Ivermectin disinformation leads to new kinds of chaos

BY JUSTINE COLEMAN – 09/29/21 06:00 AM EDT

An avalanche of misinformation about the antiparasitic drug ivermectin’s ability to treat COVID-19 has caused a series of national problems, from increased calls to poisoning centers to a shortage of the medicine itself. 

Patients have become desperate for a treatment that’s most commonly used for livestock and have taken their disputes over ivermectin with hospitals to court. 

Disinformation has flooded the internet, where dozens of Facebook groups centered around ivermectin remain active despite insufficient evidence that the medicine works in treating people for COVID-19. 

It’s also gone well beyond the internet to popular podcast hosts like Joe Rogan, who has touted the medicine to his millions of listeners. 

The Food and Drug Administration (FDA), other state health departments and even Merck, the drug’s main manufacturer, have all warned against using ivermectin for COVID-19. 

Still, online influences supporting the controversial COVID-19 treatment endure. 

It’s all raising questions about whether the government needs to do more to step in. 

“The promise that there are miracle solutions to an illness is really persuasive,” Jennifer Reich, a professor of sociology at the University of Colorado Denver. “And the idea that individuals can manage their own health, if they read a lot, gather information and make their own decisions is really powerful.”

Media Matters for America found 60 public and private Facebook groups dedicated to ivermectin last month, before the social media giant removed 25 of them after the liberal watchdog’s report. But the other groups still involve more than 70,000 combined users. 

Media Matters released a report on Tuesday concluding that Facebook users are getting around the platform’s moderation strategies by posting links and screenshots of misinformation in the comments of posts and by purposely misspelling keywords such as ivermectin and vaccines. 

“Unfortunately, due to Facebook’s lax moderation of the content on its platform, these evasion techniques are working, and misinformation is thriving on the social media site,” the report reads.

Kayla Gogarty, the associate research director for Media Matters, criticized Facebook for not adequately responding to such misinformation in groups.

“The fact that Facebook has not taken much action against these groups is definitely problematic,” she said.

A Facebook spokesperson told The Hill that the company has removed 20 million pieces of content from Facebook and Instagram for violating COVID-19 misinformation policies.  

“As we enforce our policies against COVID misinformation, we know people will keep trying new tactics to get around our policies and we are constantly evolving to stay ahead of them,” the spokesperson said. 

“We will continue to enforce against any account or group that violates our COVID-19 and vaccine policies,” the statement continued. 

A spokesperson also told The New York Times that the platform removes “content that attempts to buy, sell or donate for ivermectin” and any claims that the drug is “a guaranteed cure or guaranteed prevention.”

Ivermectin is not the first drug to gain traction online as a possible COVID-19 treatment despite lacking evidence. Several experts compared the dewormer’s popularity to that of antimalarial hydroxychloroquine that former President Trump promoted last year.

Yunkang Yang, a postdoctoral research scientist at the Institute for Data, Democracy and Politics at George Washington University, said that influential figures, including Republican politicians, have contributed to the discourse of ivermectin as a “miracle cure.”

For instance, Rogan declared to his millions of listeners that he was taking ivermectin following his COVID-19 diagnosis.

“It would be hard to imagine this information gaining any traction without [their] participation,” he said. 

Misinformation surrounding ivermectin specifically is also not new, as the drug was proposed as a possible treatment earlier in the pandemic, including in some studies retracted due to flawed or fabricated data.

But ivermectin-related calls to poison control centers this year have more than tripled compared to the same period last year, with 1,440 calls through Sept. 20, according to the American Association of Poison Control Centers. 

July, in particular, saw a five-fold increase in ivermectin calls compared to the “pre-pandemic baseline,” according to the Centers for Disease Control and Prevention. Some cases have been fatal, with New Mexico reporting this week two deaths from misusing ivermectin as a COVID-19 medication.

The spikes in ivermectin misuse sparked the FDA to issue an advisory against using the drug for the virus earlier this month. 

“You are not a horse. You are not a cow. Seriously, y’all. Stop it,” the agency said on Twitter. 

While the FDA has approved ivermectin to treat parasitic worms, lice and skin conditions like rosacea among humans, the drug is more often used to treat animals, including cattle and horses. 

