Ivermectin Use Associated with Reduced Duration of Covid-19 Febrile Illness in a Community Setting

Ghauri et al., International Journal of Clinical Studies & Medical Case Reports, doi:10.46998/IJCMCR.2021.13.000320 (date from preprint)

Dec 2020

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Ivermectin for COVID-19

4th treatment shown to reduce risk in August 2020, now with p < 0.00000000001 from 105 studies, recognized in 23 countries.

Lower risk for mortality, ventilation, ICU admission, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments.

5,100+ studies for 109 treatments. c19ivm.org

Retrospective 95 outpatients in Pakistan with strong clinical suspicion of COVID-19 (testing was not widely available), with 40 patients treated with ivermectin, showing significantly shorter duration of febrile illness with treatment. Most patients also received HCQ, AZ, zinc, and aspirin. Authors note that there was a treatment delay-response relationship.

This is the 26th of 105 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 774 quintillion).

52 studies are RCTs, which show efficacy with p=0.00000021.

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risk of fever, 92.2% lower, RR 0.08, p = 0.04, treatment 0 of 37 (0.0%), control 7 of 53 (13.2%), NNT 7.6, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), day 14.

risk of fever, 86.4% lower, RR 0.14, p < 0.001, treatment 2 of 37 (5.4%), control 21 of 53 (39.6%), NNT 2.9, day 10.

risk of fever, 55.7% lower, RR 0.44, p < 0.001, treatment 13 of 37 (35.1%), control 42 of 53 (79.2%), NNT 2.3, day 7.

risk of fever, 42.2% lower, RR 0.58, p < 0.001, treatment 21 of 37 (56.8%), control 52 of 53 (98.1%), NNT 2.4, day 5.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Ghauri et al., 15 Dec 2020, retrospective, Pakistan, peer-reviewed, 6 authors, dosage 12mg days 1-6.

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Ivermectin Use Associated with Reduced Duration of Covid-19 Febrile Illness in a Community Setting

Muhammad Ishaq Ghauri2, Ali Nasir, Muslim Afsar1, Abbas1, Shariq Muhammad, Mukarram2, Yahya Muhammad, Khizra Ishaq1 Peracha1, Ishaq1, Muhammad Shariq Mukarram, Muhammad Abbas1, Shariq Mukarram, Iver

International Journal of Clinical Studies and Medical Case Reports, doi:10.46998/ijcmcr.2021.13.000320

Background: SARS-CoV-2 infection (COVID-19) is a potentially lethal disease that may progress into severe respiratory distress syndrome requiring ventilatory support. While azithromycin (AZI) and hydroxychloroquine (HCQ) are considered similar to placebo in COVID-19, other drugs such as ivermectin (IVER), are being repurposed to treat this pandemic. This study was designed to assess the effects of ivermectin on duration of febrile illness and disease outcomes in mild-to-moderate COVID-19 infection in a community setting. Methods: In this case-control study 95 suspected patients of mild-to-moderate COVID-19 were included. The controls (Group-A) received AZI+HCQ for seven days while the cases (Group-B) received IVER+AZI+HCQ for six days. Results: A total of 41 patients were in Group-B, while 54 patients were in Group-A. Group-B had consistently and significantly shorter span of fever on days 5, 7, 10 and 14, where the logistic regression showed IVER as the major (Exp B 49•55; p<0•001) underlying factor. The Kaplan-Meier survival analysis showed that Group-A had a prolonged febrile illness (p<0•001). Conclusions: Ivermectin use is associated with reduced duration of febrile illness in COVID-19 in outpatient setting, thus potentially saving precious lives, reducing direct load on healthcare facilities and preventing high cost of management in a community setting.

Supplementary Table: Logistic Regression Analysis Conflict of Interest The authors state that there is no financial or any other conflict of interest in relation to this research. Authors' Contribution NAA and MIG contributed equally. Both contributed in study design, data analysis, writing up the manuscript, overall supervision at their participating institutions respectively, and final approval. MA contributed in data entry and manuscript writing. MSM contributed in data collection and manuscript writing. MYP contributed in data entry and manuscript writing. KI contributed in data collection.

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