Anti-COVID property of subcutaneous ivermectin in synergy with zinc among midlife moderately symptomatic patients: a structured summary of a study protocol for a randomised controlled trial

Ashraf, Shoaib; Ashraf, Sohaib; Farooq, Iqra; Ashraf, Sidra; Ashraf, Moneeb; Imran, Muhammad; Kalsoom, Larab; Akmal, Rutaba; Ghufran, Muhammad; Rafique, Sundas; Akram, Muhammad; Habib, Zaigham; Siddiqui, Uzma Nasim; Ahmad, Ammara; Arshad, Shahroze; Virk, Muhammad Abdul Rehman; Gul, Mehak; Awais, Abeer Bin; Hassan, Muhammad; Sherazi, Syed Sami Hussain; Safdar, Zartasha; Munir, Isra; Khalid, Hamna; Munir, Khalid; Majeed, Nighat; Alahmadi, Yaser M.; Humayun, Ayesha; Saboor, Qazi Abdul; Ahmad, Ali; Ashraf, Muhammad; Izhar, Mateen

doi:10.1186/s13063-021-05487-z

Cited by 3 publications

(3 citation statements)

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“…These data show that Zn has a potentiating effect on some anti-COVID-19 drugs regarding viral clearance in nasopharyngeal swabs [216]. Randomized clinical studies have shown that Zn and ivermectin have synergistic actions among moderately symptomatic patients with COVID-19 [217]. Apart from this synergism, Zn administered alone (oral Zn, 20 mg/8 h) inhibits the replication of many viruses (including SARS-CoV-2).…”

Section: Pharmacodynamic Interactionsmentioning

confidence: 86%

Importance of Magnesium Status in COVID-19

Guerrero‐Romero

Micke

Simental‐Mendía

et al. 2023

Biology

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A large amount of published research points to the interesting concept (hypothesis) that magnesium (Mg) status may have relevance for the outcome of COVID-19 and that Mg could be protective during the COVID disease course. As an essential element, Mg plays basic biochemical, cellular, and physiological roles required for cardiovascular, immunological, respiratory, and neurological functions. Both low serum and dietary Mg have been associated with the severity of COVID-19 outcomes, including mortality; both are also associated with COVID-19 risk factors such as older age, obesity, type 2 diabetes, kidney disease, cardiovascular disease, hypertension, and asthma. In addition, populations with high rates of COVID-19 mortality and hospitalization tend to consume diets high in modern processed foods, which are generally low in Mg. In this review, we review the research to describe and consider the possible impact of Mg and Mg status on COVID-19 showing that (1) serum Mg between 2.19 and 2.26 mg/dL and dietary Mg intakes > 329 mg/day could be protective during the disease course and (2) inhaled Mg may improve oxygenation of hypoxic COVID-19 patients. In spite of such promise, oral Mg for COVID-19 has thus far been studied only in combination with other nutrients. Mg deficiency is involved in the occurrence and aggravation of neuropsychiatric complications of COVID-19, including memory loss, cognition, loss of taste and smell, ataxia, confusion, dizziness, and headache. Potential of zinc and/or Mg as useful for increasing drug therapy effectiveness or reducing adverse effect of anti-COVID-19 drugs is reviewed. Oral Mg trials of patients with COVID-19 are warranted.

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Section: Pharmacodynamic Interactionsmentioning

confidence: 86%

Importance of Magnesium Status in COVID-19

Guerrero‐Romero

Micke

Simental‐Mendía

et al. 2023

Biology

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“… 51 Still, we hope to see some results from a meta-analysis studying the impact of ivermectin in the population. 52 , 53…”

Section: Drug Used For Self-medication In Covid-19mentioning

confidence: 99%

“…51 Still, we hope to see some results from a meta-analysis studying the impact of ivermectin in the population. 52,53 Safety and monitoring. Pedrozo et al analyzed in a small group, the characteristics of self-medication in healthcare workers diagnosed with COVID-19.…”

Section: Ivermectinmentioning

confidence: 99%

Drug safety of frequently used drugs and substances for self-medication in COVID-19