In addition to taking unprescribed ivermectin, several cases have emerged where people have been using these animal products. 

“The issue happens when you have inappropriate use where you have a non-human product, for example, that is meant for cattle that has a different formulation composition,” said Ziad Kazzi, a professor of medical toxicology at Emory University.

“The strength of the formulation is different than what you would use in a human,” said Kazzi, who is also the secretary treasurer of the American College of Medical Toxicology,.

Tara Kirk Sell, a senior scholar at the Johns Hopkins Center for Health Security, said the government can always counter specific COVID-19 rumors such as ivermectin’s effectiveness, but it may not be perceived as a “trusted messenger.”

Instead, she said the government needs to develop a national strategy to fight against misinformation in general so Americans are “more resilient to future misinformation.”

“That can kind of be more of a role for government, rather than deciding what’s true, helping people have the tools to figure it out for themselves,” she said.  

“We’ll see this again with something else,” she added. “And we have to realize that we’re going to have to be pushing back against these rumors for a long time to come.”

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

Authors: Bryant, Andrew MSc1,*; Lawrie, Theresa A. MBBCh, PhD2; Dowswell, Therese PhD2; Fordham, Edmund J. PhD2; Mitchell, Scott MBChB, MRCS3; Hill, Sarah R. PhD1; Tham, Tony C. MD, FRCP4 American Journal of Therapeutics: July/August 2021 – Volume 28 – Issue 4 – p e434-e460doi: 10.1097/MJT.0000000000001402

Abstract

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; I2 = 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.

For More Information:https://journals.lww.com/americantherapeutics/Fulltext/2021/08000/Ivermectin_for_Prevention_and_Treatment_of.7.aspx

Prophylaxis against covid-19: living systematic review and network meta-analysis

Authors: Jessica J Bartoszko, methodologist,1 ,*Reed A C Siemieniuk, methodologist, internist,1 ,*Elena Kum, methodologist,1 ,*Anila Qasim, methodologist,1 ,*Dena Zeraatkar, methodologist,1 ,*Long Ge, methodologist,2 ,*Mi Ah Han, methodologist,3Behnam Sadeghirad, assistant professor,1,4Arnav Agarwal, methodologist, internist,1,5Thomas Agoritsas, methodologist, internist,1,6Derek K Chu, methodologist, immunologist,1,7Rachel Couban, librarian,4Andrea J Darzi, methodologist,1Tahira Devji, methodologist,1Maryam Ghadimi, methodologist,1Kimia Honarmand, methodologist, critical care physician,8Ariel Izcovich, methodologist, internist,9Assem Khamis, data analyst,10Francois Lamontagne, methodologist, critical care physician,11Mark Loeb, methodologist, infectious disease physician,1,7Maura Marcucci, methodologist, internist,1,7Shelley L McLeod, methodologist, assistant professor,12,13Sharhzad Motaghi, methodologist,1Srinivas Murthy, clinical associate professor, paediatric critical care, infectious diseases physician,14Reem A Mustafa, methodologist, nephrologist,15John D Neary, methodologist, internist,7Hector Pardo-Hernandez, methodologist,16,17Gabriel Rada, methodologist,18,19Bram Rochwerg, methodologist, critical care physician,1,7Charlotte Switzer, methodologist,1Britta Tendal, methodologist,20Lehana Thabane, professor,1Per O Vandvik, methodologist, internist,21Robin W M Vernooij, methodologist,22,23Andrés Viteri-García, methodologist,18,24Ying Wang, methodologist, pharmacist,1Liang Yao, methodologist,1Zhikang Ye, methodologist, pharmacist,1Gordon H Guyatt, methodologist, internist,1,7 and Romina Brignardello-Petersen, methodologist1

BMJ. 2021; 373: n949.Published online 2021 Apr 26. doi: 10.1136/bmj.n949

Abstract

Objective

To determine and compare the effects of drug prophylaxis on SARS-CoV-2 infection and covid-19.

Design

Living systematic review and network meta-analysis.

Data sources

World Health Organization covid-19 database, a comprehensive multilingual source of global covid-19 literature to 25 March 2021, and six additional Chinese databases to 20 February 2021.

