MATH+

Hospital Treatment Protocol for COVID-19

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.
About this Protocol

The information in this document is our recommended approach to treating the hospitalized COVID-19 patient, based on the best (and most recent) literature.

It is provided as guidance to healthcare providers worldwide on the early treatment of COVID-19. Patients should always consult with their provider before starting any medical treatment.

New medications may be added and/or changes made to doses of existing medications as further evidence emerges. Please check this page frequently to be sure you are using the latest version of this protocol.

A note about anesthesia and surgery:

Please notify your anesthesia team if you are using the following medications and/or nutraceuticals as they can increase the risk of Serotonin Syndrome — a life-threatening condition — when opioids are administered:

  • Methylene blue
  • Curcumin
  • Nigella Sativa
  • Selective Serotonin Reuptake Inhibitors (SSRIs)

For more information on nutritional therapeutics and how they can help with COVID-19, visit our guide to Nutritional Therapeutics. For additional in