COVID is a fast-mutating virus that understands the dynamics of the ACE 2 pathways. It is a biphasic disease with three tiers of intervention.
The initial phase is viremic and is optimal for treatment with anti-viremic drugs that target viral replication in distinct parts of viral replication cycle e.g. protease inhibitors like Lopinavir/ Ritonavir and medications that containerize the COVID particles e.g. hydroxychloroquine. This is supplemented by drying inhalers e.g., Breztri or ipratropium bromide that decrease COVID rich secretions going into the lung alveoli.
The addition of H1 blockers e.g., Benadryl prevents the escalation of the bradykinin storm into the cytokine storm. The addition of JAK 2 inhibitors e.g., famotidine shuts down the progression into the cytokine storm.
This phase progresses by 8th-10th day if left unchecked to the second phase (the cytokine storm) where the body creates an acute inflammatory response causing severe damage. This results in thrombosis and pulmonary embolism. The second phase requires both antiviral medications, high dose steroids, famotidine, Benadryl, steroid inhalers e.g., Breztri and Pulmicort as well as Interleukin 7 blockers e.g., Tocilizumab if available.
Once thrombosis or pulmonary embolism has been identified appropriate anti-thrombotic like Eliquis is essential.
The third tier of intervention is identifying and treating the atypical bacteria, viruses and fungi that arise from the immunodeficiency’s that temporally arise from COVID infection.
Published Date: 2023-12-30; Received Date: 2023-12-03
