How could you possibly justify refusing to treat *known, universally* elevated plasma 5-HT, in an often-lethal disease state that is *defined* in part by *frank, known symptoms of elevated plasma 5-HT*?
Is it everything? No. Severe inflammation also matters, for example.
However:
If a patient needs a sedative, do you refuse because there is no RCT for sedatives in COVID-19?
If a patient is in pain, do you refuse analgesics because there is no RCT for analgesics in COVID-19?
We know, *with certainty*, that plasma free 5-HT is elevated *in every* severe COVID-19 patient, and for that matter even in moderate hospitalized cases.
We have well-established treatments for elevated free plasma 5-HT: 5-HT2 antagonists.
The result replicates-- a second paper is pending at this very moment.
Moreover, multiple independent physicians at separate hospitals are treating this *known biological abnormality* with nothing more than an old allergy drug, with excellent results.
The things we are discussing about 5-HT2 antagonists and plasma serotonin, about attempting to halt progression in the early severe stage, are relevant *during* these events.
Rates of PTSD following survival from severe COVID-19 exceed 30%, ditto anxiety and depression.
The ventilator settings required to keep these patients alive tend to permit blood CO2 levels to rise somewhat, in avoiding excessive mechanical damage to the lungs.
This has been repeatedly demonstrated to cause severe anxiety and promote PTSD.