Study selection

Randomized trials of people at risk of covid-19 who were assigned to receive prophylaxis or no prophylaxis (standard care or placebo). Pairs of reviewers independently screened potentially eligible articles.

Methods

Random effects Bayesian network meta-analysis was performed after duplicate data abstraction. Included studies were assessed for risk of bias using a modification of the Cochrane risk of bias 2.0 tool, and certainty of evidence was assessed using the grading of recommendations assessment, development, and evaluation (GRADE) approach.

Results

The first iteration of this living network meta-analysis includes nine randomised trials—six of hydroxychloroquine (n=6059 participants), one of ivermectin combined with iota-carrageenan (n=234), and two of ivermectin alone (n=540), all compared with standard care or placebo. Two trials (one of ramipril and one of bromhexine hydrochloride) did not meet the sample size requirements for network meta-analysis. Hydroxychloroquine has trivial to no effect on admission to hospital (risk difference 1 fewer per 1000 participants, 95% credible interval 3 fewer to 4 more; high certainty evidence) or mortality (1 fewer per 1000, 2 fewer to 3 more; high certainty). Hydroxychloroquine probably does not reduce the risk of laboratory confirmed SARS-CoV-2 infection (2 more per 1000, 18 fewer to 28 more; moderate certainty), probably increases adverse effects leading to drug discontinuation (19 more per 1000, 1 fewer to 70 more; moderate certainty), and may have trivial to no effect on suspected, probable, or laboratory confirmed SARS-CoV-2 infection (15 fewer per 1000, 64 fewer to 41 more; low certainty). Owing to serious risk of bias and very serious imprecision, and thus very low certainty of evidence, the effects of ivermectin combined with iota-carrageenan on laboratory confirmed covid-19 (52 fewer per 1000, 58 fewer to 37 fewer), ivermectin alone on laboratory confirmed infection (50 fewer per 1000, 59 fewer to 16 fewer) and suspected, probable, or laboratory confirmed infection (159 fewer per 1000, 165 fewer to 144 fewer) remain very uncertain.

Conclusions

Hydroxychloroquine prophylaxis has trivial to no effect on hospital admission and mortality, probably increases adverse effects, and probably does not reduce the risk of SARS-CoV-2 infection. Because of serious risk of bias and very serious imprecision, it is highly uncertain whether ivermectin combined with iota-carrageenan and ivermectin alone reduce the risk of SARS-CoV-2 infection.

For More Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073806/

Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized, double-blind, placebo-controlled trial

Abstract

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has changed our lives. The scientific community has been investigating re-purposed treatments to prevent disease progression in coronavirus disease (COVID-19) patients.

Objective

To determine whether ivermectin treatment can prevent hospitalization in individuals with early COVID-19.

Design, setting and participants: A randomized, double-blind, placebo-controlled study was conducted in non-hospitalized individuals with COVID-19 in Corrientes, Argentina. Patients with SARS-CoV-2 positive nasal swabs were contacted within 48 h by telephone to invite them to participate. The trial randomized 501 patients between August 19th 2020 and February 22nd 2021.

Intervention

Patients were randomized to ivermectin (N = 250) or placebo (N = 251) arms in a staggered dose, according to the patient’s weight, for 2 days.

Main outcomes and measures

The efficacy of ivermectin to prevent hospitalizations was evaluated as primary outcome. We evaluated secondary outcomes in relationship to safety and other efficacy end points.

Results

The mean age was 42 years (SD ± 15.5) and the median time since symptom onset to the inclusion was 4 days [interquartile range 3–6]. The primary outcome of hospitalization was met in 14/250 (5.6%) individuals in ivermectin group and 21/251 (8.4%) in placebo group (odds ratio 0.65; 95% confidence interval, 0.32–1.31; p = 0.227). Time to hospitalization was not statistically different between groups. The mean time from study enrollment to invasive mechanical ventilatory support (MVS) was 5.25 days (SD ± 1.71) in ivermectin group and 10 days (SD ± 2) in placebo group, (p = 0.019). There were no statistically significant differences in the other secondary outcomes including polymerase chain reaction test negativity and safety outcomes.

