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Patient Information for COVID positive/Suspected positive results

Patient Information for COVID positive/ Suspected positive results

[Highgate Medical Group Providers follow CDC guidelines regarding the testing/ treatment/ quarantine guidelines for Covid 19 infection.]

- SARS-Cov 2 is the official name of the virus we all call “Covid 19”. This is a VIRUS, not a bacteria, so infection with Covid 19 is not responsive to antibiotics. The only time antibiotics are sometimes given is if there is a suspected secondary bacterial infection, or in cases where patients have other underlying conditions like chronic lung disease or diabetes, and we are concerned about these secondary infections.

- If you test positive for Covid 19, or are awaiting test results but are suspected to have this virus, treatment options mainly target the symptoms you are having, similarly to how we treat common colds, which are also viral respiratory infections:

· Vitamin C 500 mg twice daily, Vitamin D3 5000 IU daily, and a daily zinc supplement 50-100 mg daily may help improve symptoms more quickly by giving the immune system a boost

· Over-the-counter symptomatic therapies such as Mucinex, Robitussin, or Dayquil/Nyquil can help with the symptoms of cough and sinus/nasal congestion. Tylenol or Ibuprofen can help the headaches, fevers, and muscle aches. Immodium can help the diarrhea.

· Hydrate and rest!!!

- Covid-19-specific therapies:

These therapies are approved for outpatient use in patients with risk for SEVERE DISEASE, and were approved by the FDA for emergency-use authorization only. Patients are deemed appropriate if:

o Positive PCR covid test

o Chronic kidney disease

o Body Mass Index (BMI) >35

o Diabetic

o Immunosuppressive disease

o Older than 65 years of age

o Older than 55 years of age AND have: cardiovascular disease or hypertension or COPD/chronic respiratory disease

1) Oral Antiviral agents

Currently there are two novel oral antiviral agents available in the US-- nirmatrelvir-ritonavir and molnupiravir. These medications must be initiated ASAP- within 5 days of symptom onset to offer any benefit. Currently, local supply at pharmacies is very limited. Both medications inhibit viral replication.

2)Monoclonal Antibodies

These antibodies, synthesized in mice, target the spike protein on the outside of the virus, thereby causing difficulty with the virus entering our cells and replicating. The are only available given IV and have to be done at an infusion center or hospital. They are in limited supply and are only effective given early on within the illness, 10 days or less from symptom onset. If monoclonal antibodies are administered, a patient must wait at least 90 days to have a covid booster vaccine, if they have not already had one.

***NOTE: Since Covid-19 came on the scene, there have been other potential outpatient treatments that have been under investigation with clinical trials, but are not recommended to be prescribed at this time due to limited efficacy in trials or potential toxicity in unmonitored settings. Those include:

o Fluvoxamine (an anti-depressant)

o Convalescent plasma

o Systemic steroids (dexamethasone)

o Inhaled steroids

o Ivermectin

o Hydroxychloroquine and azithromycin

- Current Quarantine guidelines:

Remain at home and away from others for at least 5 days from symptom onset. If at 5 days, you are feeling mostly fully recovered and have not had a fever in 24 hours without medication to reduce fever, then you can return to work/school but with wearing a mask (N-95 if you have one available) for an additional 5 days in case there is still minimal viral shedding. If you are still highly symptomatic or running at 5 day, continue to isolate in your home until which time you are recovered. If you have a rapid test available, you can also perform a rapid test at 5 days and if that is negative, you can return to normal activities with the mask on.

- If I have not had my booster shot yet, or been vaccinated at all, how long should I wait after having Covid-19 to get a shot?

Current recommendation is to wait 30 days for the booster or initial vaccine. If you have received the monoclonal antibody treatment, then you must wait 90 days for a shot, as the antibody will inhibit the effectiveness of the immunization.


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