Is This Better Than Hydroxychloroquine For Coronavirus?
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. While there is no high level evidence that this cocktail is effective; it is cheap, safe and widely available. ■ 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). Mildly Symptomatic patients (at home): ■ Vitamin C 500mg BID and Quercetin 250-500 mg BID (if available) ■ Zinc 75-100 mg/day ■ Melatonin 6-12 mg at night (the optimal dose is unknown) ■ Vitamin D3 1000-4000 u/day ■ Optional: Hydroxychloroquine 400mg BID day 1 followed by 200mg BID for 4 days Mildly Symptomatic patients (on floor): ■ Vitamin C 500mg BID and Quercetin 250-500 mg BID (if available) ■ Zinc 75-100 mg/day ■ Melatonin 6-12 mg at night (the optimal dose is unknown) ■ Vitamin D3 1000-4000 .u/day ■ Enoxaparin 40-60 mg daily ■ Optional: Methylprednisolone 40 mg daily ■ Optional: Hydroxychloroquine 400mg BID day 1 followed by 200mg BID for 4 days ■ N/C 2L /min if required (max 4 L/min; consider early t/f to ICU for escalation of care). ■ Avoid Nebulization and Respiratory treatments. Use “Spinhaler” or MDI and spacer if required. ■ Avoid non-invasive ventilation ■ T/f EARLY to the ICU for increasing respiratory signs/symptoms.
