Low Rates of Hospitalization and Death in 4376 COVID-19 Patients Treated With Early Ambulatory Medical and Supportive Care: A Case Series and Observational Study

This study evaluates early ambulatory protocols for treating 4376 COVID-19 patients at All Valley Urgent Care (AVUC) facilities in Imperial County, California, and compares outcomes with other patients in the same region during a nearly identical period. The goal was to contribute to evidence on whether early outpatient treatment reduces hospitalization and mortality rates. The protocols, based on data from neighboring countries, included Protocol 1 (a multivitamin pack, selective use of hydroxychloroquine, two antibiotics, and inhaled steroids) and Protocol 2 (which added ivermectin). Results were stratified by disease severity at presentation. The average patient age was 40.5 years; 12.8% of patients were under 20 years old. For the 3962 mild COVID-19 patients treated early, no deaths occurred, compared to a 3.03% mortality rate (2.25% risk-adjusted) in the same county during the same period. Hospitalization rates for this group were 0.05%, compared to 22.68% (20.76% risk-adjusted) in the general population. When treated within 7 days, patients had a 100% success rate, while those treated later had a 99.9% success rate. Mild symptom patients had lower hospitalization (OR = 0.0293; P < .0001) and mortality (OR = 0.0000; P = .0008) rates. These results suggest the multidrug protocols significantly reduced adverse outcomes, with no serious side effects observed during follow-up (3–14 days). Keywords: COVID-19, hospitalization, hydroxychloroquine, ivermectin, mortality, multidrug, SARS-CoV-2