The effect of ivermectin on non-severe and severe COVID-19 disease and gender-based difference of its effectiveness

Abstract

The COVID-19 pandemic has led to mortality and morbidity since December 2019. Many possible treatment options have been advised till date. The role of ivermectin in the treatment of COVID-19 disease remains controversial. The aim of our study was to evaluate the effect of ivermectin in hospitalized patients with non-severe and severe COVID-19 disease. We conducted a retrospective cohort study that compared outcomes in 2 groups of COVID-19 patients hospitalized at the largest tertiary care center of Pakistan. The study group was given ivermectin along with standard treatment of covid-19 disease; the comparison group was not. Data on mortality, inflammatory markers such as C-reactive protein (CRP) and ferritin, length of hospital stay and baseline characteristics were collected from Aga Khan University’s database from October 2020 till February 2021. Statistical analysis was done to determine the effectiveness of ivermectin in non-severe and severe COVID-19. Comparison of effectiveness of Ivermectin in both the genders was also conducted. The cohort included 188 patients out of which 90 were treated with ivermectin. Mortality and length of hospitalization was not found to be significantly different in the study group compared with the control group (5.6% vs 5.1%; p=0.87 and 5 days vs 4 days; p=0.27). Analysis of secondary outcomes did not yield statistically significant results, apart from ferritin levels which were significantly less in patients treated with ivermectin (547.1 vs 756.7; p=0.03). The ferritin and CRP levels in affected males were higher than in females on admission and discharge. Our findings suggest ivermectin does not significantly affect all-cause mortality, length of hospitalization and CRP levels in hospitalized COVID-19 patients. Large scale randomized controlled trials (RCTs) are required to further evaluate the role of ivermectin in covid-19 disease.

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

“…Egypt The effect of ivermectin on non-severe and severe COVID-19 disease and gender-based difference of its effectiveness. Zubair et al, 2022 Pakistan…”

“…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.…”

“…Overall, IVM has shown 60–85% improvement in outcomes, including mortality, ventilation, recovery, clearance, and hospital/ICU admissions. The effectiveness could be particularly strong at high doses ( Krolewiecki et al, 2021 ; Buonfrate et al, 2022 ; Mayer et al, 2022 ) and for severe SARS-CoV-2 infection ( Beltran Gonzalez et al, 2022 ; Hazan et al, 2022a ; Zubair et al, 2022 ), and one must consider that the effective dose is very affected by food co-administration ( Food and Drug Administration, 2022 ). Thus, there is a tremendous need to ascertain, not whether but how IVM is ideally applied for SARS-CoV-2 infection.…”

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

“…Besides, an Egyptian study observed a decreased in IL-6 and IL-1 cytokines in COVID-19 patients treated with IVM, with a reduction in the mortality rate and the hospitalization time [ 251 ]. Conversely, studies conducted in Pakistan and China did not detect differences in mortality rate, inflammatory markers, time of hospitalization, time of resolution of symptoms and syndrome course in mild and severe COVID-19 subjects [ 252 , 253 ]. Likewise, an American prospective study on 286 patients treated with two doses of IVM found no benefits in hospitalization time, intensive care unit admission, intubation rate or mortality [ 254 ].…”