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Ivermectin Effect on In-Hospital Mortality and Need for Respiratory Support in COVID-19 Pneumonia: Propensity Score-Matched Retrospective Study

Llenas-García et al., Viruses, doi:10.3390/v15051138

May 2023

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Ivermectin for COVID-19

4th treatment shown to reduce risk in August 2020

^*, now known with p < 0.00000000001 from 102 studies, recognized in 22 countries.

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

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 96 late stage patients receiving a single dose of 200 μg/kg ivermectin for strongyloides and 96 matched controls, showing no significant difference in outcomes. Authors note that this may be due to the low dose used.

This is the 98th of 102 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 560 quintillion).

49 studies are RCTs, which show efficacy with p=0.00000038.

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risk of death, 16.7% lower, RR 0.83, p = 0.82, treatment 10 of 96 (10.4%), control 12 of 96 (12.5%), NNT 48.

risk of oxygen therapy, 18.4% lower, RR 0.82, p = 0.37, treatment 31 of 96 (32.3%), control 38 of 96 (39.6%), NNT 14.

risk of progression, 23.0% lower, OR 0.77, p = 0.52, treatment 96, control 96, adjusted per study, in-hospital mortality or respiratory support, multivariable, primary outcome, RR approximated with OR.

risk of ICU admission, 4.0% higher, OR 1.04, p = 0.92, treatment 96, control 96, adjusted per study, multivariable, RR approximated with OR.

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

Llenas-García et al., 10 May 2023, retrospective, Spain, peer-reviewed, 11 authors, study period 23 February, 2020 - 14 March, 2021, average treatment delay 6.0 days, dosage 200μg/kg single dose. Contact: jllenas@umh.es (corresponding author), alfonsodelpozo@gmail.com, igcuello@hotmail.com.

This Paper Ivermectin All

Ivermectin Effect on In-Hospital Mortality and Need for Respiratory Support in COVID-19 Pneumonia: Propensity Score-Matched Retrospective Study

Jara Llenas-García, Alfonso Del Pozo, Alberto Talaya, Nuria Roig-Sánchez, Noemí Poveda Ruiz, Carlos Devesa García, Emilio Borrajo Brunete, Inmaculada González Cuello, Ana Lucas Dato, Miriam Navarro, Philip Wikman-Jorgensen

Viruses, doi:10.3390/v15051138

Introduction. There is negligible evidence on the efficacy of ivermectin for treating COVID-19 pneumonia. This study aimed to assess the efficacy of ivermectin for pre-emptively treating Strongyloides stercoralis hyperinfection syndrome in order to reduce mortality and the need for respiratory support in patients hospitalized for COVID-19. Methods. This single-center, observational, retrospective study included patients admitted with COVID-19 pneumonia at Hospital Vega Baja from 23 February 2020 to 14 March 2021. Because strongyloidiasis is endemic to our area, medical criteria support empiric administration of a single, 200 µg/kg dose of ivermectin to prevent Strongyloides hyperinfection syndrome. The outcome was a composite of all-cause in-hospital mortality and the need for respiratory support. Results. Of 1167 patients in the cohort, 96 received ivermectin. After propensity score matching, we included 192 patients. The composite outcome of in-hospital mortality or need for respiratory support occurred in 41.7% of the control group (40/96) and 34.4% (33/96) of the ivermectin group. Ivermectin was not associated with the outcome of interest (adjusted odds ratio [aOR] 0.77, 95% confidence interval [CI] 0.35, 1.69; p = 0.52). The factors independently associated with this endpoint were oxygen saturation (aOR 0.78, 95% CI 0.68, 0.89, p < 0.001) and C-reactive protein at admission (aOR: 1.09, 95% CI 1.03, 1.16, p < 0.001). Conclusions. In hospitalized patients with COVID-19 pneumonia, ivermectin at a single dose for pre-emptively treating Strongyloides stercoralis is not effective in reducing mortality or the need for respiratory support measures.

Conflicts of Interest: The authors declare no conflict of interest.

References

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Late treatment
is less effective

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