Ivermectin as a SARS-CoV-2 Pre-Exposure Prophylaxis Method in Healthcare Workers: A Propensity Score-Matched Retrospective Cohort Study
Jose Morgenstern, Jose N Redondo, Alvaro Olavarria, Isis Rondon, Santiago Roca, Albida De Leon, Juan Canela, Johnny Tavares, Miguelina Minaya, Oscar Lopez, Ana Castillo, Ana Placido, Rafael Cruz, Yudelka Merette, Marlenin Toribio, Juan Francisco
Cureus, doi:10.7759/cureus.17455
Background: Ivermectin is a drug that has been shown to be active against coronavirus disease 19 (COVID-19) in previous studies. Healthcare personnel are highly exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Therefore, we decided to offer them ivermectin as a pre-exposure prophylaxis (PrEP) method. Purpose: Primary outcome was to measure the number of healthcare workers with symptomatic SARS-CoV-2 infection and a positive reverse transcription polymerase chain reaction (RT-PCR) COVID-19 test in the ivermectin group and in the control group. Secondary outcome was to measure the number of sick healthcare workers with a positive RT-PCR COVID-19 test whose condition deteriorated and required hospitalization and/or an Intensive Care Unit (ICU), or who died, in the ivermectin group and in the control group. Material and methods: This observational and retrospective cohort study was carried out in two medical centers,
Additional Information Disclosures Human subjects: Consent was obtained or waived by all participants in this study. Grupo Rescue Ethics Committee issued approval ME-GRUR-328-2020. This study was submitted for consideration, comment, guidance and approval to the Grupo Rescue Ethics Committee before the Ivermectin pre-exposure prophylaxis started. . Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
References
Behera, Patro, Singh, Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: a matched case-control study, PLoS One,
doi:10.1371/journal.pone.0247163Biber, Mandelboim, Harmelin, Favorable outcome on viral load and culture viability using Ivermectin in early treatment of non-hospitalized patients with mild COVID-19 -a double-blind, randomized placebo-controlled trial, PREPRINT,
doi:10.1101/2021.05.31.21258081Bryant, Lawrie, Dowswell, Fordham, Mitchell et al., Ivermectin for prevention and treatment of COVID-19 infection: a systematic review, meta-analysis, and trial sequential analysis to inform clinical guidelines, Am J Ther,
doi:10.1097/MJT.0000000000001402Chahla, Ruiz, Ortega, A randomized trial -intensive treatment based in ivermectin and iota-carrageenan as pre-exposure prophylaxis for COVID-19 in healthcare agents, PREPRINT,
doi:10.1101/2021.03.26.21254398Guzzo, Furtek, Porras, Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects, J Clin Pharmacol,
doi:10.1177/009127002237994Kory, Meduri, Varon, Iglesias, Marik, Review of the emerging evidence demonstrating the efficacy of ivermectin in the prophylaxis and treatment of COVID-19, Am J Ther,
doi:10.1097/MJT.0000000000001377Krolewiecki, Lifschitz, Moragas, Antiviral effect of high-dose ivermectin in adults with COVID-19: a proof-of-concept randomized trial, EClinicalMedicine,
doi:10.1016/j.eclinm.2021.100959Lespine, Alvinerie, Sutra, Pors, Chartier, Influence of the route of administration on efficacy and tissue distribution of ivermectin in goat, Vet Parasitol,
doi:10.1016/j.vetpar.2004.11.028Morgenstern, Redondo, León, The use of compassionate ivermectin in the management of symptomatic outpatients and hospitalized patients with clinical diagnosis of Covid-19 at the Centro Medico Bournigal and at the Centro Medico Punta Cana, Grupo Rescue, Dominican Republic, from May 1 to, J Clin Trials,
doi:10.1016/S0140-6736(07)61602-XMuñoz, Ballester, Antonijoan, Safety and pharmacokinetic profile of fixed-dose ivermectin with an innovative 18mg tablet in healthy adult volunteers, PLoS Negl Trop Dis,