Limitations

Low percentage of hospitalization events, dose of ivermectin and not including only high-risk population.

Conclusion

Ivermectin had no significant effect on preventing hospitalization of patients with COVID-19. Patients who received ivermectin required invasive MVS earlier in their treatment. No significant differences were observed in any of the other secondary outcomes.

Trial registration

ClinicalTrials.gov NCT04529525.

For More Information: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06348-5

Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19

Authors: Pierre Kory, MD,1,*Gianfranco Umberto Meduri, MD,2Joseph Varon, MD,3Jose Iglesias, DO,4 and Paul E. Marik, MD5

Background:

After COVID-19 emerged on U.S shores, providers began reviewing the emerging basic science, translational, and clinical data to identify potentially effective treatment options. In addition, a multitude of both novel and repurposed therapeutic agents were used empirically and studied within clinical trials.

Areas of Uncertainty:

The majority of trialed agents have failed to provide reproducible, definitive proof of efficacy in reducing the mortality of COVID-19 with the exception of corticosteroids in moderate to severe disease. Recently, evidence has emerged that the oral antiparasitic agent ivermectin exhibits numerous antiviral and anti-inflammatory mechanisms with trial results reporting significant outcome benefits. Given some have not passed peer review, several expert groups including Unitaid/World Health Organization have undertaken a systematic global effort to contact all active trial investigators to rapidly gather the data needed to grade and perform meta-analyses.

Data Sources:

Data were sourced from published peer-reviewed studies, manuscripts posted to preprint servers, expert meta-analyses, and numerous epidemiological analyses of regions with ivermectin distribution campaigns.

Therapeutic Advances:

A large majority of randomized and observational controlled trials of ivermectin are reporting repeated, large magnitude improvements in clinical outcomes. Numerous prophylaxis trials demonstrate that regular ivermectin use leads to large reductions in transmission. Multiple, large “natural experiments” occurred in regions that initiated “ivermectin distribution” campaigns followed by tight, reproducible, temporally associated decreases in case counts and case fatality rates compared with nearby regions without such campaigns.

Conclusions:

Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.

For More Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088823/

India’s Ivermectin Blackout

Authors: Authored by Justus R Hope, MD. via TheDesertReview.com,

Ivermectin Wins in India

News of India’s defeat of the Delta variant should be common knowledge. It is just about as obvious as the nose on one’s face. It is so clear when one looks at the graphs that no one can deny it.

Yet, for some reason, we are not allowed to talk about it. Thus, for example, Wikipedia cannot mention the peer-reviewed meta-analyses by Dr. Tess Lawrie or Dr. Pierre Kory published in the American Journal of Therapeutics

Wikipedia is not allowed to publish the recent meta-analysis on Ivermectin authored by Dr. Andrew Hill.

Furthermore, it is not allowed to say anything concerning www.ivmmeta.com showing the 61 studies comprising 23,000 patients which reveal up to a 96% reduction in death [prophylaxis] with Ivermectin.

One can see the bias in Wikipedia by going on the “talk” pages for each subject and reading about the fierce attempts of editors to add these facts and the stone wall refusals by the “senior” editors who have an agenda. And that agenda is not loyalty to your health.

The easy way to read the “talk” page on any Wikipedia subject is to click the top left “talk” button. Anyone can then review the editors’ discussions.

There is a blackout on any conversation about how Ivermectin beat COVID-19 in India. When I discussed the dire straits that India found itself in early this year with 414,000 cases per day, and over 4,000 deaths per day, and how that evaporated within five weeks of the addition of Ivermectin, I am often asked, “But why is there no mention of that in the news?”

Yes, exactly. Ask yourself why India’s success against the Delta variant with Ivermectin is such a closely guarded secret by the NIH and CDC. Second, ask yourself why no major media outlets reported this fact, but instead, tried to confuse you with false information by saying the deaths in India are 10 times greater than official reports.

Perhaps NPR is trying so hard because NPR is essentially a government mouthpiece. The US government is “all-in” with vaccines with the enthusiasm of a 17th century Catholic Church “all-in” with a Geocentric Model of the Universe disputing Galileo. Claiming that India’s numbers are inaccurate might distract from the overwhelming success of Ivermectin.

