Low Rates of Hospitalization and Death in 4376 COVID-19 Patients Treated With Early Ambulatory Medical and Supportive Care: A Case Series and Observational Study

Tyson et al., Journal of Independent Medicine, doi:10.71189/JIM/2025/V01N02A06, Jan 2022 (preprint)

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Retrospective 4,376 patients with mild/moderate COVID-19 in the USA treated with multiple medications including HCQ/ivermectin, zinc, azithromycin, budesonide, and dexamethasone (exact treatments specific to each patient), showing significantly lower hospitalization and mortality compared to the surrounding community.

Standard of Care (SOC) for COVID-19 in the study country, the USA, is very poor with very low average efficacy for approved treatments1. Only expensive, high-profit treatments were approved for early treatment. Low-cost treatments were excluded, reducing the probability of early treatment due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.

Important missing comments or errors? Let us know.

Study covers ivermectin, HCQ, vitamin B9, vitamin B12, zinc, budesonide, and dexamethasone.

risk of death, 99.9% lower, RR 0.001, p < 0.001, treatment 0 of 3,962 (0.0%), control 636 of 20,921 (3.0%), NNT 33, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), All AVUC mild patients vs. Imperial County (corrected).

risk of hospitalization, 99.8% lower, RR 0.002, p < 0.001, treatment 2 of 3,962 (0.1%), control 4,770 of 20,921 (22.8%), NNT 4.4, All AVUC mild patients vs. Imperial County (corrected).

risk of death, 97.7% lower, RR 0.02, p < 0.001, treatment 3 of 4,374 (0.1%), control 636 of 20,921 (3.0%), NNT 34, All AVUC patients vs. Imperial County (corrected).

risk of hospitalization, 99.1% lower, RR 0.009, p < 0.001, treatment 9 of 4,374 (0.2%), control 4,770 of 20,921 (22.8%), NNT 4.4, All AVUC patients vs. Imperial County (corrected).

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

1. c19early.org, c19early.org/soc/usa.html.

Tyson et al., 13 Jan 2022, retrospective, USA, peer-reviewed, 13 authors, this trial uses multiple treatments in the treatment arm (combined with multiple treatments) - results of individual treatments may vary. Contact: btysonmd@gmail.com.

This Paper Vitamin B9 All

Low Rates of Hospitalization and Death in 4376 COVID-19 Patients Treated With Early Ambulatory Medical and Supportive Care: A Case Series and Observational Study

Dr Brian Marshall Tyson, George Fareed, Emmanuel Gutierrez, Robert Villegas, Edgar Gomez, Paloma Lopez, Ernesto Breton Herrera, Miriam Castro, Jesus Palomera Iii, Christiany Alexandrah Morales, Ana Gonzalez, Fabiola Tyson, Mathew Crawford

Journal of Independent Medicine, doi:10.71189/jim/2025/v01n02a06

This study evaluates early ambulatory protocols for treating 4376 COVID-19 patients at All Valley Urgent Care (AVUC) facilities in Imperial County, California, and compares outcomes with other patients in the same region during a nearly identical period. The goal was to contribute to evidence on whether early outpatient treatment reduces hospitalization and mortality rates. The protocols, based on data from neighboring countries, included Protocol 1 (a multivitamin pack, selective use of hydroxychloroquine, two antibiotics, and inhaled steroids) and Protocol 2 (which added ivermectin). Results were stratified by disease severity at presentation. The average patient age was 40.5 years; 12.8% of patients were under 20 years old. For the 3962 . mild COVID-19 patients treated early, no deaths occurred, compared to a 3.03% mortality rate (2.25% risk-adjusted) in the same county during the same period. Hospitalization rates for this group were 0.05%, compared to 22.68% (20.76% risk-adjusted) in the general population. When treated within 7 days, patients had a 100% success rate, while those treated later had a 99.9% success rate. Mild symptom patients had lower hospitalization (OR = 0.0293; P < .0001) and mortality (OR = 0.0000; P = .0008) rates. These results suggest the multidrug protocols significantly reduced adverse outcomes, with no serious side effects observed during followup (3-14 days).

Competing Interests None of the authors report any conflicts of interest. Authors' Contribution: All authors had access to the data and wrote the manuscript. This page is intentionally left blank https://doi.org/10.71189/JIM/2025/V01N02A06

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