Zelenko Protocol for COVID-19 Review

This review aims to provide an updated perspective based on recent emerging evidence that is related to this zelenko protocol.

The original Zelenko protocol consists of zinc, low-dose hydroxychloroquine and azithromycin (Zithromax). Based on rapidly emerging clinical trials evidence of ivermectin, an anti-parasitic medicine, has highly potent real-world, anti-viral and anti-inflammatory properties against COVID-19 virus, Dr Zelenko has also included ivermectin as part of his prevention and treatment protocols.

zelenko protocol

Zelenko COVID-19 Prophylaxis Protocol

The Zelenko prophylaxis protocol is sub-divided into:
  1. Prevention Protocol for Low and Moderate Risk Patients
  2. Prevention Protocol for High Risk Patients
Prophylaxis is an action taken to prevent or protect against a specified disease. Greek in origin, from the word "phylax", meaning "to guard" and "watching." 
  
Low Risk Patients 

Young healthy people do not need prophylaxis against COVID-19. In young and healthy people, this infection causes mild cold-like symptoms. It is advantageous for these patients to be exposed to Covid-19, build up their antibodies and have their immune system clear the virus. This will facilitate the development of herd immunity and help prevent future Covid-19 pandemics. However, if these patients desire prophylaxis against Covid-19, then they should take the protocol noted below. 

Moderate Risk Patients 

Patients from this category are healthy but have high potential viral-load exposure. This group includes medical personnel, caregivers of high-risk patients, people who use public transportation, first responders and other essential personnel who are crucial to the continued functioning of society. These patients should be encouraged to take prophylaxis against Covid-19 in accordance with the protocol noted below. 

High Risk Patients 

Patients are considered high risk if they are over the age of 45, or if they are younger than 45 but they have co-morbidities, that is, they have other health conditions that put them at risk. These patients have between a 5 to 10% mortality rate if they are infected with COVID-19. These patients should be strongly encouraged to take prophylaxis against Covid-19 in accordance with the protocol noted below.

Protocol for Low and Moderate Risk Patients: 

Elemental Zinc 25mg 1 time a day (PubMed(Amazon)
Vitamin D3 5000 iu 1 time a day (vdnmeta.com) (Amazon)
Vitamin C 250 - 500 mg 1 time a day (PubMed(Amazon)

Quercetin 250 mg 1 time a day until a safe and efficacious vaccine becomes available (J. Agric. Food Chem. 2014(Amazon)

If Quercetin is unavailable, then use Epigallocatechin-gallate (EGCG) 200mg 1 time a day (J. Agric. Food Chem. 2014


Protocol for High Risk Patients:
Zelenko vs FLCCC I-MASK+ protocol for prevention

In addition to what is recommended by the zelenko protocol, the FLCCC I-MASK+ prevention protocol includes mouthwash, melatonin and ivermectin as part of the prevention protocol. However, the I-MASK+ prevention protocol does not categorise the patients into low risk or high risk and does not include hydroxychloroquine. For the zelenko protocol, hydroxychloroquine is only recommended for those in high risk category.

Zelenko Protocol - Treatment Plan for Patients with COVID-19 symptoms

Fundamental Principles (Dr Zelenko Protocol When to Start)

Treat patients based on clinical suspicion as soon as possible, preferably within the first 5 days of symptoms. Perform PCR testing, but do not withhold treatment pending results.

Patient Categories

Low risk patient - Younger than 45, no co-morbidities, and clinically stable
High risk patient - Older than 45, younger than 45 with co-morbidities, or clinically unstable

Treatment Options

Low risk patients - over the counter options:


1. Elemental Zinc 50mg 1 time a day for 7 days (PubMed) (Amazon)

2.1. Quercetin 500mg 2 times a day for 7 days (PubMed) (AmazonOR

2.2. Epigallocatechin-gallate (EGCG) 400mg 1 time a day for 7 days (J. Agric. Food Chem. 2014)

3. Vitamin C 1000mg 1 time a day for 7 days (Amazon)
4. Vitamin D3 5000iu 1 time a day for 7 days (Amazon)


Moderate / High risk patients


Hydroxychloroquine (HCQ) 200mg 2 times a day for 5-7 days (ScienceDirect)


and/or

Ivermectin 0.4-0.5mg/kg/day for 5-7 days (ivmmeta.com). (Find a Doctor)

Either or both HCQ and IVM can be used, and if one only, the second agent may be added after about 2 days of treatment if obvious recovery has not yet been observed etc.

If HCQ is not available, Quercetin 500mg 3 times a day for 7 days OR EGCG 400mg 2 times a day for 7 days


In combination with the above (AND):


1. Elemental Zinc 50 - 100 mg 1 time a day for 7 days (Amazon)

2. Hydroxychloroquine (HCQ) 200mg 2 times a day for 7 days  (Find a Doctor)

3. Azithromycin 500mg 1 time a day for 5 days OR Doxycycline 100mg 2 times a day for 7 days

4. Vitamin C 1000 mg 1 time a day for 7 days (Amazon)

5. Vitamin D3 10,000 IU 1 time a day for 7 days (Amazon)


Both protocols can be viewed from his website.

