“MATH+” Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale
Kory et al.,
“MATH+” Multi-Modal Hospital Treatment Protocol for COVID-19 Infection: Clinical and Scientific Rationale,
Journal of Clinical Medicine Research, doi:10.14740/jocmr4658 (Review)
Review of the data supporting the MATH+ hospital treatment protocol for COVID-19.
Kory et al., 24 Feb 2022, peer-reviewed, 6 authors.
Abstract: Review
J Clin Med Res. 2022;14(2):53-79
“MATH+” Multi-Modal Hospital Treatment Protocol for
COVID-19 Infection: Clinical and Scientific Rationale
Pierre Korya, f, Ginfranco Umberto Medurib, Jose Iglesiasc, Joseph Varond,
Flavio Adsuara Cadegianie, Paul E. Marika
Abstract
Keywords: MATH plus; Methylprednisolone; Ascorbic acid; Thiamine; Heparin
In December 2019, coronavirus disease 2019 (COVID-19), a severe
respiratory illness caused by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The greatest impact that COVID-19 had was on intensive care units
(ICUs), given that approximately 20% of hospitalized cases developed
acute respiratory failure (ARF) requiring ICU admission. Based on
the assumption that COVID-19 represented a viral pneumonia and no
anti-coronaviral therapy existed, nearly all national and international
health care societies recommended “supportive care only” avoiding
other therapies outside of randomized controlled trials, with a specific
prohibition against the use of corticosteroids in treatment. However,
early studies of COVID-19-associated ARF reported inexplicably high
mortality rates, with frequent prolonged durations of mechanical ventilation (MV), even from centers expert in such supportive care strategies. These reports led the authors to form a clinical expert panel called
the Front-Line COVID-19 Critical Care Alliance (www.flccc.net). The
panel collaboratively reviewed the emerging clinical, radiographic, and
pathological reports of COVID-19 while initiating multiple discussions among a wide clinical network of front-line clinical ICU experts
from initial outbreak areas in China, Italy, and New York. Based on
the shared early impressions of “what was working and what wasn’t
working”, the increasing medical journal publications and the rapidly
accumulating personal clinical experiences with COVID-19 patients, a
treatment protocol was created for the hospitalized patients based on the
core therapies of methylprednisolone, ascorbic acid, thiamine, heparin
and non-antiviral co-interventions (MATH+). This manuscript reviews
the scientific and clinical rationale behind MATH+ based on published
in-vitro, pre-clinical, and clinical data in support of each medicine, with
a special emphasis of studies supporting their use in the treatment of
patients with viral syndromes and COVID-19 specifically.
Manuscript submitted January 5, 2022, accepted February 8, 2022
Published online February 24, 2022
aFront Line Critical Care Consortium (FLCCC.org), Washington DC, USA
bDepartment of Medicine, University of Tennessee Health Science Center,
Memphis, TN, USA
cJersey Shore University Medical Center, Hackensack School of Medicine at
Seton Hall, NJ, USA
dUniversity of Texas Health Science Center, Houston, TX, USA
eCorpometria Institute, Brasilia, Brazil
fCorresponding Author: Pierre Kory, Front Line Critical Care Consortium
(FLCCC.org), Washington DC, USA. Email: pierrekory@icloud.com
doi: https://doi.org/10.14740/jocmr4658
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