But in the end, the truth matters. It mattered in 1616, and it matters in 2021.

The graphs and data from the Johns Hopkins University CSSE database do not lie.

On the contrary, they provide a compelling trail of truth that no one can dispute, not even the NIH, CDC, FDA, and WHO.

For More Information: https://www.zerohedge.com/covid-19/indias-ivermectin-blackout

Ivermectin for COVID-19: real-time meta analysis of 63 studies

Authors: Covid AnalysisAug 12, 2021Version 109 — twitter personality response, added Together Trial (V1 Nov 26, 2020)

•Meta analysis using the most serious outcome reported shows 73% and 86% improvement for early treatment and prophylaxis (RR 0.27 [0.16-0.44] and 0.14 [0.08-0.25]), with similar results after exclusion based sensitivity analysis, restriction to peer-reviewed studies, restriction to serious outcomes, and restriction to Randomized Controlled Trials.•61% and 96% lower mortality is observed for early treatment and prophylaxis (RR 0.39 [0.17-0.90] and 0.04 [0.00-0.59]). Statistically significant improvements are seen for mortalityhospitalizationrecoverycases, and viral clearance. 27 studies show statistically significant improvements in isolation.

StudiesProphylaxisEarly treatmentLate treatmentPatientsAuthors
All studies6386% [75‑92%]73% [56‑84%]40% [24‑52%]26,422613
With exclusions5188% [76‑94%]76% [66‑83%]50% [28‑65%]18,907525
Peer-reviewed4286% [73‑93%]75% [61‑84%]43% [21‑59%]16,455436
Randomized Controlled Trials3184% [25‑96%]67% [54‑76%]30% [2‑50%]6,561359
Mortality results2596% [41‑100%]61% [10‑83%]53% [32‑67%]13,911263
Percentage improvement with ivermectin treatment
Meta-Analysis of Studies for Ivermectin Effectiveness Against COVID-19

•The probability that an ineffective treatment generated results as positive as the 63 studies to date is estimated to be 1 in 1 trillion (p = 0.00000000000083).

Heterogeneity arises from many factors including treatment delay, population, dose, and effect measured, and is low in specific cases, e.g., early treatment mortality.

•While many treatments have some level of efficacy, they do not replace vaccines and other measures to avoid infection. Only 29% of ivermectin studies show zero events in the treatment arm.

•Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. All practical, effective, and safe means should be used. Those denying the efficacy of treatments share responsibility for the increased risk of COVID-19 becoming endemic; and the increased mortality, morbidity, and collateral damage.

•The evidence base is much larger and has much lower conflict of interest than typically used to approve drugs.•All data to reproduce this paper and sources are in the appendix.

See [BryantHariyantoHillKoryLawrieNardelli] for other meta analyses with similar results confirming effectiveness. 00.250.50.7511.251.51.752+Kory et al.69%0.31 [0.20-0.47]Improvement, RR [CI]Hill et al.75%0.25 [0.12-0.52]Bryant et al.62%0.38 [0.19-0.73]Lawrie et al.83%0.17 [0.08-0.35]Nardelli et al.79%0.21 [0.11-0.36]Hariyanto et al.69%0.31 [0.15-0.62]WHO (OR)81%0.19 [0.09-0.36]ivmmeta61%0.39 [0.28-0.56]Ivermectin meta analysis mortality resultsivmmeta.com 8/14/21Lower RiskIncreased Risk

Global adoption: 30%
Evidence base used for other COVID-19 approvals
MedicationStudiesPatientsImprovement
Budesonide (UK)11,77917%
Remdesivir (USA)11,06331%
Casiri/imdevimab (USA)179966%
Ivermectin evidence6326,39869% [60‑75%]
Effectiveness of Other Medications Against COVID-19

For More Information: https://ivmmeta.com/

Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns

The preprint endorsing ivermectin as a coronavirus therapy has been widely cited, but independent researchers find glaring discrepancies in the data

Authors: Melissa Davey

The efficacy of a drug being promoted by rightwing figures worldwide for treating Covid-19 is in serious doubt after a major study suggesting the treatment is effective against the virus was withdrawn due to “ethical concerns”.

