\/p>\n

    See also<\/strong>: Illustration of the mechanisms of action<\/a> of HCQ, quercetin and bromhexine<\/p>\n

    Additional notes<\/h4>\n

    The early treatment<\/strong> of patients as soon as the first typical symptoms appear and even without a PCR test is essential to prevent progression of the disease. Zinc, HCQ, quercetin and bromhexin may also be used prophylactically<\/a> for people at high risk or high exposure (e.g. for health care workers).<\/p>\n

    In contrast, isolating infected high-risk patients at home and without early treatment until they develop serious respiratory problems, as often happened during lockdowns, may be detrimental.<\/p>\n

    The alleged or actual negative results with hydroxychloroquine in some studies were based on delayed use<\/a> (intensive care patients), excessive doses<\/a> (up to 2400mg per day), manipulated data sets<\/a> (the Surgisphere scandal), or ignored contraindications<\/a> (e.g., favism or heart disease).<\/p>\n

    Early treatment based on the above protocol is intended to avoid<\/strong> hospitalization. If hospitalization nevertheless becomes necessary, experienced ICU doctors recommend<\/a> avoiding invasive ventilation (intubation) whenever possible and using oxygen therapy (HFNC) instead.<\/p>\n

    It is conceivable that the above treatment protocol, which is simple, safe<\/a> and inexpensive, could render more complex medications, vaccinations, and other measures largely obsolete<\/a>.<\/p>\n

    Background<\/h4>\n

    The efficacy of HCQ against SARS coronaviruses was established<\/a> in 2005 in the wake of the SARS-1 epidemic. The efficacy of zinc in blocking RNA replication of coronaviruses was discovered<\/a> in 2010 by world-leading SARS virologist Ralph Baric. The efficacy of HCQ in supporting the cellular uptake of zinc was discovered<\/a> in 2014 as part of cancer research. The efficacy of the flavonoid quercetin in supporting the cellular uptake of zinc was also discovered<\/a> in 2014. The efficacy of bromhexine in blocking cell entry of coronaviruses was established<\/a> in 2017.<\/p>\n

    References<\/h4>\n

    General<\/strong><\/p>\n