Diagnosing and Treating COVID-19

Currently, the best test for COVID19 is the PCR nasal swab (often required for travel), and the rapid Antigen tests are improving in accuracy.  Testing is most accurate when someone has symptoms or if asymptomatic and at least 5-7 days after exposure.  Testing too early will lead to false negative results.

We have both PCR ($40 with insurance or $110 self pay) and Rapid Antigen ($75) tests.

The COVID19 antibody tests are helpful for those who may have already had the infection, exposed to it, or have symptoms for over a week.  It takes 3-9 days to develop antibodies.  

We may use Hydroxychloroquine, Azithromycin, and Ivermectin with Zinc, Vit C&D to treat positive cases of COVID 19, depending on each individual’s illness.  There is a lot of debate, and we think the evidence and safety is very good and best when started early to stop progression of illness and hinder spread of the virus (C19Study.com for comprehensive research).  Regardless, the most important thing we can do to stop the spread of COVID19 is first washing our hands (gloves get dirty) and social distancing.

Chloroquine and Hydroxychloroquine (Plaquenil) are very similar anti-malaria medications that have anti-inflammatory qualities for people with autoimmune disorders.  They have been used safely for decades – even in pregnancy.  Side effects are few and simple screening can assess risk we can do in clinic in a few minutes.

Research starting with SARS in 2002-3 has shown Chloroquine and Hydroxychloroquine block COVID19 from getting into our cells and further hinders viral replication (multiplying).  Azithromycin (Z-pack) also has a biochemical effect of hindering viral replication and activating various molecules in our immune system to fight viral infections.  Zinc only works well when it can get into the cell, which it cannot do on its own.  Hydroxycholoquine is one of the drugs that helps Zinc get into the cell.  The three work together by hindering COVID19 virus.

This link provides a summary of current understanding of COVID19 – Features, Evaluation and Treatment of COVID19

Bradykinin hypothesis – New research is revealing the molecular mechanisms of how COVID19 attacks our systems.  The virus attaches onto a receptor called ACE2 to get into our cells then hijack our proteins to reproduce itself.  ACE2 helps control our blood pressure and we have more as we age, which is why children are rarely ill.  Link below explains in more details the symptoms caused by disregulation of ACE2 and Bradykinin.

COVID and Exercise YouTube

What makes COVID-19 so hard to kill?

Unlike antibiotics that actually kill bacteria, only an individual’s white blood cells can kill the virus (Antibodies are critical component, called IgM and IgG).  We treat COVID19 using medications to hinder viral growth and respiratory support until the body can get ahead of and then clear the viral load.  All therapies are designed to hinder viral growth and help us survive long enough to clear the virus.  This is challenging for older patients, poor immunity (HIV, chemotherapy, etc.), or lung disease.  Simple soap destroys the viral capsules outside the body and is why we wash everything.

Similarly to Tamiflu or Xofluza for influenza, the earlier we treat the better.

 

Checkout the Research

A fundamental principle of medical research ethics is to stop a trial early if there is harm to patients and not withhold treatment if there is benefit.  The term in the press “unproven” is misleading.  Nothing is “proven” in medicine, only the amount of evidence that supports or opposes a therapy.  The principle of do no harm to an individual is more important than any specific research methodology. 

The current research and trials are based on 15 years of work throughout the world.  Some studies show benefit and others show limited or none.  We are not certain which patients will benefit the most, or if the virus is evolving to be resistant.  Currently, it appears the virus is stable, giving promise for vaccine development.  Here are a few older and more recent studies.  
 
We are always available to discuss the research and science behind our medical options with all our guests.  
Time to discuss medicine is another advantage of Texas Direct Medical Care.