Prehospital Management of COVID-19 Zelenko Protocol

Treatment Plan for Patients with symptoms of Covid-19

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Fundamental Principles

Treat patients based on clinical suspicion as soon as possible, preferably within the first 5 days of symptoms. Perform PCR testing, but do not withhold treatment pending results.

Risk Stratify Patient

Low risk patient - Younger than 60, no comorbidities, and not toxic (i.e. no shortness of breath). High risk patient - Older than 60, younger than 60 with comorbidities, or looks toxic

Treatment Options

Low risk patients

1. Rest, oral fluids, Tylenol as needed

2. Vitamin C 1gm once a day for 7 days

3. Quercetin 500mg twice a day for 7 days

4. Elemental Zinc 50mg once a day for 7 days

5. Close follow up with doctor

High risk patients

1. Rest, oral fluids

2. Tylenol as needed

3. Elemental Zinc 50mg once a day for 5 to 7 days.

4. Hydroxychloroquine (HCQ) 200mg twice a day for 5 to 7 days.

5. Azithromycin 500mg once a day for 5 days or doxycycline 100mg twice a day for 5 to 7 days

Note: If HCQ is inaccessible then use Quercetin 500mg three times a day in place of HCQ. If HCQ becomes accessible (e.g. positive PCR test result), then switch to HCQ.

Additional treatment options. Should be uniquely custom tailored for every patient

1. Ivermectin 6mg twice a day for 1 day

2. Budesonide 1mg/2cc solution via nebulizer twice a day for 7 days

3. Dexamethasone 6mg once a day for 5 to 7 days

4. Blood thinners (i.e. Eliquis or Xarelto)

5. Home O2

6. Home IV fluids

IF POSSIBLE, KEEP PATIENTS OUT OF THE HOSPITAL