Introduction: The rate of secondary attacks of SARS-COV-2 is high among household close contacts. Social distancing, isolation and infection control measures are important for preventing exposure to infection, but insufficient. Aim: The study aimed to evaluate possible role of oral ivermectin as a chemoprophylaxis in asymptomatic family close contacts with COVID-19 patients. Materials and Methods: A prospective interventional randomised open label-controlled study was conducted (registered at clinicaltrials.gov; NCT04422561) during June and July 2020. Two arms were designed according to use of ivermectin. In ivermectin arm, contacts received ivermectin according to Body Weight (BW) on day of the diagnosis of their index case. The non-intervention group received no treatment. Both groups were followed-up for two weeks for development of symptoms suggestive of COVID-19. Results: Ivermectin group included 203 contacts (to 52 index cases) aged 39.75±14.94 years; 52.2% were males. Non-intervention group included 101 contacts (to a total of 24 index cases) aged 37.69±16.96 years, 49.5% were males. Fifteen contacts (7.4%) developed COVID-19 in the ivermectin arm compared to 59 (58.4%) in the non-intervention arm (p<0.001). The protection rate for ivermectin was more prominent in contacts aged less than 60-year-old (6.2% infected compared to 58.7% if no treatment). Ivermectin in the protection against SARS-CoV-2 infection had an OR of 12.533 and 11.445 (compared to nontreatment) in both univariate and multivariate models, respectively. Side effects of ivermectin were reported in 5.4%; they were mild. Conclusion: Ivermectin is suggested to be a promising, effective and safe chemoprophylactic drug in management of COVID-19.

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During the current era of the COVID-19 pandemic, the dissemination of Mucorales has been reported globally, with elevated rates of infection in India, and because of the high rate of mortality and morbidity, designing an effective vaccine against mucormycosis is a major health priority, especially for immunocompromised patients. In the current study, we studied shared Mucorales proteins, which have been reported as virulence factors, and after analysis of several virulent proteins for their antigenicity and subcellular localization, we selected spore coat (CotH) and serine protease (SP) proteins as the targets of epitope mapping. The current study proposes a vaccine constructed based on top-ranking cytotoxic T lymphocyte (CTL), helper T lymphocyte (HTL), and B cell lymphocyte (BCL) epitopes from filtered proteins. In addition to the selected epitopes, β-defensins adjuvant and PADRE peptide were included in the constructed vaccine to improve the stimulated immune response. Computational tools were used to estimate the physicochemical and immunological features of the proposed vaccine and validate its binding with TLR-2, where the output data of these assessments potentiate the probability of the constructed vaccine to stimulate a specific immune response against mucormycosis. Here, we demonstrate the approach of potential vaccine construction and assessment through computational tools, and to the best of our knowledge, this is the first study of a proposed vaccine against mucormycosis based on the immunoinformatics approach.

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