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COVID-19

Morbus coronaviralis 2019

What it is

SARS-CoV-2 infection, from a cold-like illness to fatal lung injury and long-term sequelae.

Symptoms & signs

  • Fever
  • cough
  • loss of smell
  • fatigue
  • breathlessness
  • body aches
  • long-lasting brain fog in some

🚩 Get help if…

  • call 112 / 911 now Struggling to breathe, or breathless at rest
  • call 112 / 911 now Blue or grey lips, confusion or very drowsy
  • see a doctor soon Oxygen level 94% or lower on a finger meter
  • see a doctor soon Getting worse again after the first week

Where it strikes

Medical treatment

  • Nirmatrelvir-ritonavir within 5 days — clear benefit in unvaccinated high risk, none found in vaccinated standard-risk adults mixed evidence
  • Remdesivir — shorter illness, no clear effect on deaths mixed evidence
  • Dexamethasone once oxygen is needed — one of the few drugs here that cut deaths trials support
  • Oxygen and proning trials support
  • Vaccination — large absolute benefit against severe disease in the old and frail, small in the healthy young, with myocarditis in roughly 1 in 10 000 young men after an mRNA dose mixed evidence

Natural & lifestyle

  • Vaccination, weighed as above mixed evidence
  • Ventilation and filtration trials support
  • Rest and a graded return trials support
  • Food and protein trials support
  • Stopping smoking trials support

Emerging & experimental

  • Pan-coronavirus and nasal mucosal vaccines
  • long-COVID antiviral persistence trials
  • BC007 — no benefit in its phase 2 trial not confirmed in trials

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Ivermectin (FLCCC and Zelenko protocols) — laboratory work and early small studies suggested an antiviral effect; the large randomised trials (TOGETHER, ACTIV-6, COVID-OUT, PRINCIPLE) found no effect on hospitalisation or death, PRINCIPLE only slightly faster self-reported recovery not confirmed in trials
  • The Zelenko protocol (hydroxychloroquine + zinc + azithromycin, started early) — its own reports were uncontrolled case series; randomised trials of hydroxychloroquine (RECOVERY, WHO Solidarity, outpatient trials) showed no benefit and more heart-rhythm side effects not confirmed in trials
  • Vitamin D3 — low blood levels go with severe disease; supplementation trials are mixed (CORONAVIT found no fewer infections, a small calcifediol trial found fewer ICU admissions) mixed evidence
  • Inhaled budesonide early in the illness — the STOIC and PRINCIPLE trials found faster recovery at home trials support
  • Metformin started early — one large trial (COVID-OUT) found about 40% fewer long-COVID diagnoses; not yet repeated mixed evidence
  • Fluvoxamine — the TOGETHER trial found fewer prolonged emergency visits; larger US trials did not confirm it mixed evidence
  • Zinc, vitamin C, quercetin, melatonin — plausible mechanisms; small trials show little or no effect early / small studies
  • Povidone-iodine or saline nose and throat rinses — lower the virus in the nose for a while; effect on the illness uncertain early / small studies

ICD codes