Ivermectin and covid
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Ivermectin and COVID-19: A Comprehensive Review
Introduction to Ivermectin and COVID-19
Ivermectin, an antiparasitic drug, has been explored for its potential use in treating COVID-19 due to its antiviral properties observed in vitro. However, the clinical efficacy and safety of ivermectin for COVID-19 treatment and prevention remain controversial and are the subject of ongoing research.
Efficacy of Ivermectin in Treating COVID-19
Hospitalized Patients with Moderate to Severe COVID-19
Several studies have investigated the use of ivermectin in hospitalized patients with moderate to severe COVID-19. A systematic review and meta-analysis of randomized clinical trials indicated that ivermectin might reduce the severity of COVID-19 and mortality rates, but the evidence is of low certainty1 7 8. Another study found no significant difference in clinical improvement or duration of hospitalization when comparing ivermectin to placebo or standard care1.
Outpatients with Mild to Moderate COVID-19
For outpatients with mild to moderate COVID-19, the results are similarly mixed. The I-TECH randomized clinical trial found that ivermectin did not prevent the progression to severe disease among high-risk patients2. Another study conducted in Brazil showed no significant reduction in hospitalization or prolonged emergency department observation for patients treated with ivermectin compared to placebo3. Additionally, a pilot study indicated no difference in viral load reduction or symptom resolution between ivermectin and placebo groups, although there was a reduction in symptoms like anosmia and cough4 5.
Ivermectin for COVID-19 Prevention
The evidence for ivermectin as a preventive measure against COVID-19 is limited. Only one study investigated its use for preventing SARS-CoV-2 infection and found no significant effect on mortality or the development of COVID-19 symptoms1. The overall certainty of the evidence remains very low, and more high-quality studies are needed to draw definitive conclusions.
Safety and Adverse Events
The safety profile of ivermectin in COVID-19 patients has been generally favorable, with no severe adverse events reported in most studies. Common side effects include diarrhea and mild gastrointestinal symptoms2 9. However, the variability in dosing regimens and study designs makes it challenging to establish a consistent safety profile.
Conclusion
Current evidence on the efficacy and safety of ivermectin for treating and preventing COVID-19 is inconclusive and of low certainty. While some studies suggest potential benefits, others do not support its use outside of well-designed clinical trials. Ongoing and future research will be crucial in providing clearer answers regarding the role of ivermectin in the COVID-19 pandemic.
Sources and full results
Most relevant research papers on this topic
Ivermectin for preventing and treating COVID‐19
Ivermectin shows mixed evidence for treating COVID-19 and preventing SARS-CoV-2 infection, with no clear evidence supporting its use in either setting.
Meta-Analysis
Very Rigorous Journal
Highly CitedEfficacy of Ivermectin Treatment on Disease Progression Among Adults With Mild to Moderate COVID-19 and Comorbidities: The I-TECH Randomized Clinical Trial.
Ivermectin treatment does not significantly prevent severe disease progression in high-risk COVID-19 patients, with the most common adverse event being diarrhea.
RCT
Large Human Trial
Rigorous JournalHighly CitedEffect of Early Treatment with Ivermectin among Patients with Covid-19
Ivermectin treatment did not significantly reduce the incidence of hospitalization due to Covid-19 progression or prolonged emergency department observation among outpatients with early Covid-19 diagnosis.
RCTLarge Human TrialRigorous JournalHighly CitedThe effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial
A single dose of ivermectin within 48 hours of fever or cough onset reduced anosmia/hyposmia, decreased cough, and showed a tendency to lower viral loads and IgG titers in mild COVID-19 patients.
RCTRigorous JournalHighly CitedThe effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial
A single dose of ivermectin within 72 hours of fever or cough onset did not significantly reduce the proportion of PCR positive patients, but may have improved symptoms and humoral response.
RCTRigorous JournalHighly CitedA five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness
A 5-day course of ivermectin is safe and effective in treating mild COVID-19 in adult patients, potentially reducing the duration of illness.
RCTHighly CitedIvermectin and outcomes from Covid‐19 pneumonia: A systematic review and meta‐analysis of randomized clinical trial studies
Ivermectin may offer beneficial effects towards Covid-19 outcomes, reducing severity, mortality, and hospitalization time.
Meta-AnalysisRigorous JournalIvermectin and mortality in patients with COVID-19: A systematic review, meta-analysis, and meta-regression of randomized controlled trials
Ivermectin was associated with decreased mortality in COVID-19 patients, but further double-blind placebo-controlled trials are needed for definite conclusions.
Meta-AnalysisLB1528C. Ivermectin for Treatment of Mild-to-Moderate COVID-19 in the Outpatient Setting A Decentralized, Placebo-controlled, Randomized, Platform Clinical Trial
Ivermectin 400 mcg/kg daily for 3 days resulted in less than one day of symptom shortening and did not lower incidence of hospitalization or death in outpatients with mild-to-moderate COVID-19.
RCTLarge Human TrialRigorous JournalNon-effectiveness of Ivermectin on Inpatients and Outpatients With COVID-19; Results of Two Randomized, Double-Blinded, Placebo-Controlled Clinical Trials
Ivermectin showed no significant improvement in clinical improvement, reduced ICU admissions, or increased negative RT-PCR assays for COVID-19 in hospitalized patients or outpatients.
RCTLarge Human Trial