ABSTRACT

Introduction

COVID-19 disease progresses through a number of distinct phases. The management of each phase is unique and specific. The pulmonary phase of COVID-19 is characterized by an organizing pneumonia with profound immune dysregulation, activation of clotting, and a severe microvascular injury culminating in severe hypoxemia. The core treatment strategy to manage the pulmonary phase includes the combination of methylprednisolone, ascorbic acid, thiamine, and heparin (MATH+ protocol). The rationale for the MATH+ protocol is reviewed in this paper.

Areas covered

We provide an overview on the pathophysiological changes occurring in patients with COVID-19 respiratory failure and a treatment strategy to reverse these changes thereby preventing progressive lung injury and death.

Expert opinion

While there is no single ‘Silver Bullet’ to cure COVID-19, we believe that the severely disturbed pathological processes leading to respiratory failure in patients with COVID-19 organizing pneumonia will respond to the combination of Methylprednisone, Ascorbic acid, Thiamine, and full anticoagulation with Heparin (MATH+ protocol).We believe that it is no longer ethically acceptable to limit management to ‘supportive care’ alone, in the face of effective, safe, and inexpensive medications that can effectively treat this disease and thereby reduce the risk of complications and death.

中文翻译：

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用于治疗SARS-CoV-2感染的MATH +方案：科学依据

摘要

介绍

COVID-19疾病经历了许多不同的阶段。每个阶段的管理都是唯一且特定的。COVID-19的肺期的特征是组织性肺炎，伴有严重的免疫失调，凝血激活和严重的微血管损伤，最终导致严重的低氧血症。管理肺部阶段的核心治疗策略包括甲基强的松龙，抗坏血酸，硫胺素和肝素的组合（MATH +方案）。本文综述了MATH +协议的基本原理。

覆盖区域

我们提供了COVID-19呼吸衰竭患者发生的病理生理变化的概述，以及逆转这些变化从而防止进行性肺损伤和死亡的治疗策略。

专家意见

虽然没有单一的“银弹”可以治愈COVID-19，但我们认为导致COVID-19并发肺炎的患者严重干扰的导致呼吸衰竭的病理过程将对甲基泼尼松，抗坏血酸，硫胺素和完全肝素抗凝治疗（MATH +方案）。我们认为，面对可以有效治疗该疾病并因此降低患病风险的有效，安全和廉价药物，将治疗仅限于“支持性护理”已不再是道德上可接受的。并发症和死亡。