Baracaldo-Santamaría

Pabón-Londoño

Rojas-Rodriguez

2022

Therapeutic Advances in Drug Safety

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During the COVID-19 pandemic, the behavior of self-medication has increased. The dissemination of misleading information regarding the efficacy of certain drugs or substances for the prevention and treatment of COVID-19 has been the major contributing factor for this phenomenon. Alongside with the increase in self-medication behavior, the inherent risks to this act such as drug–drug interactions, adverse events, drug toxicity, and masking of symptoms have also increased. Self-medication in the context of COVID-19 has led to drug misuse leading in some cases to the development of fatal adverse drug reactions. It is important that during this ongoing pandemic drugs with potential clinical efficacy against COVID-19 are adequately analyzed regarding their efficacy, safety, and monitoring. The aim of this review is to describe the available evidence regarding the efficacy, safety, and monitoring of the drugs and substances that have been shown to be frequently used for self-medication in patients with COVID-19 (hydroxychloroquine, non-steroidal anti-inflammatory drugs, ivermectin, azithromycin, vitamins, aspirin, and chlorine dioxide) to adequately characterize their risks, safe use, monitoring strategies, and to reinforce the concept that these substances should not be used for self-medication and require a medical prescription. Plain Language Summary Drug safety of frequently used drugs and substances for self-medication in COVID-19 Dissemination of information about potential COVID-19 treatments has led individuals to self-medicate and expose themselves to risks such as drug–drug interactions, side effects, antibiotic resistance, and misdiagnosis. There is a need to review the medical literature to evaluate the safety and efficacy of the drugs and substances commonly used by the population for the treatment and prevention of SARS CoV-2 infection. In this review, we included drugs that are frequently used for self-medication and commonly advertised such as ivermectin, hydroxychloroquine, chlorine dioxide, azithromycin, and non-steroidal anti-inflammatory drugs, among others. A brief introduction of the drug and its mechanism of action, followed by a summary of the efficacy in COVID-19 and safety, will be described for each drug in order to promote their responsible use.

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Ivermectin for preventing and treating COVID-19

Popp

Reis

Schießer

et al. 2022

Cochrane Database of Systematic Reviews

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Background Ivermectin, an antiparasitic agent, inhibits the replication of viruses in vitro. The molecular hypothesis of ivermectin's antiviral mode of action suggests an inhibitory effect on severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) replication in early stages of infection. Currently, evidence on ivermectin for prevention of SARS‐CoV‐2 infection and COVID‐19 treatment is conflicting. Objectives To assess the efficacy and safety of ivermectin plus standard of care compared to standard of care plus/minus placebo, or any other proven intervention for people with COVID‐19 receiving treatment as inpatients or outpatients, and for prevention of an infection with SARS‐CoV‐2 (postexposure prophylaxis). Search methods We searched the Cochrane COVID‐19 Study Register, Web of Science (Emerging Citation Index and Science Citation Index), WHO COVID‐19 Global literature on coronavirus disease, and HTA database weekly to identify completed and ongoing trials without language restrictions to 16 December 2021. Additionally, we included trials with > 1000 participants up to April 2022. Selection criteria We included randomized controlled trials (RCTs) comparing ivermectin to standard of care, placebo, or another proven intervention for treatment of people with confirmed COVID‐19 diagnosis, irrespective of disease severity or treatment setting, and for prevention of SARS‐CoV‐2 infection. Co‐interventions had to be the same in both study arms. For this review update, we reappraised eligible trials for research integrity: only RCTs prospectively registered in a trial registry according to WHO guidelines for clinical trial registration were eligible for inclusion. Data collection and analysis We assessed RCTs for bias, using the Cochrane RoB 2 tool. We used GRADE to rate the certainty of evidence for outcomes in the following settings and populations: 1) to treat inpatients with moderate‐to‐severe COVID‐19, 2) to treat outpatients with mild COVID‐19 (outcomes: mortality, clinical worsening or improvement, (serious) adverse events, quality of life, and viral clearance), and 3) to prevent SARS‐CoV‐2 infection (outcomes: SARS‐CoV‐2 infection, development of COVID‐19 symptoms, admission to hospital, mortality, adverse events and quality of life). Main results We excluded seven of the 14 trials included in the previous review version; six were not prospectively registered and one was non‐randomized. This updated review includes 11 trials with 3409 participants investigating ivermectin plus standard of care compared to standard of care plus/minus placebo. No trial investigated ivermectin for prevention of infection or compared ivermectin to an intervention with proven efficacy. Five trials treated participants with moderate COVID‐19 (inpatient settings); six treated mild COVID‐19 (outpatient settings). Eight trials were double‐bli...

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Anti-COVID property of subcutaneous ivermectin in synergy with zinc among midlife moderately symptomatic patients: a structured summary of a study protocol for a randomised controlled trial

Cited by 3 publications

References 0 publications

Importance of Magnesium Status in COVID-19

Importance of Magnesium Status in COVID-19

Drug safety of frequently used drugs and substances for self-medication in COVID-19

Ivermectin for preventing and treating COVID-19

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