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'title': 'Ivermectin as a SARS-CoV-2 Pre-Exposure Prophylaxis Method in Healthcare Workers: A Propensity '
'Score-Matched Retrospective Cohort Study',
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{'given': 'Johnny', 'family': 'Tavares', 'sequence': 'additional', 'affiliation': []},
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'member': '297',
'reference': [ { 'key': 'ref1',
'doi-asserted-by': 'publisher',
'DOI': '10.1016/j.antiviral.2020.104787',
'article-title': 'The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 '
'in vitro',
'volume': '178',
'author': 'Caly L',
'year': '2020',
'unstructured': 'Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. The FDA-approved drug '
'ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral '
'Res. 2020, 178:104787. 10.1016/j.antiviral.2020.104787',
'journal-title': 'Antiviral Res'},
{ 'key': 'ref2',
'doi-asserted-by': 'publisher',
'DOI': '10.1101/2021.05.31.21258081',
'article-title': 'Favorable outcome on viral load and culture viability using Ivermectin '
'in early treatment of non-hospitalized patients with mild COVID-19 - a '
'double-blind, randomized placebo-controlled trial [PREPRINT]',
'author': 'Biber A',
'year': '2021',
'unstructured': 'Biber A, Mandelboim M, Harmelin G, et al.. Favorable outcome on viral '
'load and culture viability using Ivermectin in early treatment of '
'non-hospitalized patients with mild COVID-19 - a double-blind, '
'randomized placebo-controlled trial [PREPRINT]. medRxiv. 2021, '
'10.1101/2021.05.31.21258081',
'journal-title': 'medRxiv'},
{ 'key': 'ref3',
'doi-asserted-by': 'publisher',
'DOI': '10.1016/j.eclinm.2021.100959',
'article-title': 'Antiviral effect of high-dose ivermectin in adults with COVID-19: a '
'proof-of-concept randomized trial',
'volume': '37',
'author': 'Krolewiecki A',
'year': '2021',
'unstructured': 'Krolewiecki A, Lifschitz A, Moragas M, et al.. Antiviral effect of '
'high-dose ivermectin in adults with COVID-19: a proof-of-concept '
'randomized trial. EClinicalMedicine. 2021, 37:100959. '
'10.1016/j.eclinm.2021.100959',
'journal-title': 'EClinicalMedicine'},
{ 'key': 'ref4',
'doi-asserted-by': 'publisher',
'DOI': '10.1097/MJT.0000000000001377',
'article-title': 'Review of the emerging evidence demonstrating the efficacy of '
'ivermectin in the prophylaxis and treatment of COVID-19',
'volume': '28',
'author': 'Kory P',
'year': '2021',
'unstructured': 'Kory P, Meduri GU, Varon J, Iglesias J, Marik PE. Review of the emerging '
'evidence demonstrating the efficacy of ivermectin in the prophylaxis and '
'treatment of COVID-19. Am J Ther. 2021, 28:e299-318. '
'10.1097/MJT.0000000000001377',
'journal-title': 'Am J Ther'},
{ 'key': 'ref5',
'doi-asserted-by': 'publisher',
'DOI': '10.1097/MJT.0000000000001402',
'article-title': 'Ivermectin for prevention and treatment of COVID-19 infection: a '
'systematic review, meta-analysis, and trial sequential analysis to '
'inform clinical guidelines',
'volume': '28',
'author': 'Bryant A',
'year': '2021',
'unstructured': 'Bryant A, Lawrie TA, Dowswell T, Fordham EJ, Mitchell S, Hill SR, Tham '
'TC. Ivermectin for prevention and treatment of COVID-19 infection: a '
'systematic review, meta-analysis, and trial sequential analysis to '
'inform clinical guidelines. Am J Ther. 2021, 28:e434-60. '
'10.1097/MJT.0000000000001402',
'journal-title': 'Am J Ther'},
{ 'key': 'ref6',
'article-title': 'The use of compassionate ivermectin in the management of symptomatic '
'outpatients and hospitalized patients with clinical diagnosis of '
'Covid-19 at the Centro Medico Bournigal and at the Centro Medico Punta '
'Cana, Grupo Rescue, Dominican Republic, from May 1 to August 10, 2020',
'volume': '11',
'author': 'Morgenstern J',
'year': '2021',
'unstructured': 'Morgenstern J, Redondo JN, León AD, et al.. The use of compassionate '
