Personalized Expanded Kelleni’s Immunomodulatory COVID-19 Protocol Safely Used to Manage Severe COVID-22: A Case-Report.

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Version 5 represents my keynote presentation today at the 35th World Congress on Pharmacology on August 01, 2022, Rome, Italy. The earlier versions represent my trials to send it to journals wishing for a peer-review. Background:SARS CoV-2 is continuing to evolve, and multiple new variants have been previously reported. The current hepatitis of unknown origin described in the pediatric population could be a presentation of a novel pathogen/variant; SARS CoV-3 to be investigated that might cause unusual presentations in vulnerable groups as pediatric, geriatric and immunocompromised patients, and I call this potential new syndrome; COVID-22.Case presentation:A female in her late seventh decade with a history of chronic hepatitis B viral infection and moderately reduced kidney function suffered a syndrome of severe headache, acute epigastric abdominal pain, nausea, vomiting, confusion, and insomnia that could have been attributed to pancreatitis. However, oxygen saturation, CT chest and laboratory investigations showed evidence of severe COVID-19 while she suffered silent hypoxia and didn’t complain of cough, sore throat, or fever. She was safely and effectively managed using personalized expanded Kelleni’s protocol.Conclusion: The possibility of a novel SARS CoV-2 variant has not been excluded and it could include an immune-evasive variant that might selectively affect certain high-risk groups. I call for routine oxygen saturation screening by pulse oximeter for all high-risk patients currently seeking medical advice for any reason and I suggest if the current criteria to diagnose pediatric hepatitis of unknown origin is modified to include patients with ALT or AST level lower than the currently adopted 500 IU/L, the iceberg would be better revealed.

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