COVID-19 Outpatient Treatment Guidelines - AAPS, FLCCC, Zelenko Treatment Protocols

The COVID-19 Outpatient treatment guidelines are based on various protocols including (but not limited to) AAPS (American Association of Physicians and Surgeons), FLCCC (Front Line Covid-19 Critical Care Alliance) and Dr Vladimir Zelenko . The aim of this article is to publish the guidelines and compile related resources in an electronic format that can be updated in step with the rapid pace and growing volume of related information regarding the outpatient treatment of COVID-19.

What's New

Feb 9, 2021 - Ivermectin plus Azithromycin plus Montelukast plus Aspirin totally crush Covid-19 in propective Mexican study (n=768). The TNR4 multidrug therapy (New Therapy for Recovery of COVID-19 infection, 4 medications; in Spanish: Terapia Nueva para la Recuperación en la infección por COVID19, 4 medicamentos).
Lima-Morales R, Mendez-Hernandez P, Flores YN, Osorno-Romero P, Cuecuecha-Rugerio E, Nava-Zamora A, Hernandez-Galdamez DR, Romo-Duenas DK, Salmeron J, Effectiveness of a multidrug therapy consisting of ivermectin, azithromycin, montelukast and acetylsalicylic acid to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico, International Journal of Infectious Diseases (2021), doi: https://doi.org/10.1016/j.ijid.2021.02.014

Successful UK randomized trial of 146 outpatient inhaled budesonide, with 90% reduction in need for urgent care, ED or hospitalization. Median/avg clinical recovery 1/3 days quicker. 

Feb 4, 2021 - Guenezan et al., JAMA Otolaryngol Head Neck Surg., doi:10.1001/jamaoto.2020.5490 (Peer Reviewed)
Povidone Iodine Mouthwash, Gargle, and Nasal Spray to Reduce Nasopharyngeal Viral Load in Patients With COVID-19: A Randomized Clinical Trial
RCT of PCR+ patients with Ct<=20 with 12 treatment and 12 control patients, concluding that nasopharyngeal decolonization may reduce the carriage of infectious SARS-CoV-2 in adults with mild to moderate COVID-19. All patients but 1 had negative viral titer by day 3 (group not specified). There was no significant difference in viral RNA quantification over time. The mean relative difference in viral titers between baseline and day 1 was 75% [43%-95%] in the intervention group and 32% [10%-65%] in the control group. Thyroid dysfunction occurred in 42% of treated patients, with spontaneous resolution after the end of treatment. Patients in the treatment group were younger.


Jan 7, 2021 - Brian Procter, Casey Ross, Vanessa Pickard, et al. Early Ambulatory Multidrug Therapy Reduces Hospitalization and Death in High-Risk Patients with SARS-CoV-2 (COVID-19)Authorea. January 07, 2021.
Early ambulatory, multidrug therapy is associated with substantial reductions in hospitalization and death compared to available rates in the community. Prompt ambulatory treatment should be offered to high-risk patients with COVID-19 instead of watchful watching and late-stage hospitalization for salvage therapies. Their early ambulatory treatment regimen was associated with estimated 87.6% and 74.9% reductions in hospitalization and death respectively, p<0.0001.

Dec. 31, 2020 - A peer-reviewed updated summary of COVID-19 early-treatment best practices was published in Reviews in Cardiovascular Medicine, an interdisciplinary scientific, open access journal.


This international collaboration — comprised of physicians, like lead author Peter McCullough, MD, outlines the urgency of "prompt early initiation of sequenced multi-drug therapy (SMDT) … to stem the tide of hospitalizations and death."

The authors explain:

The early stage of viral replication provides a therapeutic window of tremendous opportunity to potentially reduce the risk of more severe sequelae in high risk patients. Precious time is squandered with a 'wait and see' approach … resulting in unnecessary hospitalization, morbidity, and death.… In newly diagnosed, high-risk, symptomatic patients with COVID-19, SMDT has a reasonable chance of therapeutic gain with an acceptable benefit-to-risk profile.

Included in the paper is a "sequential multidrug treatment algorithm" and summaries of the rationale and evidence for each component.

In an alert issued to members, the Association of American Physicians and Surgeons, urges physicians to "share this new article with your colleagues, any contacts you have in the media, and with leaders in your community." "To overcome the increasing censorship of lifesaving information, it is imperative that everyone pitch in to see that this manuscript is distributed as widely as possible," AAPS states.

The article also includes a list of the numerous countries around the world that are encouraging early treatment. The authors contrast the situation in countries including the U.S. where "the current failure of government support for randomized clinical trials evaluating widely available, generic, inexpensive therapeutics, and the lack of instructive outpatient treatment guidelines (U.S., Canada, U.K., Western EU, Australia, some South American Countries), clinicians must act according to clinical judgement and in shared decision making with fully informed patients."

"Until the pandemic closes with population-level herd immunity potentially augmented with vaccination, early ambulatory SMDT should be a standard practice in high risk and severely symptomatic acute COVID-19 patients beginning at the onset of illness," conclude the authors.



Early Treatment COVID-19 Protocols


COVID-19 Prevention Protocols


Find Physicians/Facilities Offering COVID-19 Early Treatment in USA

Telemedicine: https://www.americasfrontlinedoctors.com/how-do-i-get-covid-19-medication/

Telemedicine: https://speakwithanmd.com/corsination

Telemedicine: FrontlineMDs.com

Telemedicine: https://myfreedoctor.com/

List of Independent Practices: https://aapsonline.org/covidearlytreatment

List #2 Independent Practices: https://www.doctorsdontfearcovid.com/

FLCCC Alliance: https://covid19criticalcare.com/network-support/the-flccc-alliance/

Arnot Health & Lake Erie College of Medicine (upstate NY): https://www.arnothealth.org/

Bethany Medical (North Carolina): https://bethanymedicalcenter.com/

Budesonide Protocol Practices: https://budesonideworks.com/providers/

For those who have found a doctor that has prescribed HCQ but their pharmacy will not fulfill the early treatment prescription – it can be overnighted by – Ravkoo Pharmacy : Phone: 863-875-5700
https://www.myravkoo.com/public/pharmacy

COVID-19 Clinical Study Tracking and Meta-analysis


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