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.