Outcomes associated with Hydroxychloroquine and Ivermectin in hospitalized patients with COVID-19: a single-center experience

Abstract

OBJECTIVE: Hydroxychloroquine and Ivermectin are advocated as potential treatments for coronavirus disease 2019 (COVID-19) despite the lack of supportive clinical evidence. In this study, outcomes associated with Hydroxychloroquine and/or Ivermectin were determined in a series of patients with confirmed COVID-19 from a single institution in Brazil. METHODS: Consecutive patients admitted between March and July 2020 were retrospectively analyzed and divided into four treatment categories: no treatment (Group 0), Ivermectin only (Group I), Hydroxychloroquine only (Group II), and Hydroxychloroquine and Ivermectin (Group III). Intensive care unit admission, mechanical ventilation, and death were compared between the Groups.RESULTS: A total of 230 patients were included, with the following treatment distribution: 35.2% (0), 9.1% (I), 48.3% (II), and 7.4% (III). Groups I, II, and III had the higher rates of Intensive care unit admission, mechanical ventilation, or death (0: 23.5% versus I: 38.1% versus II: 37.8% versus III: 70.6%, p=0.002), and the greatest mortality was found in Group III (0 versus III: 13.6% versus 35.3%, p=0.03).In the multivariate analysis, Hydroxychloroquine remained significantly associated with death (OR 3.3, 95%CI 1.1-9.6, p=0.03). CONCLUSION:In a series of consecutive hospitalized patients with COVID-19, Ivermectin was not associated with improved outcomes and Hydroxychloroquine may have resulted in a harmful effect.

RETRACTED: Microbiome-Based Hypothesis on Ivermectin’s Mechanism in COVID-19: Ivermectin Feeds Bifidobacteria to Boost Immunity

“…Over 40 peer-reviewed studies ( Table 1 ) have demonstrated studies on the effectiveness of IVM in SARS-CoV-2 infection ( Alam et al, 2020 ; Khan et al, 2020 ; Kishoria et al, 2020 ; Reaz et al, 2020 ; Abd-Elsalam et al, 2021 ; Ahmed et al, 2021 ; Ahsan et al, 2021 ; Aref et al, 2021 ; Behera et al, 2021 ; Cadegiani et al, 2021 ; Chaccour et al, 2021 ; Chahla et al, 2021 ; Chowdhury et al, 2021 ; Elalfy et al, 2021 ; Faisal et al, 2021 ; Ferreira et al, 2021 ; Hellwig and Maia, 2021 ; Krolewiecki et al, 2021 ; Lima-Morales et al, 2021 ; López-Medina et al, 2021 ; Mohan et al, 2021 ; Morgenstern et al, 2021 ; Mukarram, 2021 ; Okumuş et al, 2021 ; Podder et al, 2021 ; Rajter et al, 2021 ; Ravikirti et al, 2021 ; Rezk et al, 2021 ; Seet et al, 2021 ; Shahbaznejad et al, 2021 ; Shoumann et al, 2021 ; Abbas et al, 2022 ; Ascencio-Montiel et al, 2022 ; Babalola et al, 2022 ; Beltran Gonzalez et al, 2022 ; Buonfrate et al, 2022 ; Hazan et al, 2022a ; Kerr et al, 2022 ; Lim et al, 2022 ; Mayer et al, 2022 ; Mustafa et al, 2022 ; Ozer et al, 2022 ; Reis et al, 2022 ; Shimizu et al, 2022 ; Zubair et al, 2022 ), with over 80% of studies showing positive outcomes with IVM treatment. Overall, IVM has shown 60–85% improvement in outcomes, including mortality, ventilation, recovery, clearance, and hospital/ICU admissions.…”

Dados de Vida Real sobre o Uso da Hidroxicloroquina ou da Cloroquina Combinadas ou Não à Azitromicina em Pacientes com Covid-19: Uma Análise Retrospectiva no Brasil

“… 20 Uma análise retrospectiva de pacientes internados com covid-19 que usaram HCQ também detectou uma taxa mais alta de mortalidade (OR 3,3; IC95% 1,1-9,6; p=0,03). 21 …”

“… 20 A retrospective analysis of COVID-19 inpatients who used HCQ also detected a higher rate of mortality (OR 3.3, 95%CI 1.1-9.6, p=0.03). 21 …”

“…20 Uma análise retrospectiva de pacientes internados com covid-19 que usaram HCQ também detectou uma taxa mais alta de mortalidade (OR 3,3; IC95% 1,1-9,6; p=0,03). 21 A maioria da evidência robusta existente sobre HCQ/CQ e ventilação mecânica invasiva deriva do ensaio RECOVERY, 5 o maior ECR até o momento, que, sozinho, representou 47% da amostra e 76% do peso da revisão sistemática mencionada acima que incluiu 28 ECRs. 18 Nesse estudo, que incluiu 1561 pacientes tratados com HCQ, comparados a 3155 pacientes que receberam tratamento usual, o grupo que recebeu HCQ apresentou uma frequência mais alta de desfecho composto de ventilação mecânica invasiva ou morte (30,7% vs. 26,9%, RR = 1,14, IC95% 1,03 -1,27).…”

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

“…Further, the combination of IVM, AZ, acetaminophen, and aspirin, given to mild COVID-19 patients with no respiratory failure, reduced the risk of hospitalization and mortality [ 264 ]. On the contrary, the combination of IVM and HCQ did not reduce the viral load nor the mortality rate [ 265 , 266 ].…”