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0 0.5 1 1.5 2+ Mortality 48% Improvement Relative Risk Ivermectin for COVID-19  Munir et al.  LATE TREATMENT Is late treatment with ivermectin beneficial for COVID-19? Retrospective 1,000 patients in Pakistan (March 2021 - March 2022) Lower mortality with ivermectin (not stat. sig., p=0.13) c19ivm.org Munir et al., Healthcare, April 2023 Favors ivermectin Favors control

Clinical Disease Characteristics and Treatment Trajectories Associated with Mortality among COVID-19 Patients in Punjab, Pakistan

Munir et al., Healthcare, doi:10.3390/healthcare11081192
Apr 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 103 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.
4,100+ studies for 60+ treatments. c19ivm.org
Retrospective 1,000 hospitalized COVID-19 patients in Pakistan, showing lower mortality with ivermectin without statistical significance.
Although the 48% lower mortality is not statistically significant, it is consistent with the significant 49% lower mortality [35‑60%] from meta analysis of the 51 mortality results to date.
This is the 97th of 103 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 1 sextillion).
50 studies are RCTs, which show efficacy with p=0.00000014.
risk of death, 48.2% lower, OR 0.52, p = 0.13, treatment 92, control 908, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Munir et al., 21 Apr 2023, retrospective, Pakistan, peer-reviewed, 3 authors, study period March 2021 - March 2022, dosage not specified.
This PaperIvermectinAll
Clinical Disease Characteristics and Treatment Trajectories Associated with Mortality among COVID-19 Patients in Punjab, Pakistan
Muhammad Zeeshan Munir, Amer Hayat Khan, Tahir Mehmood Khan
doi:10.3390/healthcare11081192
Background: Data on Pakistani COVID-19 patient mortality predictors is limited. It is essential to comprehend the relationship between disease characteristics, medications used, and mortality for better patient outcomes. Methods: The medical records of confirmed cases in the Lahore and Sargodha districts were examined using a two-stage cluster sampling from March 2021 to March 2022. Demographics, signs and symptoms, laboratory findings, and pharmacological medications as mortality indicators were noted and analyzed. Results: A total of 288 deaths occurred out of the 1000 cases. Death rates were higher for males and people over 40. Most of those who were mechanically ventilated perished (OR: 124.2). Dyspnea, fever, and cough were common symptoms, with a significant association amid SpO2 < 95% (OR: 3.2), RR > 20 breaths/min (OR: 2.5), and mortality. Patients with renal (OR: 2.3) or liver failure (OR: 1.5) were at risk. Raised C-reactive protein (OR: 2.9) and D-dimer levels were the indicators of mortality (OR: 1.6). The most prescribed drugs were antibiotics, (77.9%), corticosteroids (54.8%), anticoagulants (34%), tocilizumab (20.3%), and ivermectin (9.2%). Conclusions: Older males having breathing difficulties or signs of organ failure with raised C-reactive protein or D-dimer levels had high mortality. Antivirals, corticosteroids, tocilizumab, and ivermectin had better outcomes; antivirals were associated with lower mortality risk.
Author Contributions: Elements of this work including the conception of ideas, literature search, study designs, clinical data collections, statistical data analysis, data interpretation, manuscript drafting, and paper writing were done by M.Z.M., T.M.K. and A.H.K. Supervised and performed project administration, critical revisions of the paper, final editing, agreed to submit the manuscript to this journal, gave the final approval for the submitted version, and agreed to be accountable for all aspects of the work. All authors have read and agreed to the published version of the manuscript. Conflicts of Interest: The authors declare no conflict of interest.
