The following is our recommended approach to COVID-19 in the hospitalized patient, based on the best (and most recent) literature. It is provided as guidance to healthcare providers worldwide and should only be used by medical professionals in formulating their approach to COVID-19. Patients should always consult with their provider before starting any medical treatment. As this is a highly dynamic topic, we will update these guidelines as new information emerges. Please ensure you are using the latest version of this protocol.
The core principle of MATH+ is the use of anti-inflammatory agents to dampen the “cytokine storms,” together with anticoagulation to limit the microvascular and macrovascular clotting, and supplemental oxygen to help overcome the hypoxia.
It is critically important to recognize that infection with SARS-CoV-2, the virus that causes COVID-19, progresses through stages. Treatment approaches are therefore highly stage-specific. Antiviral therapy is likely to be effective only during the viral replicative phase. Anti-inflammatory therapy is expected to be effective during the pulmonary phase and possibly the post-COVID phase.
The pulmonary phase of COVID-19 is a treatable disease; it is inappropriate to limit therapy to “supportive care” alone. As patients progress down the pulmonary cascade the disease becomes more difficult to reverse. The implications of this are two-fold:
- Early treatment of the pulmonary phase is ESSENTIAL to a good outcome.
- Treatment in the late pulmonary phase may require escalation of the dose of corticosteroids as well as the use of salvage methods (i.e., plasma exchange). However, patients who present in the late pulmonary phase may have progressed to the irreversible pulmonary fibroproliferative phase.
Please do not consider these protocols as personal medical advice, but as a recommendation for use by professional providers. Consult with your doctor, share the information on this website and discuss with her/him. Please review our Disclaimers.