Early outpatient treatments effective against COVID-19, including hydroxychloroquine

Editor's Note

Researchers from 17 healthcare organizations report that COVID-19 hospitalizations and death can be reduced with early outpatient treatments.

The researchers designed an algorithm comprising treatments in order of disease severity:

• Immediately give zinc lozenges 5 times per day or zinc sulphate 220 mg every day for 5 days.
• If symptoms worsen, immediately give Hydroxychloroquine 200 mg by mouth twice a day with Azithromycin 250 mg by mouth twice a day or with Doxycycline 100 mg by mouth twice a day, or give Favipiravir 600 mg by mouth twice a day alone.
• If respiratory symptoms develop or on day 5 of illness, give Prednisone 1 mg/kg every day for 5 days ± taper ± Colchicine 0.6 mg by mouth twice a day.
• If micro- or overt thrombosis is suspected, give Aspirin 81 mg by mouth every day ± low-molecular weight heparin or Apixaban, Rivaroxaban, Dabigatran, Edoxaban in standard doses.

In the absence of clinical trials and guidelines and with hospitalizations and mortality increasing, it is prudent to deploy treatments for COVID-19 based on pathophysiological principles, the researchers say.