Ivermectin Treatment May Improve the Prognosis of Patients With COVID-19

Khan, Md. Saiful Islam; Khan, Md. Sakirul Islam; Debnath, C R; Nath, Progga Nanda; Mahtab, Mamun Al; Nabeka, Hiroaki; Matsuda, Seiji; Akbar, Sheikh Mohammad Fazle

doi:10.1016/j.arbr.2020.08.011

Cited by 24 publications

(35 citation statements)

References 13 publications

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“…In addition to the evidence from systematic reviews, the findings of several controlled observational studies are consistent with existing evidence and suggest improved outcomes with ivermectin treatment. 55 , 57 , 59 Similarly, with respect to ivermectin prophylaxis of frontline workers and those at risk, controlled observational studies from Bangladesh and Argentina (the latter which involved 1195 health care workers) have shown apparent reductions in COVID-19 transmission with ivermectin prophylaxis, including in some reports total protection (zero infections) where infection rates in the control group exceeded 50%. 122 , 123 A very large trial of ivermectin prophylaxis in health care workers in India 124 covered 3532 participants and reported risk ratios not significantly different from this meta-analysis (prophylaxis outcome).…”

Section: Discussionmentioning

confidence: 99%

Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines

Bryant

Lawrie

Dowswell

et al. 2021

American Journal of Therapeutics

189

106

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Background: Repurposed medicines may have a role against the SARS-CoV-2 virus. The antiparasitic ivermectin, with antiviral and anti-inflammatory properties, has now been tested in numerous clinical trials. Areas of uncertainty: We assessed the efficacy of ivermectin treatment in reducing mortality, in secondary outcomes, and in chemoprophylaxis, among people with, or at high risk of, COVID-19 infection. Data sources: We searched bibliographic databases up to April 25, 2021. Two review authors sifted for studies, extracted data, and assessed risk of bias. Meta-analyses were conducted and certainty of the evidence was assessed using the GRADE approach and additionally in trial sequential analyses for mortality. Twenty-four randomized controlled trials involving 3406 participants met review inclusion. Therapeutic Advances: Meta-analysis of 15 trials found that ivermectin reduced risk of death compared with no ivermectin (average risk ratio 0.38, 95% confidence interval 0.19–0.73; n = 2438; I 2 = 49%; moderate-certainty evidence). This result was confirmed in a trial sequential analysis using the same DerSimonian–Laird method that underpinned the unadjusted analysis. This was also robust against a trial sequential analysis using the Biggerstaff–Tweedie method. Low-certainty evidence found that ivermectin prophylaxis reduced COVID-19 infection by an average 86% (95% confidence interval 79%–91%). Secondary outcomes provided less certain evidence. Low-certainty evidence suggested that there may be no benefit with ivermectin for “need for mechanical ventilation,” whereas effect estimates for “improvement” and “deterioration” clearly favored ivermectin use. Severe adverse events were rare among treatment trials and evidence of no difference was assessed as low certainty. Evidence on other secondary outcomes was very low certainty. Conclusions: Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.

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Section: Discussionmentioning

confidence: 99%

Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines

Bryant

Lawrie

Dowswell

et al. 2021

American Journal of Therapeutics

189

106

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“…The nuclear importation of virus and host proteins has been known to be inhibited. Virus integrase protein and importin (IMP) alpha/β1 heterodimer is responsible for nuclear import, further increasing infection are also, inhibited 10–26 …”

Section: Introductionmentioning

confidence: 99%

Clinical study evaluating the efficacy of ivermectin in COVID‐19 treatment: A randomized controlled study

