COVID-19: Ivermectin Prophylaxis in Adult Contacts: First Report on Health Personnel and Post-Exposure Prophylaxis

Prophylaxis is aimed at preventing the development of infection and disease after exposure to an infectious agent. The WHO, PAHO and other recognized organizations recommend Post-Exposure Prophylaxis (PEP) for cases of possible infection with HIV, Hepatitis B, C and Tuberculosis. There are also studies that report the use of Ivermectin as prophylaxis for scabies. To date, several studies of PEP in COVID-19 patients using Hydroxychloroquine have been reported, and there are also at least 2 ongoing studies on prophylaxis using Ivermectin. In this article, the first cases in Lima, Perú, of prophylaxis with Ivermectin implemented on healthcare personnel beginning April 7, 2020 are reported and, a study design of PEP with Ivermectin for COVID-19 is also detailed. MATERIALS AND METHODS: For the PEP study, the following protocol was followed: in all persons who qualified as Contacts and tested negative for SARS CoV-2 in the laboratory were given a dose of Ivermectin of 0.2 mg per kilogram of body weight on day one. Additionally, in the men over 45 years of age it was indicated to evaluate giving a second dose of Ivermectin on day 2 or 3, this would be done in case other people in the home or place of residence present characteristic symtoms of COVID-19. The presence of COVID-19 symptoms within the first 3 days of taking Ivermectin was established as the Exclusion Criterion, because the incubation period for COVID-19 is 5 days on average and these patients could have contracted COVID-19 prior to initiation of the study. Daily clinical follow-up was performed for all participants until day 21 after taking Ivermectin. RESULTS: Out of a total of 40 people enrolled, 7 tested positive and were therefore excluded from the study, leaving 33 participants. During the clinical evaluation process of the first 3 days, no person with symptoms of COVID-19 was identified. Therefore no molecular laboratory testing was performed on any participant, no second doses of Ivermectin were indicated, and no participants were excluded from the study. Daily clinical followup was continued for 21 days after taking Ivermectin, and none of the participants exhibited symptoms, nor did they develop COVID-19 disease. CONCLUSION: The result of the present study finds utility in the use of Ivermectin as prophylaxis for COVID-19. Given the high morbidity and mortality caused by COVID-19, prophylaxis should be taken into account as a preventive measure to complement those measures already established such as social distancing and wearing a mask. We also recommend conducting similar clinical studies on prophylaxis for COVID-19 with a larger number of participants.