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Abstract
The SARS-CoV-2 virus spreading across the world has led to surges of COVID-19 illness,
hospitalizations, and death. The complex and multifaceted pathophysiology of life-threatening
COVID-19 illness including viral mediated organ damage, cytokine storm, and thrombosis
warrants early interventions to address all components of the devastating illness.
In countries where therapeutic nihilism is prevalent, patients endure escalating symptoms
and without early treatment can succumb to delayed in-hospital care and death. Prompt
early initiation of sequenced multidrug therapy (SMDT) is a widely and currently available
solution to stem the tide of hospitalizations and death. A multipronged therapeutic
approach includes 1) adjuvant nutraceuticals, 2) combination intracellular anti-infective
therapy, 3) inhaled/oral corticosteroids, 4) antiplatelet agents/anticoagulants, 5)
supportive care including supplemental oxygen, monitoring, and telemedicine. Randomized
trials of individual, novel oral therapies have not delivered tools for physicians
to combat the pandemic in practice. No single therapeutic option thus far has been
entirely effective and therefore a combination is required at this time. An urgent
immediate pivot from single drug to SMDT regimens should be employed as a critical
strategy to deal with the large numbers of acute COVID-19 patients with the aim of
reducing the intensity and duration of symptoms and avoiding hospitalization and death.