Gustavo Aguirre Chang MD | National University of San Marcos
Preprints and early-stage research may not have been peer reviewed yet. The study address the problem with chronic covid or long covid.
This new study came is proposing a process for the treatment and diagnosis of therapeutics for the management of patients with Persistent Symptoms of COVID (Long COVID or Chronic COVID).
It is clarified that in medicine we use the term management to refer both to the part of the clinical examination, as well as to the diagnostic tests and the treatment of patients with a certain disease. When developing the management of the Persistent Symptoms of COVID, the steps to follow are presented sequentially or progressively. 6 steps are described (see Graphic).
Each step would amount to an evaluation or medical consultation. In the 1st step, which would be the first clinical evaluation, one should seek to differentiate the symptoms that are caused by a Persistent Infection by SARS CoV2, from those that are not, and that may be due to other causes, such as Co-infections. , nutrient depletion and hormone deficiency, alteration in the intestinal microbiota (dysbiosis or SIBO) and other microbiota (oral, vascular, renal, pulmonary, upper respiratory, others), immune dysfunctions, sequelae and other coexisting pathologies or conditions (see at the bottom of the graph shown above).
In a separate document, the 2nd step has been developed in detail, which is the “Therapeutic Test” and the First Treatment Scheme to be indicated. The drugs and supplements included in it are shown in the attached Table as an image. The Therapeutic Plan and the 3-3-3 Treatment Scheme, which is included in the 4th step, has also been developed in detail in a separate document (an image of the Scheme Table 3-3-3 is attached). Details of the remaining steps will be published in separate documents.
The main cause of Chronic COVID or Long COVID is Persistent Intracellular Infection by SARS CoV-2. There may also be persistence of viral components or particles. Regarding the “Therapeutic Test” indicated in Step 2, the first version was published in September 2020, and in April 2021 we have published a new version of this Test.
Basically the change made has been the increase in the dose of IVM and the inclusion with details of the alternatives to Aspirin and IVM. In the attached image, in addition to the details of the medications and doses, the interpretation of this Test is included, which is carried out on the 7th day, at the end of its application.
According to the percentage of improvement in symptoms achieved, a test result is established. If the improvement in symptoms is 40% or more, the test is POSITIVE for Persistent SARS CoV-2 Infection. If there is no improvement in symptoms, or this is only 1 to 4%, the test is NEGATIVE, so other causes must be investigated, or it may be sequelae. The % of patients who achieve a complete recovery with resolution of persistent symptoms due to SARS CoV-2 infection has been included in the Management Graph. These % are included at the end of the 2nd, 4th and 6th steps, which are the Steps in which treatments are given. Upon completing the 2nd step, the% of patients who achieve a complete recovery is 75% (3 out of 4). This% rises to between 81 and 87% if the 4th step is completed, this would mean that, of the 25% who did not reach recovery with the 2nd step, on average, half reach the recovery by following the treatment described in the 4th step . And if the 6th step is completed, the half of the 13 to 19% who did not make the recovery with the previous steps, will make it. As a whole, by completing the 6 steps mentioned, it is estimated that complete recovery is achieved with the eradication of the persistent infection by SARS CoV-2, in 91 to 97% of patients.
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