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0 0.5 1 1.5 2+ Recovery time 74% Improvement Relative Risk Ivermectin  Aref et al.  LATE TREATMENT  RCT  LONG COVID Does ivermectin reduce the risk of Long COVID (PASC)? RCT 96 patients in Egypt (March - April 2021) Faster recovery with ivermectin (p=0.0005) Aref et al., Infection and Drug Resist.., Sep 2022 Favors ivermectin Favors control

Possible Role of Ivermectin Mucoadhesive Nanosuspension Nasal Spray in Recovery of Post-COVID-19 Anosmia

Aref et al., Infection and Drug Resistance, doi:10.2147/IDR.S381715, NCT04951362
Sep 2022  
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Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020
*, now known with p < 0.00000000001 from 103 studies, recognized in 22 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments.
96 patient RCT showing faster resolution of post-COVID anosmia with an ivermectin nanosuspension nasal spray.
5 studies use direct respiratory tract administration Aref, Aref (B), Carvallo, Carvallo (B), Chahla
Targeted administration to the respiratory tract provides treatment directly to the typical source of initial SARS-CoV-2 infection and replication, and allows for rapid onset of action, higher local drug concentration, and reduced systemic side effects (early treatment may be more beneficial).
This is the 42nd of 50 COVID-19 RCTs for ivermectin, which collectively show efficacy with p=0.00000014.
This is the 92nd of 103 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 1 sextillion).
recovery time, 74.0% lower, relative time 0.26, p < 0.001, treatment 49, control 47, anosmia.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Aref et al., 19 Sep 2022, Randomized Controlled Trial, placebo-controlled, Egypt, peer-reviewed, 9 authors, study period 1 March, 2021 - 30 April, 2021, dosage 2 puffs of 70 μg/mL nasal ivermectin, trial NCT04951362 (history). Contact:,
This PaperIvermectinAll
Possible Role of Ivermectin Mucoadhesive Nanosuspension Nasal Spray in Recovery of Post-COVID-19 Anosmia
Zaki F Aref, Shamardan Ezz Eldin S Bazeed, Mohammed H Hassan, Abeer S Hassan, Ali A Ghweil, Mennatallah Ali Abdelrhman Sayed, Alaa Rashad, Haggagy Mansour, Aida A Abdelmaksoud
Infection and Drug Resistance, doi:10.2147/idr.s381715
Anosmia or hyposmia, with or without taste changes, are common symptoms that occur in SARS-CoV-2 infection and frequently persist as post-COVID-19 manifestations. This is the first trial to assess the potential value of using local ivermectin in the form of a mucoadhesive nanosuspension nasal spray to treat post-COVID-19 anosmia. Methods: It is a controlled, randomized trial. Participants were recruited from South Valley University Hospitals in Qena, Upper Egypt, from the ENT and Chest Diseases Departments and outpatient clinics. Patients with persistent post COVID-19 anosmia were randomly divided into two groups, the first group "ivermectin group" included 49 patients treated by ivermectin nanosuspension mucoadhesive nasal spray (two puffs per day). The second group included 47 patients "placebo group" who received saline nasal spray. Follow-up of anosmia [using Visual analogue scale (VAS)] in all patients for three months or appearance of any drug related side effects was done. Results: The mean duration of pre-treatment post COVID-19 anosmia was 19.5± 5.8 days in the ivermectin group and 19.1± 5.9 days in the placebo group,p˃0.05. Regarding the median duration of anosmia recovery, the ivermectin group recovered from post COVID-19 anosmia in 13 days compared to 50 days in the placebo group, p˂ 0.001. Following the first week of ivermectin nanosuspension mucoadhesive nasal spray therapy, the ivermectin group had a significantly higher percentage of anosmia recovery (59.2%) than the placebo group (27.7%), p˂ 0.01, with no significant differences in recovery rates between the two groups at 1, 2, and 3 months of follow up, p˃0.05. Conclusion: In the small number of patients treated, local Ivermectin exhibited no side effects. In persistent post-COVID-19 anosmia, it could be used for one week at the most as the treatment was extended to one, two and three months, with no difference in recovery compared to the placebo treatment. Trial Registration No: NCT04951362.
Consent for Publication Not applicable because the manuscript lacked the names, identifiers, or images of the patients. Consent for Participation After thorough explanation of the study's objectives and procedures, informed written consent was obtained from each participant in the trial, or from relatives if the patients were less than 18 years old and those who supplied consent on their behalf were their parents or legal guardians. Author Contributions All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. Disclosure The authors report no conflicts of interest in relation to this work. Infection and Drug Resistance Dovepress
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Late treatment
is less effective
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