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Phase 2 randomized study on chloroquine, hydroxychloroquine or ivermectin in hospitalized patients with severe manifestations of SARS-CoV-2 infection

Galan et al., Pathogens and Global Health, doi:10.1080/20477724.2021.1890887
Mar 2021  
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Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020
*, now known with p < 0.00000000001 from 100 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.
3,800+ studies for 60+ treatments.
RCT 168 very late stage severe condition hospitalized patients comparing CQ, HCQ, and ivermectin not showing significant differences.
Authors indicate that it would have been unethical to include an untreated control group. However, authors explicitly discriminated against indigenous people who were excluded from the trial.
Authors claim that "the mortality rates of the three groups are very similar to historical reports of other studies that used placebo in hospitalized patients", without providing any reference. However shows 43% hospital mortality in the northern region of Brazil, where the study was performed, from which we can estimate the mortality with ivermectin in this study is 47% lower, RR 0.53. Further, the study is restricted to more severe cases, hence the expected mortality may be higher.
Galan et al., 8 Mar 2021, peer-reviewed, 19 authors.
This PaperIvermectinAll
Phase 2 randomized study on chloroquine, hydroxychloroquine or ivermectin in hospitalized patients with severe manifestations of SARS-CoV-2 infection
Luis Enrique Bermejo Galan, Nayara Melo Dos Santos, Jucineide Mauro Shosuka Asato, Jucineide Vieira Araújo, Adriana De Lima Moreira, Aléxia Mahara Marques Araújo, Artur Diogenes Pinheiro Paiva, Diego Guilherme Santos Portella, Frank Silas Saldanha Marques, Gabriel Melo Alexandre Silva, Joana De Sousa Resende, Marycassiely Rodrigues Tizolim, Poliana Lucenados Santos, Steffi Ferreira Buttenbender, Stephanye Batista De Andrade, Roberto Carlos Cruz Carbonell, Juliana Gomes Da Rocha, Ruy Guilherme Silveira De Souza, Allex Jardim Da Fonseca
Pathogens and Global Health, doi:10.1080/20477724.2021.1890887
Objective: Given the urgent need for strategies to minimize the damage caused by this pandemic, this study performed a randomized, double-blind phase 2 study to assess the safety of the effectiveness of chloroquine (CQ), hydroxychloroquine (HCQ) or ivermectin in severe forms of COVID-19, in addition to identifying predictors of mortality in this group of patients. Methods: Phase 2, double-blind, randomized study to assess the safety and efficacy of enteral CQ, HCQ or ivermectin in patients hospitalized for SARS-CoV-2 infection, admitted to a Reference Hospital in Roraima (Brazil) in may 2020. Patients were randomized in a 1:1:1 ratio. The endpoints were need of supplemental O 2 , invasive ventilation, admission in ICU and death. The study was approved by an independent IRB. Results: 168 patients were randomized. The mean age was 53.4 years (±15.6), most participants were male (n = 95; 58.2%). Therapy with corticosteroid, anticoagulant or antibiotics was a decision of the attending physicians, and there was no difference between the groups. The mortality was similar in three groups (22.2%; 21.3% and 23.0%) suggesting ineffectiveness of the drugs. No difference in the incidence of serious adverse events were observed. To be older than 60 years of age, obesity, diabetes, extensive pulmonary involvement and low SaO 2 at hospital admission due to independent risk factors for mortality. Conclusion: Although CQ, HCQ or ivermectin revealed a favorable safety profile, the tested drugs do not reduce the need for supplemental oxygen, ICU admission, invasive ventilation or death, in patients hospitalized with a severe form of COVID-19.
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