Treat patients based on clinical suspicion as soon as possible, preferably within the first 5 days of symptoms. Perform PCR testing, but do not withhold treatment pending results.
Risk Stratify Patients
· Low risk patient - Younger than 45, no comorbidities, and clinically stable
· High risk patient - Older than 45, younger than 45 with comorbidities, or clinically unstable
Treatment Options
Low risk patients
· Supportive care with fluids, fever control, and rest
· Elemental Zinc 50mg 1 time a day for 7 days
· Vitamin C 1000mg 1 time a day for 7 days
· Vitamin D3 5000iu 1 time a day for 7 days
Optional over the counter options
· Quercetin 500mg 2 times a day for 7 days or
· Epigallocatechin-gallate (EGCG) 400mg 1 time a day for 7 days
Moderate / High risk patients
· Elemental Zinc 50-100mg once a day for 7 days
· Vitamin C 1000mg 1 time a day for 7 days
· Vitamin D3 10000iu once a day for 7 days or 50000iu once a day for 1-2 days
· Azithromycin 500mg 1 time a day for 5 days or
· Doxycycline 100mg 2 times a day for 7 days
· Hydroxychloroquine (HCQ) 200mg 2 times a day for 5-7 days and/or
· Ivermectin 0.4-0.5mg/kg/day for 5-7 days Either or both HCQ and IVM can be used, and if one only, the second agent may be added after about 2 days of treatment if obvious recovery has not yet been observed etc.
Treatment Options
· Dexamethasone 6-12mg 1 time a day for 7 days or
· Prednisone 20mg twice a day for 7 days, taper as needed
· Budesonide 1mg/2cc solution via nebulizer twice a day for 7 days
· Blood thinners (i.e. Lovenox, Eliquis, Xarelto, Pradaxa, Aspirin)
· Colchicine 0.6mg 2-3 times a day for 5-7 days
· Monoclonal antibodies
· Home IV fluids and oxygen