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0 0.5 1 1.5 2+ Hospitalization 52% Improvement Relative Risk Recovery time 43% Mortality 51% late Ventilation 63% late Hospitalization time 30% late Mebendazole  Galal et al.  EARLY TREATMENT Is early treatment with mebendazole beneficial for COVID-19? Retrospective 185 patients in Egypt (June - August 2020) Faster recovery with mebendazole (p=0.001) c19ivm.org Galal et al., Advances in Virology, Dec 2022 Favors mebendazole Favors control

The Use of Mebendazole in COVID-19 Patients: An Observational Retrospective Single Center Study

Galal et al., Advances in Virology, doi:10.1155/2022/3014686
Dec 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. c19ivm.org
Retrospective 157 inpatients and 185 outpatients in Egypt, showing improved recovery with mebendazole. For outpatients, the trreatment group was younger (40 vs. 48). Mebendazole was offered to patients when ivermectin/HCQ were unavailable.
risk of hospitalization, 51.6% lower, RR 0.48, p = 0.33, treatment 3 of 94 (3.2%), control 6 of 91 (6.6%), NNT 29.
recovery time, 42.9% lower, relative time 0.57, p < 0.001, treatment 94, control 91.
risk of death, 50.9% lower, RR 0.49, p = 0.35, treatment 3 of 68 (4.4%), control 8 of 89 (9.0%), NNT 22, late treatment result.
risk of mechanical ventilation, 62.6% lower, RR 0.37, p = 0.30, treatment 2 of 68 (2.9%), control 7 of 89 (7.9%), NNT 20, late treatment result.
hospitalization time, 30.0% lower, relative time 0.70, p < 0.001, treatment 68, control 89, late treatment result.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Galal et al., 10 Dec 2022, retrospective, Egypt, peer-reviewed, 11 authors, study period 1 June, 2020 - 30 August, 2020. Contact: zgobaramd@gmail.com.
This PaperIvermectinAll
Abstract: Hindawi Advances in Virology Volume 2022, Article ID 3014686, 6 pages https://doi.org/10.1155/2022/3014686 Research Article The Use of Mebendazole in COVID-19 Patients: An Observational Retrospective Single Center Study Mostafa W. Galal,1 Mahmoud Ahmed,2 Yanqiu Shao,3,4 Chao Xing,4,5 Wael Ali,6 Abd Elhamid Baly,7 Abdallah Elfky,8 Khaled Amer,9 John Schoggins,10 Hesham A. Sadek ,11,2 and Zeinab N. Gobara 7 1 School of Medicine, Aim Shams University, Cairo, Egypt Department of Internal Medicine Cardiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 3 Department of Statistical Science, Southern Methodist University, Dallas, TX 75275, USA 4 Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 5 McDermott Center for Human Growth and Development and Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 6 Egyptian Center for Research in Regenerative Medicine, Cairo, Egypt 7 Department of Clinical Pathology, Cura El-Nasr Hospitals, Cairo, Egypt 8 Department of Radiology, Cura El-Nasr Hospitals, Helwan university, Cairo, Egypt 9 Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 10 Epartments Microbiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 11 Departments Biophysics and Molecular Biology and Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA 2 Correspondence should be addressed to Zeinab N. Gobara; zgobaramd@gmail.com Received 5 February 2022; Revised 16 May 2022; Accepted 26 August 2022; Published 10 December 2022 Academic Editor: Shih-Chao Lin Copyright © 2022 Mostafa W. Galal et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. An in-silico screen identifed mebendazole with potential antiviral activity that could be a repurposed drug against SARSCoV-2. Mebendazole is a well-tolerated and cheap antihelminthic agent that is readily available worldwide and thus could be a therapeutic tool in the fght against COVID-19. Methods. Tis is an observational retrospective study of PCR-confrmed COVID-19 patients who received mebendazole with the intention-to-treat. Te study included an inpatient cohort (157 inpatients) and an outpatient cohort (185 outpatients). Of the 157 inpatients and 185 outpatients, 68 (43.3%) and 94 (50.8%) received mebendazole, respectively. Patients who presented within the same timeframe but did not receive mebendazole were used as controls. Patients received standard-ofcare treatment including remdesivir, dexamethasone, and anticoagulants as deemed necessary by the treating physician. Te following clinical outcomes were evaluated: for the inpatient cohort, length of stay (LOS) at the hospital, need for ventilation (combined invasive and noninvasive), and mortality; for the outpatient cohort, time to symptom resolution, need for hospitalization, and mortality. Results. For the inpatient cohort, the median age did not difer between the treatment and control groups; 62 (56, 67) vs. 62 (56, 68), P, and there was a comparable proportion of males in both groups; 43 (63%) vs. 55 (62%), P � 0.85. Te hospital LOS was 3.5 days shorter in the treatment group compared to the..