Note on Zinc supplements: 
  • How much zinc you should take per day depends on the type and forms of zinc, as each supplement contains a different amount of 'elemental zinc'. The percentage of elemental zinc varies by form. 
  • For example, approximately 23% of zinc sulfate consists of elemental zinc; thus, 220 mg of zinc sulfate contains 50 mg of elemental zinc (Ref). Zinc picolinate (20% of elemental zinc), zinc ascorbate (15%), zinc chloride (48%), zinc carbonate (52%), zinc citrate (31%), zinc bisglycinate (25%) (Ref) and zinc gluconate (14%) and zinc oxide (80%) (Ref).
Zelenko vs FLCCC I-MASK+ protocol for treatment

In addition to what is recommended by the zelenko protocol, the FLCCC I-MASK+ treatment protocol includes mouthwash, melatonin and ivermectin and incorporates repurposed and newer agents like anti-androgens (spironolactone, finasteride and dutasteride), fluvoxamine and monoclonal antibodies as part of the treatment protocol. The I-MASK+ treatment protocol also categorises the treatment agents into first line agents and second line agents for those who do not respond to first line agents and for those high risk patients with co-morbidities.

About Dr Vladimir Zelenko

He graduated with a B.A. degree with high honors in Chemistry from Hofstra University. After receiving an academic scholarship to attend S.U.N.Y. at Buffalo School of Medicine, he earned his M.D. degree in May 2000. Dr. Zelenko completed his family medicine residency at South Nassau Communities Hospital in Oceanside, N.Y. in May 2004. Since then, Dr. Zelenko has practiced family medicine in New York’s Hudson Valley. He has been described by his patients as like a family member to thousands of families, and is a medical adviser to the volunteer ambulance corps in Kiryas Joel, New York.

When asked about studies that seemed to discredit the efficacy of HCQ in treating the Chinese coronavirus, Zelenko explained “You don’t fire a gun without a bullet in it and then say the gun doesn’t work when you don’t kill the target. The studies that were done on HCQ did not include the use of Zinc.  HCQ is what opens the cell and enables Zinc to attack the virus. One is not effective without the other, or without a suitable substitute for HCQ. The studies were designed to fail.”

Dr. Zelenko says that both prophylaxis measures and actual case treatments need to be customized to the individual. As a general rule, he says, those people who are in the higher risk groups, both by age and by other pre-existing conditions, require more aggressive actions on both the preventative and diagnostic side.

“This virus remains relatively stable inside the host for about the first five days,” Zelenko says. “After that it starts to multiply rapidly. It also starts to migrate from sinus to lungs and cardio areas where involvement becomes more severe and treatment becomes more difficult. The key is early intervention.” Zelenko again mentioned his 84% success rate in high-risk patients.

Updates




June 1, 2021: The Drug that Obliterates 97% of New Delhi Cases by Justus R. Hope, MD


May 19, 2021 - A study by Juan Chamie, Jennifer Hibberd of the University of Toronto and David Scheim of the US Public Health Service, shows the sharp rise, fall and resurgence in excess deaths (among the over 60 year-old cohort) in Peru as the virus waxed, waned and waxed again.


Apr, 2021: Prevention study from Singapore (N=3,037) showed "Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial."


Feb 9, 2021 - Ivermectin plus Azithromycin plus Montelukast plus Aspirin totally crush Covid-19 in propective Mexican study (n=768). The TNR4 multidrug therapy (New Therapy for Recovery of COVID-19 infection, 4 medications; in Spanish: Terapia Nueva para la Recuperación en la infección por COVID19, 4 medicamentos).
Lima-Morales et al, Effectiveness of a multidrug therapy consisting of ivermectin, azithromycin, montelukast and acetylsalicylic acid to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico, International Journal of Infectious Diseases (2021), doi: https://doi.org/10.1016/j.ijid.2021.02.014

Ivermectin vs Hydroxychloroquine

Clinical evidence to date has reported promising results for Ivermectin in prevention, early treatment as well as late treatment for COVID-19. While both Ivermectin and Hydroxychloroquine might be useful for early treatment, Ivermectin has a broader potential benefit i.e. prevention, early treatment as well as late treatment / hospital treatment.

Can hydroxychloroquine and ivermectin be used together? The 2 drugs do not seem to have a between-drug interaction. However, no in vitro or in vivo studies have been conducted on the combined effect of HCQ and ivermectin on COVID-19 infection.

That said, the Zelenko protocol recommends that both hydroxychoroquine and ivermectin can be used together, especially for high risk patients. If you have started with only one, the second agent may be added after about 2 days of treatment if obvious recovery has not yet been observed.

Quercetin is a viable stand-in, if you simply cannot get hydroxychloroquine or ivermectin. Quercetin works best when taken with vitamin C and Bromelain, as vitamin C helps activate it and bromelain helps with the absorption. Do not forget to combine it with zinc.

Although ivermectin and hydroxychloroquine are relatively safe drugs, they are still synthetic chemicals that can have side effects. Quercetin and Vitamin D, C, Zinc are nutrients that your body require for optimal health. Nutrients are safer alternatives especially if your risk is low e.g. age below 50 and no other chronic illness. Discuss with your doctor on the benefit vs risk for each treatment. If you are on multiple medications, be aware of supplement-drug interactions that might enhance the possibilities of adverse effects.


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