Study design
Egypt is considered one of the highest African countries with regards to
the number of COVID-19 fatalities compared to that of infected cases;
119,702 infections and 6,832 coronavirus-related deaths as of December
10, 202016. Since late April 2020, we have strongly,
promptly and publicly through YouTube videos, Facebook posts and local
newspapers criticized the use of hydroxychloroquine, oseltamivir and
lopinavir-ritonavir and remdesivir in COVID-19
protocols17, considering them as possible causes for
the declared high mortality rate encountered in Egypt, a criticism
attributed to their lack of efficacy that was being revealed later18-21. The author, while working in KSA, has received
compassionate requests and consents for treating Egyptian patients since
the 13th of May 2020 and the last patient reported in
this manuscript has been enrolled on the 19th of
October 2020 after his return to Egypt. We have responded immediately to
the received requests from patients and a personalized fully documented
telemedicine approach, using the author’s Facebook messenger account and
WhatsApp, was used and we have used the described protocol using NSAIDs,
nitazoxanide, azithromycin +/- cefoperazone in full or part as described
later for those patients knowing that all the used drugs are relatively
safe and potentially more effective as compared to the used drugs used
in MOH criticized protocols. Notably, antibiotics are liberally
purchased without a formal prescription in Egypt. The primary endpoint
of this study was full relief of COVID-19 induced hazardous, i.e. other
than anosmia and/or ageusia, symptoms and signs e.g. fever, progressive
cough, moderate/severe dyspnea and/or disturbed level of consciousness.