There is hope for American hospital systems after all.

Old friend of mine (who isn't really local to me and who shall remain nameless) requested help presenting with 76% SpO2 ambulatory at least 10 days post #SARSCoV2 infection.

Rule#1: don't panic the ill by conveying severity
Pt obtained ivermectin. We immediately began IVM+NAC+doxycycline+ASA. SpO2 popped to 87% within one hour - no doubt thanks to NAC. Gradually declined back to 82% after 5mg of melatonin and attempts to sleep for the evening. Obvious signs of hypoxemia = 911 & hospital transport.
Instantly landed in ICU. Critical care docs stabilized using high flow 80% FiO2 5L (bipap at night), low dose dex, and anticoagulation therapy, Over the course of several days (and after #remdesivir failure), I fed the ICU doc (via FB messenger) some of the molecular biology...
...surrounding ivermectin's late stage MOA and also advocated for 5-HT2 antagonism.

After minimal cardiopulmonary progress, they decided to aggressively dose him with ivermectin. Patient went from 80% FiO2 to 30% in ONE DAY.

Looking to exit ICU on room air tomorrow.

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