Titre:	Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)
Auteur(s):	McCullough, Peter A. Alexander, Paul E. Armstrong, Robin Arvinte, Cristian Bain, Alan F. Bartlett, Richard P. Berkowitz, Robert L. Berry, Andrew C. Borody, Thomas J. Brewer, Joseph H. Brufsky, Adam M. Clarke, Teryn Derwand, Roland Eck, Alieta Eck, John Eisner, Richard A. Fareed, George C. Farella, Angelina Fonseca, Silvia N. S. Geyer Jr., Charles E. Gonnering, Russell S. Graves, Karladine E. Gross, Kenneth B. V. Hazan, Sabine Held, Kristin S. Hight, H. Thomas Immanuel, Stella Jacobs, Michael M. Ladapo, Joseph A. Lee, Lionel H. Littell, John Lozano, Ivette Mangat, Harpal S. McKinnon, John E. Merritt, Lee D. Orient, Jane M. Oskoui, Ramin Pompan, Donald C. Procter, Brian C. Prodromos, Chad Rajter, Juliana Cepelowicz Rajter, Jean-Jacques Ram, C. Venkata S. Rios, Salete da Silva Risch, Harvey A. Robb, Michael J. A. Rutherford, Molly Scholz, Martin Singleton, Marilyn M. Tumlin, James A. Tyson, Brian M. Urso, Richard G. Victory, Kelly Vliet, Elizabeth Lee Wax, Craig M. Wolkoff, Alexandre G. Wooll, Vicki Zelenko, Vladimir
metadata.dc.identifier.orcid:	https://orcid.org/0000-0002-0997-6355 https://orcid.org/0000-0001-8425-438X https://orcid.org/0000-0001-8952-6559 https://orcid.org/0000-0001-8080-7960 https://orcid.org/0000-0002-2379-5702 https://orcid.org/0000-0002-5228-7512 https://orcid.org/0000-0003-1846-6354 https://orcid.org/0000-0003-3916-4021 https://orcid.org/0000-0003-4378-3458 https://orcid.org/0000-0003-3520-281X https://orcid.org/0000-0003-1162-6263 https://orcid.org/0000-0001-5337-3941 https://orcid.org/0000-0002-3019-4139 https://orcid.org/0000-0002-2373-2576 https://orcid.org/0000-0001-8681-8214 https://orcid.org/0000-0003-4347-8621
Assunto::	SARS-CoV-2 Covid-19 Hospitalização Mortalidade Tratamento Medicamentos
Date de publication:	30-déc-2020
Editeur:	IMR Press
Référence bibliographique:	MCCULLOUGH, Peter A. et al. Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19). Reviews in Cardiovascular Medicine, v. 21, n. 4, p. 517-530, 2020. DOI: 10.31083/j.rcm.2020.04.264. Disponível em: https://rcm.imrpress.com/article/2020/2153-8174/RCM2020264.shtml. Acesso em: 11 jan. 2021.
Abstract:	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.
metadata.dc.description.unidade:	Faculdade de Medicina (FMD)
Licença::	This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
DOI:	10.31083/j.rcm.2020.04.264
Collection(s) :	Artigos publicados em periódicos e afins UnB - Covid-19

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