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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Discharge -8% Improvement Relative Risk Viral clearance -8% primary Viral clearance (b) -220% Ivermectin  Kishoria et al.  LATE TREATMENT  RCT Is late treatment with ivermectin beneficial for COVID-19? RCT 32 patients in India 47% vs. 23% >40 years old in the treatment group, unadjusted Kishoria et al., Paripex - Indian J. R.., Aug 2020 Favors ivermectin Favors control

Ivermectin as adjuvant to hydroxychloroquine in patients resistant to standard treatment for SARS-CoV-2: results of an open-label randomized clinical study

Kishoria et al., Paripex - Indian Journal of Research, doi:10.36106/paripex/4801859
Aug 2020  
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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.
Small RCT of hospitalized patients in India with 19 ivermectin patients and 13 control patients, with all receiving SOC including HCQ, showing no significant differences. The patient population is biased because the study recruited patients that did not respond to standard treatment.
Authors do not specify the treatment delay but it is likely relatively late because the patients had already undergone standard treatment. Criteria for discharge are not provided. The time of discharge status is not specified and may not have been an equal time since treatment initiation for all patients.
Authors indicate 19 treatment and 16 control patients, but the results only show 13 control patients. Authors do not indicate why the other 3 are missing.
Randomization in this small sample resulted in very large differences in the groups, with over twice as many in the ivermectin group with age >40, and the only 2 patients with age >60 both in the ivermectin group. Authors did not adjust for these differences.
Viral load measured by PCR may not accurately reflect infectious virus measured by viral culture. Porter show that viral load early in infection was correlated with infectious virus, but viral load late in infection could be high even with low or undetectable infectious virus. Assessing viral load later in infection may underestimate reductions in infectious virus with treatment.
This is the 3rd of 47 COVID-19 RCTs for ivermectin, which collectively show efficacy with p=0.0000002.
This is the 5th of 100 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 1 sextillion).
This study is excluded in the after exclusion results of meta analysis: excessive unadjusted differences between groups.
risk of no hospital discharge, 7.5% higher, RR 1.08, p = 1.00, treatment 11 of 19 (57.9%), control 7 of 13 (53.8%).
risk of no viral clearance, 7.5% higher, RR 1.08, p = 1.00, treatment 11 of 19 (57.9%), control 7 of 13 (53.8%), day 3, primary outcome.
risk of no viral clearance, 220.0% higher, RR 3.20, p = 0.45, treatment 1 of 5 (20.0%), control 0 of 6 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm), day 5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kishoria et al., 31 Aug 2020, Randomized Controlled Trial, India, peer-reviewed, 7 authors, dosage 12mg single dose.
This PaperIvermectinAll
Dr Naveen Kishoria, Dr S L Mathur, Dr Veeram Parmar, Dr Rimple Jeet Kaur, Dr Harish Agarwal, Dr B S Parihar, Dr Somil Verma
BACKGROUND: A cluster of pneumonia cases of unknown etiology was reported from the city of Wuhan, in the Hubei province of China, in December 2019. A novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the causative agent of the disease which was subsequently termed as the coronavirus disease (COVID-19) by the World Health Organization (WHO). SARS-CoV-2 mainly affects the lower respiratory tract and manifests as 1 pneumonia in humans. The incidence of COVID-19 continues to rise, with 9,653,048 laboratory-confirmed cases and 491,128 deaths worldwide and India has reported 508,953 cases and 15,685 deaths till th 2 27 , June 2020. The clinical manifestations of COVID-19 range from fever, cough, fatigue, sore throat, shortness of breath and less 3,4 common symptoms such as headache, nausea and diarrhea. The most common abnormalities in vital signs are increased temperature and tachypnea. The most common radiological findings are bilateral pulmonary infiltrates, ground glass opacities and consolidation. The most common findings associated with severe disease are older age, d-dimer levels greater, higher SOFA score, elevated IL-6, increased Lactate Dehydrogenase, hyperferritinemia and lymphopenia on 5,6 admission. The most common complications are sepsis, respiratory failure, acute respiratory distress syndrome (ARDS), cardiac injury and acute kidney injury.
Bray, Rayner, Noël, Jans, Wagstaff, Ivermectin and COVID-19: A report in Antiviral Research, widespread interest, an FDA warning, two letters to the editor and the authors' responses, r i n t
Caly, Druce, Catton, Jans, Wagstaff, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Res, doi:10.1016/j.antiviral.2020.104787
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Guan, Ni, Hu, Clinical Characteristics of Coronavirus Disease 2 0 1 9 i n C h i n a, N E n g l J M e, doi:10.1056/NEJMoa2002032
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Patrì, Fabbrocini, Hydroxychloroquine and ivermectin: A synergistic combination for COVID-19 chemoprophylaxis and treatment?, Journal of the American Academy of Dermatology
Smit, Pharmacokinetics-Pharmacodynamics of High-Dose Ivermectin with Dihydroartemisinin-Piperaquine on Mosquitocidal Activity and QT-Prolongation (IVERMAL) ClinPharmacolTher
Tay, Nuclear localization of dengue virus (DENV) 1-4 non-structural protein 5; protection against all 4 DENV serotypes by the inhibitor Ivermectin, Antivir. Res
Wagstaff, Ivermectin is a specific inhibitor of importin alpha/beta-mediated nuclear import able to inhibit replication of HIV-1 and dengue virus, Biochem. J
Wang, Hu, Hu, Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, C h i n a . J A M A P u b l i s h e d O n l i n e F i r s t, Fe b r u a r y, doi:10.1001/jama.2020.1585
Who, None
Who, None
Yavuz, Ünal, Antiviral treatment of COVID-19, Turk J Med Sci, doi:10.3906/sag-2004-145
Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, The Lancet, doi:10.1016/S0140-6736(20)30566-3
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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