Combination therapy with Azithromycin, Pentoxifylline and Dexamethasone shows Complete Recovery in Severe COVID 19: Case Series of Patients in First and Second wave of Pandemic in India.

Abstract

Background: COVID 19 infection caused by SARS-CoV2 virus is causing high mortality all over the world. This causes asymptomatic, mildly symptomatic , moderate, and severe illness. In severe illness, mortality is remarkably high as drugs are not effective enough to avert cytokine storm, stroke, myocarditis, or myocardial infarction. COVID-19 is a positive sense virus that directly enters the ACE2 cell and starts replication after encountering the host protein. Effective treatment has been limited to only mild and sometimes moderate cases but there is a high mortality in severe cases. Case Presentation: Severe COVID-19 cases with different comorbities were assessed and treated in the first wave as well as the second wave of the pandemic in North India.. A total number of 305 patients were assessed for severity with their symptoms and abnormal blood parameters , out of which 109 patients severe patients were given the drugs and their symptoms and vitals were monitored along with therapy. In both the single SARS CoV 2 and the double mutant virus strain in the second wave. We measured their severity through their blood parameters by calculating high Neutrophil lymphocyte ratio, Platelet lymphocyte ratio after getting their complete blood count, diabetes, and other inflammatory markers like high LDH, CRP, Serum Ferritin, D Dimer, or IL 6 in critically ill patients as studied in previous studies. Hence, we designed this combination therapy drug protocol which was home based oral therapy with hundred percent recovery rate if initiated early. Wherever required oxygen therapy had also been recommended along with diet modification, low fatty acid diet and low carbohydrates for more effectivity. The combination of Azithromycin , Pentoxifylline and Dexamethasone had shown to be highly effective in controlling the inflammation and viral replication with dose modification. Intravenous Ceftriaxone was given as infusion in patients having viral Pnemonia .Conclusions: This combination therapy of drugs has shown to decrease TLR mediated cytokine production. This therapy has shown full success in all high-risk patients especially in the elderly having comorbidities like Diabetes, heart diseases, cancer, autoimmune diseases.