Dr. Mike Vasilomanolakis, with COVID 19 update

Dr. Emmanuel (Mike)Vasilomanolakis, MD is a Cardiology Specialist in Long Beach, CA and has over 42 years of experience in the medical field. ...

COVID-19 UPDATE

The latest summary information regarding the prevention and treatment of COVID-19 infections is as follows.

For prevention vitamin C is an immune booster. Take 500 to 2000 mg daily. Vitamin D has been suggested to boost immunity and lessen the bradykinin storm that happens when you get really sick. Take 1000 to 4000 units per day. Perhaps the most important is zinc. Not sure what the optimum dose is because at higher doses there is loss of taste, etc. Probably 40 to 100 mg per day should suffice.

For additional potential prophylaxis you can consider these agents.

Melatonin 2-6 mg at night (remember this is also a sleeping pill and can make you sleepy) and Quercetin 250-500 mg daily.

This is based on a poll of doctors from a conference. I am not saying you need to get these but these are some additional professional ideas.

If you develop the infection in order to minimize the chance of blood clot formation take aspirin 81-325 mg per day at the time you become sick or think you are coming down with something. If you are hospitalized they will start you on more potent blood thinners (anticoagulants).

There has been some controversy regarding the use of Pepcid (Famotidine) which is an antacid medication. It is thought that perhaps at high doses its anatomic spike protein similarity with the COVID-19 may compete with the virus for H2 receptor sites and as such may lessen the severity of the illness. There is no need to take this prophylactically. However, like Aspirin you can start it if you think you are getting sick. Recommended dose is 40 mg daily tho in the hospital they give a much higher dose either by pill or IV....however from my experience many doctors are not using this.

There are several other treatments proposed for once you become sick including Fenofibrate which is an anti-triglyceride agent but more interestingly Ivermectin which is an anti-scabies medication. There is a researcher from Australia that convincingly advocates this in particular with the antibiotic Doxycycline and some additional Zinc. They have shown the virus clears more rapidly from your system.

Should you become hospitalized there are several inflammatory blood markers they monitor such as CRP and sedimentation rate. If these become elevated you will be started on steroid therapy. Steroid inhalers early on in the infection have been advocated and may help. You will also be automatically started on anticoagulation therapy to prevent blood clots.

There is the intravenous medication Remdesivir which when started early seems to lessen the severity and quickens recovery. It does not work the same on all patients but it may be the best treatment we have for now.

The patient is given oxygen and every effort is made to avoid being placed on mechanical ventilation including rotating the patient face up and face down repeatedly to let all parts of the lungs get full ventilation and expansion . If there is any suggestion of infection antibiotics are started.

Convalescent plasma from people who have recovered is also often used/transfused.

The monitoring and treatment regimens have become more standardized and the results improving. A couple months ago the mortality rate for those with known active PCR positive Covid-19 infection was 6%. Now it is down to 3%. This again is based on known cases. There are many more who have had no or minimal symptoms who have had the disease but never became sick enough to get a proof positive PCR exam. They are found to have had the infection by a blood test Immunoglobulin assay which detects antibodies. If your ( IgG and IgM) test is positive it suggests you have had the infection and now have immunity The duration of such immunity however is uncertain. It can be 4 or more months and yes you can get reinfected but it is rare and the likelihood is it will be a less severe infection.

When this pandemic is done and over with the mortality rate may well dip under 1% when taking into account all with antibody positivity.

Tho the news is better don’t drop your guard. We are in our 7th month of isolation. We are almost there. Give it 2-3 more months and there will be mass vaccination and we will be in a much safer position.

Pardon the brevity of this assessment. I welcome my colleagues and all knowledgeable individuals to add or comment.

Best wishes to you,

Dr.

Mike Vasilomanolakis