'ivermectin in the management of symptomatic outpatients and hospitalized '
'patients with clinical diagnosis of Covid-19 at the Centro Medico '
'Bournigal and at the Centro Medico Punta Cana, Grupo Rescue, Dominican '
'Republic, from May 1 to August 10, 2020. J Clin Trials. 2021, 11:',
'journal-title': 'J Clin Trials'},
{ 'key': 'ref7',
'doi-asserted-by': 'publisher',
'DOI': '10.1016/S0140-6736(07)61602-X',
'article-title': 'The Strengthening the Reporting of Observational Studies in '
'Epidemiology (STROBE) statement: guidelines for reporting observational '
'studies',
'volume': '370',
'author': 'von Elm E',
'year': '2007',
'unstructured': 'von Elm E, Altman DG, Egger M, et al.. The Strengthening the Reporting '
'of Observational Studies in Epidemiology (STROBE) statement: guidelines '
'for reporting observational studies. Lancet. 2007, 370:1453-7. '
'10.1016/S0140-6736(07)61602-X',
'journal-title': 'Lancet'},
{ 'key': 'ref8',
'doi-asserted-by': 'publisher',
'DOI': '10.1177/009127002237994',
'article-title': 'Safety, tolerability, and pharmacokinetics of escalating high doses of '
'ivermectin in healthy adult subjects',
'volume': '42',
'author': 'Guzzo C',
'year': '2013',
'unstructured': 'Guzzo C, Furtek C, Porras A, et al.. Safety, tolerability, and '
'pharmacokinetics of escalating high doses of ivermectin in healthy adult '
'subjects. J Clin Pharmacol. 2013, 42:1122-33. 10.1177/009127002237994',
'journal-title': 'J Clin Pharmacol'},
{ 'key': 'ref9',
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'DOI': '10.1371/journal.pntd.0006020',
'article-title': 'Safety and pharmacokinetic profile of fixed-dose ivermectin with an '
'innovative 18mg tablet in healthy adult volunteers',
'volume': '12',
'author': 'Muñoz J',
'year': '2018',
'unstructured': 'Muñoz J, Ballester MR, Antonijoan RM, et al.. Safety and pharmacokinetic '
'profile of fixed-dose ivermectin with an innovative 18mg tablet in '
'healthy adult volunteers. PLoS Negl Trop Dis. 2018, 12:e0006020. '
'10.1371/journal.pntd.0006020',
'journal-title': 'PLoS Negl Trop Dis'},
{ 'key': 'ref10',
'doi-asserted-by': 'publisher',
'DOI': '10.1016/j.vetpar.2004.11.028',
'article-title': 'Influence of the route of administration on efficacy and tissue '
'distribution of ivermectin in goat',
'volume': '128',
'author': 'Lespine A',
'year': '2005',
'unstructured': 'Lespine A, Alvinerie M, Sutra JF, Pors I, Chartier C. Influence of the '
'route of administration on efficacy and tissue distribution of '
'ivermectin in goat. Vet Parasitol. 2005, 128:251-60. '
'10.1016/j.vetpar.2004.11.028',
'journal-title': 'Vet Parasitol'},
{ 'key': 'ref11',
'doi-asserted-by': 'publisher',
'DOI': '10.1371/journal.pone.0247163',
'article-title': 'Role of ivermectin in the prevention of SARS-CoV-2 infection among '
'healthcare workers in India: a matched case-control study',
'volume': '16',
'author': 'Behera P',
'year': '2021',
'unstructured': 'Behera P, Patro BK, Singh AK, et al.. Role of ivermectin in the '
'prevention of SARS-CoV-2 infection among healthcare workers in India: a '
'matched case-control study. PLoS One. 2021, 16:e0247163. '
'10.1371/journal.pone.0247163',
'journal-title': 'PLoS One'},
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'DOI': '10.1101/2021.03.26.21254398',
'article-title': 'A randomized trial - intensive treatment based in ivermectin and '
'iota-carrageenan as pre-exposure prophylaxis for COVID-19 in healthcare '
'agents [PREPRINT]',
'author': 'Chahla RE',
'year': '2021',
'unstructured': 'Chahla RE, Ruiz LM, Ortega ES, et al.. A randomized trial - intensive '
'treatment based in ivermectin and iota-carrageenan as pre-exposure '
'prophylaxis for COVID-19 in healthcare agents [PREPRINT]. medRxiv. 2021, '
'10.1101/2021.03.26.21254398',
'journal-title': 'medRxiv'}],
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