A Multimodal Strategy to Reduce the Risk of Hospitalization/death in Ambulatory Patients with COVID-19

de Jesús Ascencio-Montiel et al., Archives of Medical Research, doi:10.1016/j.arcmed.2022.01.002

Jan 2022

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Retrospective 28,048 COVID+ patients in Mexico, 7,898 receiving a treatment kit including low dose ivermectin, AZ, aspirin, and acetaminophen, shower lower mortality/hospitalization for those receiving the kit. Delivery of the treatment kit was based on availability in the medical units. Adherence is unknown and may be low. Adjusted results are only provided for combined mortality/hospitalization.

This is the 77th of 99 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 2 sextillion). 46 studies are RCTs, which show efficacy with p=0.00000014.

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This study includes aspirin and ivermectin.

risk of death/hospitalization, 59.0% lower, RR 0.41, p < 0.001, treatment 7,898, control 20,150, adjusted per study, multivariable, primary outcome.

risk of death/hospitalization, 71.0% lower, RR 0.29, p < 0.001, treatment 5,557, control 12,526, adjusted per study, with phone call followup, multivariable.

risk of death, 15.0% lower, RR 0.85, p = 0.16, treatment 101 of 7,898 (1.3%), control 303 of 20,150 (1.5%), NNT 445, unadjusted, excluded in exclusion analyses: unadjusted results with alternate outcome adjusted results showing significant changes with adjustments.

risk of mechanical ventilation, 9.1% lower, RR 0.91, p = 0.51, treatment 77 of 7,898 (1.0%), control 216 of 20,150 (1.1%), NNT 1031, unadjusted, excluded in exclusion analyses: unadjusted results with alternate outcome adjusted results showing significant changes with adjustments.

risk of hospitalization, 47.6% lower, RR 0.52, p < 0.001, treatment 485 of 7,898 (6.1%), control 2,360 of 20,150 (11.7%), NNT 18, unadjusted, excluded in exclusion analyses: unadjusted results with alternate outcome adjusted results showing significant changes with adjustments.

risk of progression, 41.8% lower, RR 0.58, p < 0.001, treatment 435 of 7,898 (5.5%), control 1,906 of 20,150 (9.5%), NNT 25, unadjusted, ER, excluded in exclusion analyses: unadjusted results with alternate outcome adjusted results showing significant changes with adjustments.

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de Jesús Ascencio-Montiel et al., 24 Jan 2022, retrospective, Mexico, peer-reviewed, 10 authors, dosage 6mg days 1-2, this trial uses multiple treatments in the treatment arm (combined with AZ, acetaminophen, aspirin) - results of individual treatments may vary.

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A Multimodal Strategy to Reduce the Risk of Hospitalization/death in Ambulatory Patients with COVID-19

Iván De Jesús Ascencio-Montiel, Juan Carlos Tomás-López, Verónica Álvarez-Medina, Luisa Estela Gil-Velázquez, Hortensia Vega-Vega, Héctor Raúl Vargas-Sánchez, Manuel Cervantes-Ocampo, Miguel Ángel Villasís-Keever, Cesar Raúl González-Bonilla, Célida Duque-Molina

Archives of Medical Research, doi:10.1016/j.arcmed.2022.01.002

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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