{ 'DOI': '10.1155/2022/3014686', 'ISSN': ['1687-8647', '1687-8639'], 'URL': 'http://dx.doi.org/10.1155/2022/3014686', 'abstract': '<jats:p>Background. An in-silico screen identified mebendazole with potential antiviral ' 'activity that could be a repurposed drug against SARS-CoV-2. Mebendazole is a well-tolerated ' 'and cheap antihelminthic agent that is readily available worldwide and thus could be a ' 'therapeutic tool in the fight against COVID-19. Methods. This is an observational ' 'retrospective study of PCR-confirmed COVID-19 patients who received mebendazole with the ' 'intention-to-treat. The study included an inpatient cohort (157 inpatients) and an outpatient ' 'cohort (185 outpatients). Of the 157 inpatients and 185 outpatients, 68 (43.3%) and 94 ' '(50.8%) received mebendazole, respectively. Patients who presented within the same timeframe ' 'but did not receive mebendazole were used as controls. Patients received standard-of-care ' 'treatment including remdesivir, dexamethasone, and anticoagulants as deemed necessary by the ' 'treating physician. The following clinical outcomes were evaluated: for the inpatient cohort, ' 'length of stay (LOS) at the hospital, need for ventilation (combined invasive and ' 'noninvasive), and mortality; for the outpatient cohort, time to symptom resolution, need for ' 'hospitalization, and mortality. Results. For the inpatient cohort, the median age did not ' 'differ between the treatment and control groups; 62 (56, 67) vs. 62 (56, 68), ' '<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M1">\n' ' <mi>P</mi>\n' ' </math>\n' ' </jats:inline-formula>, and there was a comparable proportion of males in ' 'both groups; 43 (63%) vs. 55 (62%), <jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M2">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.85</mn>\n' ' </math>\n' ' </jats:inline-formula>. The hospital LOS was 3.5 days shorter in the ' 'treatment group compared to the control group (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M3">\n' ' <mi>P</mi>\n' ' <mo>&lt;</mo>\n' ' <mn>0.001</mn>\n' ' </math>\n' ' </jats:inline-formula>). There were fewer patients who required invasive or ' 'noninvasive ventilation in the treatment group, 2 (2.9%) vs. 7 (7.9%), and the mortality rate ' 'is lower in the treatment group, 3 (4.4%) vs. 8 (9.0%), though the differences did not reach ' 'statistical significance. For the outpatient cohort, the median age was lower in the ' 'treatment group compared with the control group; 40 (34, 48) vs. 48 (41, 54), ' '<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M4">\n' ' <mi>P</mi>\n' ' <mo>&lt;</mo>\n' ' <mn>0.001</mn>\n' ' </math>\n' ' </jats:inline-formula>. There was a comparable proportion of males between ' 'both groups; 50 (53%) vs. 52 (57%), <jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M5">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.59</mn>\n' ' </math>\n' ' </jats:inline-formula>. Patients in the treatment group were 3.3 days ' 'closer to symptom resolution (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M6">\n' ' <mi>P</mi>\n' ' <mo>&lt;</mo>\n' ' <mn>0.001</mn>\n' ' </math>\n' ' </jats:inline-formula>). There were numerically fewer patients requiring ' 'hospitalization in the treatment group compared with the control group, 3 (3.2%) vs. 6 ' '(6.6%), though this did not reach statistical significance (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M7">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.33</mn>\n' ' </math>\n' ' </jats:inline-formula>). Conclusion. In this retrospective observational ' 'study, the use of mebendazole in COVID-19 patients was associated with shorter ' 'hospitalizations in the inpatient cohort and shorter durations of symptom resolution in the ' 'outpatient cohort. The findings from this small observational study are hypothesis-generating ' 'and preclude drawing conclusions about clinical efficacy. Further studies are needed to ' 'examine the role of mebendazole in the treatment of COVID-19 patients.</jats:p>', 'alternative-id': ['3014686', '3014686'], 'author': [ { 'affiliation': [{'name': 'School of Medicine, Aim Shams University, Cairo, Egypt'}], 'family': 'Galal', 'given': 'Mostafa W.', 'sequence': 'first'}, { 'affiliation': [ { 'name': 'Department of Internal Medicine Cardiology, University of Texas ' 'Southwestern Medical Center, Dallas, TX 75390, USA'}], 'family': 'Ahmed', 'given': 'Mahmoud', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Department of Statistical Science, Southern Methodist ' 'University, Dallas, TX 75275, USA'}, { 'name': 'Department of Population and Data Sciences, University of Texas ' 'Southwestern Medical Center, Dallas, TX 75390, USA'}], 'family': 'Shao', 'given': 'Yanqiu', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Department of Population and Data Sciences, University of Texas ' 'Southwestern Medical Center, Dallas, TX 75390, USA'}, { 'name': 'McDermott Center for Human Growth and Development and Department ' 'of Bioinformatics, University of Texas Southwestern Medical ' 'Center, Dallas, TX 75390, USA'}], 'family': 'Xing', 'given': 'Chao', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Egyptian Center for Research in Regenerative Medicine, Cairo, ' 'Egypt'}], 'family': 'Ali', 'given': 'Wael', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Department of Clinical Pathology, Cura El-Nasr Hospitals, Cairo, ' 'Egypt'}], 'family': 'Baly', 'given': 'Abd Elhamid', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Department of Radiology, Cura El-Nasr Hospitals, Helwan ' 'university, Cairo, Egypt'}], 'family': 'Elfiky', 'given': 'Abdallah', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Department of Biochemistry, University of Texas Southwestern ' 'Medical Center, Dallas, TX 75390, USA'}], 'family': 'Amer', 'given': 'Khaled', 'sequence': 'additional'}, { 'affiliation': [ 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