The preprint study on the efficacy and safety of ivermectin – a drug used against parasites such as worms and headlice – in treating Covid-19, led by Dr Ahmed Elgazzar from Benha University in Egypt, was published on the Research Square website in November.

It claimed to be a randomised control trial, a type of study crucial in medicine because it is considered to provide the most reliable evidence on the effectiveness of interventions due to the minimal risk of confounding factors influencing the results. Elgazzar is listed as chief editor of the Benha Medical Journal, and is an editorial board member.

The study found that patients with Covid-19 treated in hospital who “received ivermectin early reported substantial recovery” and that there was “a substantial improvement and reduction in mortality rate in ivermectin treated groups” by 90%.

But the drug’s promise as a treatment for the virus is in serious doubt after the Elgazzar study was pulled from the Research Square website on Thursday “due to ethical concerns”. Research Square did not outline what those concerns were.

For More Information: https://www.theguardian.com/science/2021/jul/16/huge-study-supporting-ivermectin-as-covid-treatment-withdrawn-over-ethical-concerns

Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen

Authors: Fatemeh Heidary 1Reza Gharebaghi 2 3

Abstract

Ivermectin proposes many potentials effects to treat a range of diseases, with its antimicrobial, antiviral, and anti-cancer properties as a wonder drug. It is highly effective against many microorganisms including some viruses. In this comprehensive systematic review, antiviral effects of ivermectin are summarized including in vitro and in vivo studies over the past 50 years. Several studies reported antiviral effects of ivermectin on RNA viruses such as Zika, dengue, yellow fever, West Nile, Hendra, Newcastle, Venezuelan equine encephalitis, chikungunya, Semliki Forest, Sindbis, Avian influenza A, Porcine Reproductive and Respiratory Syndrome, Human immunodeficiency virus type 1, and severe acute respiratory syndrome coronavirus 2. Furthermore, there are some studies showing antiviral effects of ivermectin against DNA viruses such as Equine herpes type 1, BK polyomavirus, pseudorabies, porcine circovirus 2, and bovine herpesvirus 1. Ivermectin plays a role in several biological mechanisms, therefore it could serve as a potential candidate in the treatment of a wide range of viruses including COVID-19 as well as other types of positive-sense single-stranded RNA viruses. In vivo studies of animal models revealed a broad range of antiviral effects of ivermectin, however, clinical trials are necessary to appraise the potential efficacy of ivermectin in clinical setting.

For More Information: https://pubmed.ncbi.nlm.nih.gov/32533071/

A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness

Authors: Sabeena Ahmed 1Mohammad Mahbubul Karim 1Allen G Ross 1Mohammad Sharif Hossain 1John D Clemens 1Mariya Kibtiya Sumiya 1Ching Swe Phru 1Mustafizur Rahman 1Khalequ Zaman 1Jyoti Somani 2Rubina Yasmin 3Mohammad Abul Hasnat 4Ahmedul Kabir 5Asma Binte Aziz 1Wasif Ali Khan 6

Abstract

Ivermectin, a US Food and Drug Administration-approved anti-parasitic agent, was found to inhibit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication in vitro. A randomized, double-blind, placebo-controlled trial was conducted to determine the rapidity of viral clearance and safety of ivermectin among adult SARS-CoV-2 patients. The trial included 72 hospitalized patients in Dhaka, Bangladesh, who were assigned to one of three groups: oral ivermectin alone (12 mg once daily for 5 days), oral ivermectin in combination with doxycycline (12 mg ivermectin single dose and 200 mg doxycycline on day 1, followed by 100 mg every 12 h for the next 4 days), and a placebo control group. Clinical symptoms of fever, cough, and sore throat were comparable among the three groups. Virologic clearance was earlier in the 5-day ivermectin treatment arm when compared to the placebo group (9.7 days vs 12.7 days; p = 0.02), but this was not the case for the ivermectin + doxycycline arm (11.5 days; p = 0.27). There were no severe adverse drug events recorded in the study. A 5-day course of ivermectin was found to be safe and effective in treating adult patients with mild COVID-19. Larger trials will be needed to confirm these preliminary findings.

For More Information: https://pubmed.ncbi.nlm.nih.gov/33278625/