Source: COVEXIT, by Paul Marik

The Eastern Virginia Medical School – EVMS Medical Group – is providing guidance for healthcare providers treating COVID-19 patients. 

This approach to COVID-19 is based on the best (and most recent) available literature and the Shanghai Management Guideline for COVID.

The protocol we are covering here is dated May 5th. This protocol often changes daily. Please bookmark and share evms.edu/covidcare to find the most up-to-date version of the guidelines. 

Summary:

https://www.evms.edu/media/evms_public/departments/internal_medicine/Marik-Covid-Protocol-Summary.pdf

Protocol:

https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf

The protocol was developed and is regularly updated by Paul E. Marik, MD, FCCP, FCCM, Professor of Internal Medicine (picture), whose impressive bio is presented below.

In his protocol, Professor Marik distinguishes 4 phases in the development of the disease: incubation, symptomatic, early pulmonary phase and late pulmonary phase.

The protocol covers not only treatment but also prophylaxis, with zinc, vitamin c, d and melatonin. It is stated that, “while there is no high-level evidence that this cocktail is effective; it is cheap, safe and widely available.” 

For symptomatic patients at home, are added to this, optionally, aspirin, hydroxychloroquine and monitoring with home pulse oxiometry.

The paper goes on to provide the protocol details for the later stages.

Regarding the escalation of respiratory support, it emphasizes to “Try to avoid intubation if at all possible.”





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