COVID-19: IVERMECTIN PROPHYLAXIS IN ADULT CONTACTS Report on First Cases of Prophylaxis for Healthcare 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.
Aguirre-Chang, Covid, Diagnóstico de Laboratorio (PCR, IgM, IgG), Fases de
Beeres, Ravensbergen, Heidema, Efficacy of ivermectin mass-drug administration to control scabies in asylum seekers in the Netherlands: A retrospective cohort study between January 2014 -March 2016, PLoS Negl Trop Dis, doi:10.1371/journal.pntd.0006401
Bienvenu, Marty, Jones, Picot, Systematic review of registered trials of Hydroxychloroquine prophylaxis for COVID-19 health-care workers at the first third of 2020, One Health
Boulware, Pullen, Bangdiwala, A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19, N Engl J Med, doi:10.1056/NEJMoa2016638
Caly, Druce, Catton, Jans, Wagstaff, The FDA approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Research
Carvallo, USEFULNESS of Topic Ivermectin and Carrageenan to Prevent Contagion of Covid 19
Chang, Inclusion of Ivermectin in the First Line of therapeutic action for COVID-19. A very significant decrease in the Mortality Rate is reported with its use, Research Gate, doi:10.13140/RG.2.2.26424.57600
Fde, Taciro, Guerra, Eckley, Oral ivermectin for the treatment and prophylaxis of scabies in prison, J Dermatolog Treat, doi:10.1080/09546630510041277
Galvis, Hydroxychloroquine as Prophylaxis for Coronavirus SARS-CoV-2 Infection: Review of the Ongoing Clinical Trials, Ach Bronco
Lee, Son, Peck, Can post-exposure prophylaxis for COVID-19 be considered as an outbreak response strategy in long-term care hospitals?, Int J Antimicrob Agents
Molero, Redondo, Uso correcto de las pruebas diagnósticas microbiológicas del SARS-CoV-2, Revista de la Sociedad Madrileña de Medicina de Familia y Comunitaria
Ops, Vih, /SIDA. Profilaxis Posterior a la Exposición (PEP)
Romani, Whitfeld, Koroivueta, Mass Drug Administration for Scabies Control in a Population with Endemic Disease, N Engl J Med, doi:10.1056/NEJMoa1500987
Shouman, Use of Ivermectin as a Prophylactic Option in Asymptomatic Family Close Contact for Patient With COVID-19