Biography
Biography: Harpal Mangat
Abstract
Statement of the Problem: Covid 19 is a two-step disease 1,2,3. The first step lasts approximately 10 days and is viremic initially that progresses to highly inflammatory host dependent second step 1,2,3. Sadly, studies have been done using anti-viral’s in the second phase without recognition of the inflammatory condition. As the patient recovers there is a loss of T cell immunity resulting in the patient being more susceptible to mycoplasma and atypical viral infections3.
Methodology & Theoretical Orientation: Coronaviruses were first discovered in 19644. They were recognized as commensals living in the respiratory secretions of the nasopharynx with a characteristic crown appearance from the spike proteins. In 2014 it was found that coronaviruses immobilized the lung T cell response5.
Angiotensin converting enzyme (ACE) type 2 receptors are found in the nasopharynx, alveoli of the lungs, small intestine, brain, and the external surface of the pancreas. Once activated the ACE 2 enzymes not only activate the Renin Angiotensin system but also the bradykinin pathways leading to increased cell permeability. Covid 19 shows a significant increase to ACE 2 receptors compared with those discovered in1964, and each wave shows altered specificity on the spike protein. Specific JAK 2 pathways bring on the cytokine storm leading into step 2.
This can be blocked using famotidine.
Mangat has developed a two-step approach consisting of five phases in step 1 and in step 2 high dose steroids to decrease inflammation. He has treated over a thousand patients remotely with no deaths
Conclusion & Significance: The two step 5 phase approach enables Covid 19 to be treated effectively without a need of hospitalization. It moves Covid 19 from an untreatable pandemic to a highly treatable condition.