GreenEyedBlonde
Member
- Joined
- Apr 30, 2016
- Messages
- 161
Any thoughts on these suggestions for supplements?
EVMS CRITICAL CARE
COVID-19 MANAGEMENT PROTOCOL
Developed and updated by Paul Marik, MD Chief of Pulmonary and Critical Care Medicine Eastern Virginia Medical School, Norfolk, VA April 6th 2020
URGENT! Please circulate as widely as possible. It is crucial that every pulmonologist, every critical care doctor and nurse, every hospital administrator, every public health official receive this information immediately.
This is our recommended approach to COVID-19 based on the best (and most recent) available literature including the Shanghai Management Guideline for COVID. We should not re-invent the wheel, but learn from the experience of others around the world. It is important to recognize that COVID-19 does not cause your “typical ARDS”... this disease must be treated differently and it is likely we are exacerbating this situation by causing ventilator induced lung injury. This is a very fluid situation; therefore, we will be updating the guideline as new information emerges. Please check on the EVMS website for updated versions of this protocol.
EVMS COVID website: Medical Information/COVID Care Protocol - Eastern Virginia Medical School (EVMS), Norfolk, Hampton Roads Short url: evms.edu/covidcare
“If what you are doing ain’t working, change what you are doing”
Dr AB (NYC).
“We have zero success for patients who were intubated. Our thinking is changing to postpone intubation to as long as possible, to prevent mechanical injury from the ventilator. These patients tolerate arterial hypoxia surprisingly well. Natural course seems to be the best.”
This is not your “typical ARDS”. Mechanical Ventilation may be doing harm. We need to think of alternative treatment strategies.
Page 1 of 18 | EVMS Critical Care COVID-19 Management Protocol 04-06-2020 | evms.edu/covidcare
Suggested approach to prophylaxis and treatment of COVID-19
Prophylaxis
While there is very limited data (and none specific for COVID-19), the following “cocktail” may have a role in the prevention/mitigation of COVID-19 disease, especially amongst the most vulnerable citizens in our community; i.e. those over the age of 60 years and those with medical comorbidities. While there is no high level evidence that this cocktail is effective; it is cheap, safe and should be readily available. So what is there to lose?
• Vitamin C 500 mg BID and Quercetin 250-500 mg BID
• Zinc 75-100 mg/day (acetate, gluconate or picolinate). Zinc lozenges are preferred. After 1-2
months, reduce the dose to 30-50 mg/day.
• Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 1-2 mg at night
• Vitamin D3 1000-4000 u/day (optimal dose unknown). Likely that those with baseline low 25-
OH vitamin D levels and those > living at 40o latitude will benefit the most.
EVMS CRITICAL CARE
COVID-19 MANAGEMENT PROTOCOL
Developed and updated by Paul Marik, MD Chief of Pulmonary and Critical Care Medicine Eastern Virginia Medical School, Norfolk, VA April 6th 2020
URGENT! Please circulate as widely as possible. It is crucial that every pulmonologist, every critical care doctor and nurse, every hospital administrator, every public health official receive this information immediately.
This is our recommended approach to COVID-19 based on the best (and most recent) available literature including the Shanghai Management Guideline for COVID. We should not re-invent the wheel, but learn from the experience of others around the world. It is important to recognize that COVID-19 does not cause your “typical ARDS”... this disease must be treated differently and it is likely we are exacerbating this situation by causing ventilator induced lung injury. This is a very fluid situation; therefore, we will be updating the guideline as new information emerges. Please check on the EVMS website for updated versions of this protocol.
EVMS COVID website: Medical Information/COVID Care Protocol - Eastern Virginia Medical School (EVMS), Norfolk, Hampton Roads Short url: evms.edu/covidcare
“If what you are doing ain’t working, change what you are doing”
Dr AB (NYC).
“We have zero success for patients who were intubated. Our thinking is changing to postpone intubation to as long as possible, to prevent mechanical injury from the ventilator. These patients tolerate arterial hypoxia surprisingly well. Natural course seems to be the best.”
This is not your “typical ARDS”. Mechanical Ventilation may be doing harm. We need to think of alternative treatment strategies.
Page 1 of 18 | EVMS Critical Care COVID-19 Management Protocol 04-06-2020 | evms.edu/covidcare
Suggested approach to prophylaxis and treatment of COVID-19
Prophylaxis
While there is very limited data (and none specific for COVID-19), the following “cocktail” may have a role in the prevention/mitigation of COVID-19 disease, especially amongst the most vulnerable citizens in our community; i.e. those over the age of 60 years and those with medical comorbidities. While there is no high level evidence that this cocktail is effective; it is cheap, safe and should be readily available. So what is there to lose?
• Vitamin C 500 mg BID and Quercetin 250-500 mg BID
• Zinc 75-100 mg/day (acetate, gluconate or picolinate). Zinc lozenges are preferred. After 1-2
months, reduce the dose to 30-50 mg/day.
• Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 1-2 mg at night
• Vitamin D3 1000-4000 u/day (optimal dose unknown). Likely that those with baseline low 25-
OH vitamin D levels and those > living at 40o latitude will benefit the most.