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Dyspnea, fever, ' 'and cough were common symptoms, with a significant association amid SpO2 &lt; 95% (OR: 3.2), ' 'RR &gt; 20 breaths/min (OR: 2.5), and mortality. Patients with renal (OR: 2.3) or liver ' 'failure (OR: 1.5) were at risk. Raised C-reactive protein (OR: 2.9) and D-dimer levels were ' 'the indicators of mortality (OR: 1.6). The most prescribed drugs were antibiotics, (77.9%), ' 'corticosteroids (54.8%), anticoagulants (34%), tocilizumab (20.3%), and ivermectin (9.2%). ' 'Conclusions: Older males having breathing difficulties or signs of organ failure with raised ' 'C-reactive protein or D-dimer levels had high mortality. Antivirals, corticosteroids, ' 'tocilizumab, and ivermectin had better outcomes; antivirals were associated with lower ' 'mortality risk.</jats:p>', 'alternative-id': ['healthcare11081192'], 'author': [ { 'affiliation': [ { 'name': 'Discipline of Clinical Pharmacy, School of Pharmaceutical ' 'Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, ' 'Malaysia'}, { 'name': 'Institute of Pharmaceutical Sciences, University of Veterinary ' 'and Animal Sciences, Syed Abdul Qadir Jillani (Out Fall) Road, ' 'Lahore 54000, Pakistan'}], 'family': 'Munir', 'given': 'Muhammad Zeeshan', 'sequence': 'first'}, { 'ORCID': 'http://orcid.org/0000-0003-4802-6181', 'affiliation': [ { 'name': 'Discipline of Clinical Pharmacy, School of Pharmaceutical ' 'Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, ' 'Malaysia'}], 'authenticated-orcid': False, 'family': 'Khan', 'given': 'Amer Hayat', 'sequence': 'additional'}, { 'affiliation': [ { 'name': 'Institute of Pharmaceutical Sciences, University of Veterinary ' 'and Animal Sciences, Syed Abdul Qadir Jillani (Out Fall) Road, ' 'Lahore 54000, Pakistan'}, { 'name': 'School of Pharmacy, Monash University Malaysia Sdn Bhd, Jalan ' 'Lagoon Selatan, Banday Sunway, Subang Jaya 45700, Selangor, ' 'Malaysia'}], 'family': 'Khan', 'given': 'Tahir Mehmood', 'sequence': 'additional'}], 'container-title': 'Healthcare', 'container-title-short': 'Healthcare', 'content-domain': {'crossmark-restriction': False, 'domain': []}, 'created': {'date-parts': [[2023, 4, 21]], 'date-time': '2023-04-21T06:05:31Z', 'timestamp': 1682057131000}, 'deposited': { 'date-parts': [[2023, 12, 11]], 'date-time': '2023-12-11T05:14:45Z', 'timestamp': 1702271685000}, 'indexed': { 'date-parts': [[2023, 12, 11]], 'date-time': '2023-12-11T05:46:55Z', 'timestamp': 1702273615407}, 'is-referenced-by-count': 0, 'issue': '8', 'issued': {'date-parts': [[2023, 4, 21]]}, 'journal-issue': {'issue': '8', 'published-online': {'date-parts': [[2023, 4]]}}, 'language': 'en', 'license': [ { 'URL': 'https://creativecommons.org/licenses/by/4.0/', 'content-version': 'vor', 'delay-in-days': 0, 'start': { 'date-parts': [[2023, 4, 21]], 'date-time': '2023-04-21T00:00:00Z', 'timestamp': 1682035200000}}], 'link': [ { 'URL': 'https://www.mdpi.com/2227-9032/11/8/1192/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '1968', 'original-title': [], 'page': '1192', 'prefix': '10.3390', 'published': {'date-parts': [[2023, 4, 21]]}, 'published-online': {'date-parts': [[2023, 4, 21]]}, 'publisher': 'MDPI AG', 'reference': [ { 'DOI': '10.1016/j.chest.2020.10.014', 'article-title': 'Global impact of coronavirus disease 2019 infection requiring admission ' 'to the ICU: A systematic review and meta-analysis', 'author': 'Tan', 'doi-asserted-by': 'crossref', 'first-page': '524', 'journal-title': 'Chest', 'key': 'ref_1', 'volume': '159', 'year': '2021'}, { 'DOI': '10.47102/annals-acadmedsg.202057', 'article-title': 'Rapid progression to acute respiratory distress syndrome: Review of ' 'current understanding of critical illness from coronavirus disease 2019 ' '(COVID-19) infection', 'author': 'Goh', 'doi-asserted-by': 'crossref', 'first-page': '108', 'journal-title': 'Ann. 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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. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment 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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