Abd-Elsalam

Noor

Badawi

et al. 2021

Journal of Medical Virology

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Researchers around the world are working at record speed to find the best ways to treat and prevent coronavirus disease 2019 (COVID‐19). This study aimed to evaluate the efficacy of ivermectin for the treatment of hospitalized mild to moderate COVID‐19 infected patients. This was a randomized open‐label controlled study that included 164 patients with COVID‐19. Patients were randomized into two groups where Group 1 (Ivermectin group) included patients who received ivermectin 12 mg once daily for 3 days with standard care and Group 2 (control group) included patients who received standard protocol of treatment alone for 14 days. The main outcomes were mortality, the length of hospital stay, and the need for mechanical ventilation. All patients were followed up for 1 month. Overall, 82 individuals were randomized to receive ivermectin plus standard of care and 82 to receive standard of care alone. Patients in the ivermectin group had a shorter length of hospital stay (8.82 ± 4.94 days) than the control group (10.97 ± 5.28 days), but this was not statistically significant ( p = 0.085). Three patients (3.7%) in each group required mechanical ventilation ( p = 1.00). The death rate was three patients in the ivermectin group (3.7%) versus four patients (4.9%) in the control group without any significant difference between the two groups ( p = 1.00). Although there was no statistically significant difference in any endpoints by ivermectin doses (12 mg/day for 3 days); there was an observed trend to reducing hospital stay in the ivermectin‐treated group.

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Section: Discussionmentioning

confidence: 99%

“…In the present study, the inclusion of patients with double or triple therapy was observed during the mild clinical phase of COVID-19, with initiation of therapy on the 4th day of the COVID-19 disease vs. another study including patients in a moderate clinical phase with a 9-day hospital stay [24]. In relation to Azithromycin that is within the two therapies (double and triple), only 3 (2.6%) patients died, a characteristic that was also observed in presenting the lower risk of death when using Azithromycin alone in hospitalized patients with COVID-19 , reporting an adjusted Hazard Ratio of 0.56 (95% CI, 0.26-1.21) [24]. Rivaroxaban at a dose of 15mg per day in patients with moderate phase COVID-19 increases serum levels of oral anticoagulants when treated with antiviral drugs up to 6 times more [25] in the present study, there were no serious hematological alterations in the group with and without ivermectin, given this being a prophylactic dose of rivaroxaban, there are studies in the recruitment phase that are indicating the dose of rivaroxaban at a dose of 10mg in mild and moderate phase patients with COVID-19 with remote electronic monitoring for 35 days [26].…”

Section: Discussionmentioning

confidence: 99%

"Clinical Modification with Early Treatment in COVID-19"

Arteaga¹

2021

BJSTR

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Coronavirus disease (COVID-19) is caused by SARS-COV2 and represents a global public health problem. E l use of ivermectin for the treatment of SARS-COV2 the World Health Organization encourages concerns the use of therapy untested in the context of randomized clinical trial. Azithromycin has shown success in the SARS-COV2 . The low molecular weight heparins have decreased mortality COVID-19, and l Rivaroxaban is an alternative pathway oral for use. E l objective was to evaluate the percentage of patients diagnosed with COVID-19 that modify their clinical evolution under treatment comparative early intervention.Material and Methods: Design randomized experimental, single -blind, prospective, longitudinal and open in 114 patients with COVID-19 UMF No. 13 and No. 20 of November to December 2020 , prior informed consent is given medication randomized 67 patients (Azithromycin / Ivermectin a / Ribaroxaban ) vs. 47 (Azithromycin / Ribaroxaban ); followed by video call for 14 days with evaluation of the outcome of clinical symptoms such as headache, cough, fever, conjunctivitis, myalgia, arthralgia, rhinorrhea, odynophagia, anosmia, chest pain, dyspnea, using statistics with Student's t test , survival tables, using SPSS version 21. Results:There was an improvement in the modification of the clinical evolution of the symptoms of patients with COVID-19 with double therapy in 95.7% (n = 44) vs. 90.8% with triple therapy (n = 59) with therapeutic failure in 4.3 % (n = 2) vs. 9.2% (n = 6) respectively, with a value of p = 0.327.

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Ivermectin Treatment May Improve the Prognosis of Patients With COVID-19

Cited by 24 publications

References 13 publications

Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines

Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines

Clinical study evaluating the efficacy of ivermectin in COVID‐19 treatment: A randomized controlled study

"Clinical Modification with Early Treatment in COVID-19"

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