Effectiveness of Ivermectin as add-on Therapy in COVID-19 Management (Pilot Trial)

Abstract

<jats:p>Background: To date no effective therapy has been demonstrated for COVID-19. In vitro, studies indicated that ivermectin (IVM) has antiviral effect. Objectives: To assess the effectiveness of ivermectin (IVM) as add-on therapy to hydroxychloroquine (HCQ) and azithromycin (AZT) in treatment of COVID-19. Methods: This Pilot clinical trial conducted on hospitalized adult patients with mild to moderate COVID-19 diagnosed according to WHO interim guidance. Sixteen Patients received a single dose of IVM 200Mcg /kg on admission day as add on therapy to hydroxychloroquine ( HCQ)and Azithromycin (AZT) and were compared with 71 controls received HCQ and AZT matched in age, gender, clinical features, and comorbidities. The primary outcome was percentage of cured patients, defined as symptoms free to be discharged from the hospital and 2 consecutive negative PCR test from nasopharyngeal swabs at least 24 hours apart. The secondary outcomes were time to cure in both groups and evaluated by measuring time from admission of the patient to the hospital till discharge. Results: Of 87 patients included in the study,t he mean age ± SD (range) of patients in the IVM group was similar to controls [44.87 ± 10.64 (28-60) vs 45.23 ± 18.47 (8-80) years, p=0.78] Majority of patients in both groups were male but statistically not significant [11(69%) versus 52 (73%), with male: female ratio 2.21 versus 2.7-, p=0.72) All the patients of IVM group were cured compared with the controls [ 16 (100 %) vs 69 (97.2 %)]. Two patients died in the controls. The mean time to stay in the hospital was significantly lower in IVM group compared with the controls (7.62 ±2.75 versus 13.22 ±.90 days, p=0.00005, effect size= 0.82). No adverse events were observed Conclusions : Add-on use of IVM to HCQ and AZT had better effectiveness, shorter hospital stay, and relatively safe compared with controls. however, a larger prospective study with longer follow up may be needed to validate these results.</jats:p>

Ivermectin may be a clinically useful anti-inflammatory agent for late-stage COVID-19

“…Two patients died in the control group, none in the ivermectin group. 11 Note that these apparent therapeutic benefits were seen in hospitalised patients, in whom antiviral measures are suspected to be less effective than anti-inflammatory measures targeting cytokine storm.…”

A Review on the Antiparasitic Drug Ivermectin for Various Viral Infections and Possibilities of Using It for Novel Severe Acute Respiratory Syndrome Coronavirus 2: New Hope to Treat Coronavirus Disease-2019

“…A total of seven clinical trials have been registered under Clinical Trials.gov aim to evaluate the efficacy of IVM in treating COVID-19 (Table 2) [39][40][41][42][43][44][45].…”

Covid-19 Therapy: What Have We Learned In 8 Months?

“…The mean time of hospitalization was significantly shorter (7.62 ± 2.75 days) for Ivermectin-treated patients, comparing to controls (13.22 ± 5.90 days). The virus clearance was faster in Ivermectin group [63]. The effectiveness of Ivermectin, as drug or adjuvant in association with other compounds, is currently being evaluated in various randomized clinical trials, but there is still insufficient evidence to draw a conclusion on benefits or harms during treatment of COVID-19 patients [30].…”