3 research outputs found
Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)
The SARS-CoV-2 virus spreading across the world has led to surges of COVID-19 illness, hospitalizations, and
death. The complex and multifaceted pathophysiology of life-threatening COVID-19 illness including viral mediated
organ damage, cytokine storm, and thrombosis warrants early interventions to address all components of the devastating
illness. In countries where therapeutic nihilism is prevalent, patients endure escalating symptoms and without
early treatment can succumb to delayed in-hospital
care and death. Prompt early initiation of sequenced multidrug
therapy (SMDT) is a widely and currently available
solution to stem the tide of hospitalizations and death. A
multipronged therapeutic approach includes 1) adjuvant
nutraceuticals, 2) combination intracellular anti-infective
therapy, 3) inhaled/oral corticosteroids, 4) antiplatelet
agents/anticoagulants, 5) supportive care including supplemental
oxygen, monitoring, and telemedicine. Randomized
trials of individual, novel oral therapies have not
delivered tools for physicians to combat the pandemic in
practice. No single therapeutic option thus far has been
entirely effective and therefore a combination is required
at this time. An urgent immediate pivot from single drug to
SMDT regimens should be employed as a critical strategy
to deal with the large numbers of acute COVID-19 patients
with the aim of reducing the intensity and duration
of symptoms and avoiding hospitalization and death
Serum Levels of Vitamin C and Vitamin D in a Cohort of Critically Ill COVID-19 Patients of a North American Community Hospital Intensive Care Unit in May 2020: A Pilot Study
Background
The COVID-19 pandemic has placed an enormous and growing burden on the population and health infrastructure, warranting innovative ways to mitigate risk of contracting and developing severe forms of this disease. A growing body of literature raises the issue of vitamin C and vitamin D as a risk-assessment tool, and therapeutic option, in COVID-19. Objective
The objective of this pilot study was to measure serum vitamin C and vitamin D levels in a cohort of patients with critical COVID-19 illness in our community hospital ICU, correlate with other illness risk factors (age, BMI, HgbA1c, smoking status), generate hypotheses, and suggest further therapeutic intervention studies. Method
This pilot study included all 21 critically ill COVID-19 patients hospitalized in May 2020 in the ICU of North Suburban Medical Center, Thornton, Colorado, in whose care the principal investigator (C.A.) was involved. We measured patients’ serum vitamin C and vitamin D levels, and standard risk factors like age, BMI, HbA1c, and smoking status. Variables in this study were gauged using descriptive statistics. Results
Of 21 critically ill COVID-19 patients (15 males and 6 females, 17 Hispanic and 4 Caucasian, of median age 61 years, range 20–94), there were 11 survivors.
Serum levels of vitamin C and vitamin D were low in most of our critically ill COVID-19 ICU patients.
Older age and low vitamin C level appeared co-dependent risk factors for mortality from COVID-19 in our sample.
Insulin resistance and obesity were prevalent in our small cohort, but smoking was not. Conclusion
Our pilot study found low serum levels of vitamin C and vitamin D in most of our critically ill COVID-19 ICU patients. Older age and low vitamin C level appeared co-dependent risk factors for mortality. Many were also insulin-resistant or diabetic, overweight or obese, known as independent risk factors for low vitamin C and vitamin D levels, and for COVID-19.
These findings suggest the need to further explore whether caring for COVID-19 patients ought to routinely include measuring and correcting serum vitamin C and vitamin D levels, and whether treating critically ill COVID-19 warrants acute parenteral vitamin C and vitamin D replacement