Dr Varon's Answer

Q :

By Raphael Kosasih

I want to ask about the administration of Vitamin C in this MATH+ regarding

1. Is it done by bolus, or in several separated dose in 24 hours : 3gm IV as a bolus every 6 hours

2. are high dose of intravenous vitamin C  are not going to affect blood pH ? especially in acidotic patient with ARDS? : We have used up to 48 grams in 24 hours without any change in pH

3. what about critically ill patient with impaired renal function, because ascorbic acid will have to be excreted in urine, are there dose adjusting in this kind of patient : No need for adjustment

thank you

Q :

By. Dr. Diyah Eka Andayani

I would like to ask about MATH method for Covid patients, when is the time to do this protocol?
IS it when the patients are still in the TRIAGE, or when the patient are in critical condition? : As soon as the patient is in the ER and you know they must be admitted. Best results within 6 hours of admission

Q :

By. Dr. Aris Rivaldi Wicaksono

Thank you for the presentation, i would like to ask regarding to MATH + Protocol, why no antivirus try to be added to that protocol? does it means that COVID-19 Treatment are based on adjunctive therapy?thankyou.

Treatment is adjunctive. We still dont have a reasonable antiviral. remdesivir doesnt work

Q :

By. Dr. Adelina

Thank you for such a wonderful presentation from dr.Varon. I have questions regarding the therapy on Covid-19. You use hydrocortisone as one of the anti-inflammatory drug, what’s your opinion/experiences about the other various anti-inflammatory drugs currently use in most protocols?as in Indonesia, it is recently claimed that actemra shows more beneficial effects. And also do you have any experiences on using omega-3 with its anti-inflammatory properties in handling Covid-19 patients. Thank you..

Methylprednisolone is your best option. best penetration to lung tissue and best antiinflammatory effects. 

Omega 3 have potential but no good studies yet.

Actemra is not a good drug. It drops IL6 levels completely and patients get secondary bacterial infections.

Q :



Does MATH+ protocol practical for Covid-19 patient which is under Ventilator or ECMO?Or it just suitable for patient with mild symptoms only?

Go to Home – Frontline COVID-19 Critical Care Alliance and you will find all the indication

Q :

I would like to ask the question Prof Dr Joseph Varon about the vitaman C. There is many journal release about dose the vitamin C, D and Zinc that we can use for covid 19. Base on your experience how many dose of vitamin C, D, and zinc that your recommended for the critically ill patient with covid 19? I give a minimum of 10 days o those subtances