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The Place of Ivermectin in the Management of Covid-19: State of the Evidence

Babalola et al., Medical Research Archives, doi:10.18103/mra.v11i4.3778
Apr 2023  
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Review of the clinical and epidemiological evidence of efficacy, in vitro and animal studies, and the mechanisms of action of ivermectin for COVID-19.
Babalola et al., 25 Apr 2023, peer-reviewed, 2 authors.
Contact: bablo57@gmail.com.
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AI generated summary. Current AI models can provide useful summaries for non-experts, but may be inaccurate and have limited ability to analyze larger context such as the entire evidence base for ivermectin.
  • Ivermectin is an effective and safe treatment for COVID-19.
  • It can reduce the risk of hospitalization, death, and delayed viral clearance in patients with COVID-19.
  • It should be considered as a first-line treatment for patients with COVID-19, especially in areas where vaccines are unavailable or undesirable.
  • Ivermectin is a repurposed drug that has been shown to be effective in the treatment and prevention of COVID-19.
  • In vitro studies have shown that ivermectin can inhibit the replication of SARS-CoV-2, the virus that causes COVID-19.
  • In vivo studies have shown that ivermectin can reduce the severity of COVID-19 symptoms and improve survival rates.
  • A meta-analysis of clinical trials has shown that ivermectin can reduce the risk of hospitalization, death, and delayed viral clearance in patients with COVID-19.
  • The dosage of ivermectin used for the treatment of COVID-19 varies, but doses of 200-400 μg/kg twice weekly or daily for 5 consecutive days have been shown to be effective.
  • Ivermectin is generally safe and well-tolerated, but it is important to note that it can interact with other medications.
  • Ivermectin is an effective and safe treatment for COVID-19. It should be considered as a first-line treatment for patients with COVID-19, especially in areas where vaccines are unavailable or undesirable.

Here are some additional details from the article:

  • Ivermectin is a broad-spectrum antiparasitic drug that has been used for decades to treat a variety of parasitic infections.
  • Ivermectin is thought to work against COVID-19 by inhibiting the replication of the virus and by reducing inflammation.
  • Ivermectin is generally safe and well-tolerated, but it is important to note that it can interact with other medications.
  • Ivermectin is not a cure for COVID-19, but it can help to reduce the severity of the disease and improve survival rates.
The Place of Ivermectin in the Management of Covid-19: State of the Evidence
PhD Ajayi A A Md
doi:10.18103/mra.v
Background and aims. The covid 19 pandemic necessitated the use of old, repurposed, and new drugs, in addition to vaccines and public health measures. There are still many controversies about the efficacy and impact of some of the medications used, which need further elucidation. We review the pharmacological properties and the place of the repurposed drug, Ivermectin (IVM) in the prophylaxis and treatment of SARS -CoV-2 (severe acute respiratory syndrome coronavirus 2.) infection or Covid 19 disease. Major findings: in-vitro, in-vivo, and human studies In vitro studies in Vero/hSlam cells caused a 99.98 % inhibition of SARS -Cov-2 (5000-fold) within 48 hours. The IC50 (half maximal inhibitory concentration) for this virucidal action was 2.8μM, which was thought unattainable in humans in-vivo. Thus, there was initial skepticism on pharmacokinetic grounds as to possible efficacy of IVM in humans with Covid 19. There are, however, a multiplicity of anti-covid 19 mechanisms, beyond mere anti-viral effects, such as blockade of ACE2 receptor viral entry, and the anti-cytokine and anti-inflammatory effects of IVM. IVM has a long half-life of 18 -24 hours, Mean Residence Time (MRT) of 3.4 days and a preferential site of lung accumulation. In-vivo studies in Syrian Golden hamsters confirmed the symptomatic, antiinflammatory, anti-cytokine, histopathological and survival benefit of IVM, which was more manifest in female animals. In a January 2023 meta-analysis of studies (s) in total number of patients (n) for various parameters (p), the reduction in risk relative to placebo or controls were as follows: 1. Overall improvement (s= 95) (n= 134,554) was 62% [95%CI 54-69]. 2. Mortality (s=48) (n=120,000) there was 51% reduction [95%CI 37-62]. 3. Hospitalization (s=29) (n = 44, 784), there was 34% reduction [ 95% CI 20-45]. 4. Viral clearance (s=20) (n= 3945) there was 45% reduction [95%CI 31-55]. 5. Prophylaxis (s=17) (n=19,764) showed 82% reduction [95%CI 73-88] 6 Randomised Control Trial (RCT) studies (s= 45) (n=2173) showed a 54 % mortality reduction [95% CI 39-65] In addition, IVM has been shown in studies to cause a rapid reversal of hypoxemia (SPO2 < 94%) and a rapid increase in SPO2, an effect exhibiting a gender dichotomy. (SPO2 is the percentage of the maximum carrying capacity of the blood). This effect on SPO2 has been attributed to IVM's reversal and prevention of SARS-CoV-2 virus induced hemagglutination. The dosage used for treatment of covid 19 varied widely within studies, but doses of 200-400 μg/kg twice weekly or daily for 5 consecutive days, caused significant viral clearance and clinical improvement, with minimal safety concerns. For prophylaxis, a dose of 200μg/kg for two consecutive days every 15 days was found effective in studies. Conclusion: This review provides powerful evidence that IVM is efficacious singly or as a part of a regimen for covid 19. IVM could potentially be combined with newer oral anti-covid 19 agents, such as..
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