The FLCCC's JIC paper notes that early intervention is critical in preventing the deterioration and death that has been described across the world once patients enter the ICU. With the combination of corticosteroids and high-dose intravenous ascorbic acid earlier in the disease course, the need for mechanical ventilation is reduced.
The Journal of Intensive Care Medicine (JIC) is a peer-reviewed bi-monthly journal offering medical and surgical clinicians in adult and pediatric intensive care state-of-the-art, broad-based analytic reviews and updates, original articles, reports of large clinical series, techniques and procedures, topic-specific electronic resources, book reviews, and editorials on all aspects of intensive/critical/coronary care.
The paper was co-authored by the FLCCC Alliance Critical Care team—Pierre Kory, MD, G. Umberto Meduri, MD, Jose Iglesias, DO, Joseph Varon, MD, and Paul Marik, MD.
The paper 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. The review concludes with a comparison of published multi-national mortality data with MATH+ center outcomes.
The FLCCC 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 co-interventions (MATH+).
Prior to the development of MATH+, nearly all national and international health care societies recommended "supportive care only". This was based on the assumption that COVID-19 represented a viral pneumonia and no anti-coronaviral therapy existed.
"When our group created the MATH+ Hospital Treatment Protocol in March, the World Health Organization was advising against the use of steroid for COVID-19 patients," noted Dr. Meduri. "But we knew then that COVID19 was a steroid-responsive disease. That is because it is the severe inflammation sparked by the Coronavirus, not the virus itself, that kills patients. The hyper-inflammation triggered by COVID-19, also known as 'cytokine storm' requires use of corticosteroids to prevent deterioration into a very severe form of Acute Respiratory Distress Syndrome (ARDS), a condition which causes the lungs to fail."
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