Ivermectin in the Prophylaxis and Treatment of Patients with SARS-CoV-2: A Living Systematic Review and Meta-Analysis

Rodríguez-Gutiérrez, René; Raygoza-Cortez, Karina; García-Leal, Mariana; Sáenz-Flores, Melissa; Rc, Solis; Flores-Rodríguez, Andrea; Alvarez‐Villalobos, Neri Alejandro; Jg, González-González

doi:10.2139/ssrn.3802499

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…15,16 Since August 2020, inpatient and outpatient treatments of COVID-19 with IVM have been applied across 25 countries, 10 with more than 20 RCTs conducted for IVM treatment regimens. 10,17,18 Seven of nine meta-analyses of these RCTs for IVM treatment reporting in 2021, all conducted using Cochrane analysis methodology, found signi cant [18][19][20][21][22] or possible 23,24 indications of IVM e cacy, with a mean 0.33 relative risk (RR) of mortality vs controls. Most of these 20 RCTs for IVM treatment of COVID-19 showed statistically signi cant mortality reductions or other clinical bene ts.…”

Section: Ivm For Covid-19 Treatmentmentioning

confidence: 99%

Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours

Stone¹,

Ndarukwa²,

Scheim³

et al. 2021

Preprint

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Background. The emergence of COVID-19 in March 2020 challenged Zimbabwe to mount a response with limited medical facilities and therapeutic options. Ivermectin (IVM) had by then been safely used to treat a variety of human diseases affecting millions, as noted by the Nobel Committee in awarding its 2015 prize for medicine. Based upon early clinical indications of efficacy against COVID-19, IVM-based combination treatments were deployed to treat this infection in Zimbabwe.Methods. Data were retrospectively analyzed for 34 severe COVID-19 patients treated with IVM-based combination therapy between August 2020 and May 2021, for whom pre- and post-treatment SpO2 values were all recorded on room air. Mortality and deterioration outcomes were also analyzed for a larger set of 92 severe COVID-19 patients receiving IVM-based treatment.Results: For the 34-patient SpO2 tracking series, all but two patients had significantly increased SpO2 values after the first IVM dose, and all patients recovered. Mean increases in SpO2 as percentages of full normalization to SpO2=97 were 55.1% at +12 hours and 62.3% at +24 hours post-treatment. These results paralleled similar sharp increases in SpO2, all on room air, for a series of 24 RT-qPCR confirmed, mostly severe COVID-19 patients in the USA (California) who were given IVM combination treatment, all of whom recovered. For 19 of those patients having SpO2 ≤ 90 prior to IVM, the mean SpO2 normalization at +24 hours post-treatment was 65.2% as calculated from the SpO2 values reported. For our larger series of 92 severe COVID-19 patients in Zimbabwe, median age 53, only two died and two more deteriorated prior to recovery, far less than a predicted 7 deaths and 17 deteriorations for the demographics and risk factors of these patients.Conclusions. The rapid, marked increases in SpO2 for both the Zimbabwe and California patients stand in sharp contrast to the decline in SpO2 and associated pulmonary function following onset of moderate or severe COVID-19 symptoms under standard care. These rapid SpO2 increases and low mortality rates support extended deployment of IVM treatment for COVID-19, complementary to immunizations for prevention.

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Section: Ivm For Covid-19 Treatmentmentioning

confidence: 99%

Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours

Stone¹,

Ndarukwa²,

Scheim³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…3 with more than 20 randomized clinical trials (RCTs) conducted for such IVM treatments. 3,43,44 Seven of eight meta-analyses of these IVM treatment RCTs reporting in 2021, all done using Cochrane analysis methodology, found significant [44][45][46][47][48] or possible 49,50 indications of IVM efficacy, with a mean 0.33 relative risk (RR) of mortality vs. controls. The eighth meta-analyses reported no efficacy for IVM, specifying a value of RR=1.1 for mortality, 51 but corrected that to RR=0.37 (a 63% mortality reduction) in a revised version after fixing switched treatment and control values for one key RCT.…”

Section: Introductionmentioning

confidence: 99%

Ivermectin for COVID-19 in Peru: 14-fold reduction in nationwide excess deaths, p<0.002 for effect by state, then 13-fold increase after ivermectin use restricted

Chamie-Quintero¹,

Scheim²

2021

Preprint

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Introduction. On May 8, 2020, Peru’s Ministry of Health approved ivermectin (IVM), a drug of Nobel Prize-honored distinction, for inpatient and outpatient treatment of COVID-19. As IVM treatments proceeded in that nation of 33 million residents, excess deaths decreased 14-fold over four months through December 1, 2020, consistent with clinical benefits of IVM for COVID-19 found in several RCTs. But after IVM use was sharply restricted under a new president, excess deaths then increased 13-fold. Methods. To evaluate possible IVM treatment effects suggested by these aggregate trends, excess deaths were analyzed by state for ages ≥ 60 in Peru’s 25 states. To identify potential confounding factors, Google mobility data, population densities, SARS-CoV-2 genetic variations and seropositivity rates were also examined.Results. The 25 states of Peru were grouped by extent of IVM distributions: maximal (mass IVM distributions through operation MOT, a broadside effort led by the army); medium (locally managed IVM distributions); and minimal (restrictive policies in one state, Lima). The mean reduction in excess deaths 30 days after peak deaths was 74% for the maximal IVM distribution group, 53% for the medium group and 25% for Lima. Reduction of excess deaths is correlated with extent of IVM distribution by state with a p value of 0.002 using the Kendall τb test, well below the confidence threshold of 0.05 for an established clinical effect.Conclusion. Mass treatments with IVM, a drug safely used in 3.7 billion doses worldwide since 1987, most likely caused the 14-fold reductions in excess deaths in Peru, prior to their 13-fold increase under reversed IVM policy. This strongly suggests that IVM treatments can likewise effectively complement immunizations to help eradicate COVID-19. The indicated biological mechanism of IVM, competitive binding with SARS-CoV-2 spike protein, is likely non-epitope specific, possibly yielding full efficacy against emerging viral mutant strains.

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Ivermectin in the Prophylaxis and Treatment of Patients with SARS-CoV-2: A Living Systematic Review and Meta-Analysis

Cited by 2 publications

References 23 publications

Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours

Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours

Ivermectin for COVID-19 in Peru: 14-fold reduction in nationwide excess deaths, p<0.002 for effect by state, then 13-fold increase after ivermectin use restricted

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Ivermectin in the Prophylaxis and Treatment of Patients with SARS-CoV-2: A Living Systematic Review and Meta-Analysis

Cited by 2 publications

References 23 publications

Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours

Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours

Ivermectin for COVID-19 in Peru: 14-fold reduction in nationwide excess deaths, p&lt;0.002 for effect by state, then 13-fold increase after ivermectin use restricted

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Ivermectin for COVID-19 in Peru: 14-fold reduction in nationwide excess deaths, p<0.002 for effect by state, then 13-fold increase after ivermectin use restricted