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Self-prescribed Ivermectin use is associated with a lower rate of seroconversion in health care workers diagnosed with COVID, in a dose-dependent response

Pedroso et al., The Brazilian Journal of Infectious Diseases, doi:10.1016/j.bjid.2021.101603
Aug 2021  
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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.
No treatment is 100% effective. Protocols combine treatments.
5,000+ studies for 104 treatments. c19ivm.org
Retrospective 45 healthcare workers in Brazil, showing lower creation of antibodies with multiple doses of ivermectin, which may be expected due to the antiviral activity as demonstrated in multiple studies. Authors appear unaware of these studies, citing only earlier in vitro research, which they misinterpret to suggest that therapeutic concentrations are not reached (for details on why this is incorrect see1). Authors combine no dose and one dose. Clinical outcomes and timing of treatment are not provided.
Pedroso et al., 12 Aug 2021, peer-reviewed, 11 authors.
This PaperIvermectinAll
Self-prescribed Ivermectin use is associated with a lower rate of seroconversion in health care workers diagnosed with COVID, in a dose-dependent response
Célia Pedroso, Sara Vaz, Eduardo Martins Netto, Daniele Souza, Felice Deminco, Rafaela Mayoral, Eliana Menezes, Ana Patricia Amancio Da Cunha, Andres Moreira-Soto, Jan Felix Drexler, Carlos Brites
The Brazilian Journal of Infectious Diseases, doi:10.1016/j.bjid.2021.101603
Background: Over-the-counter use of ivermectin amongst other drugs as SARS-CoV-2 treatment has been increasingly common, despite the lack of evidence on its clinical efficacy. Objective: To evaluate the effect of ivermectin use on production of antibodies against SARS-CoV-2 in health care workers (HCW) diagnosed with COVID-19 and of Th1/Th2 cytokines by stimulated peripheral blood mononuclear cells of the same cohort (PBMCs). Methods: This cross-sectional study evaluated seroconversion and neutralizing antibodies production in HCW at Complexo Hospitalar Universit ario Professor Edgard Santos (Salvador, Brazil), diagnosed with COVID-19 from May to July, 2020, as well as in vitro production of antibody against SARS-CoV-2 and Th1/Th2 cytokines. Analyses were performed between December 2020 and February 2021. Participants were stratified according to the use of ivermectin (≤ 1 dose vs. multiple doses) for treatment of COVID-19. Results: 45 HCW were included (62% women). Mean age was 39 years, and disease severity was similar across groups. Neutralizing antibodies were detected less frequently in multiple doses (70%) vs. ≤ 1 dose (97%) groups, p = 0.02). PBMCs of patients in multiple doses group also were less likely to produce antibodies against SARS-CoV-2 following in vitro stimulation with purified spike protein in comparison with patients in ≤ 1 dose group (p < 0.001). PBMCs production of Th1/Th2 cytokines levels was similar across groups. Abdominal pain (15% vs 46%, p = 0.04), diarrhea (21% vs. 55%, p = 0.05) and taste perversion (0% vs. 18%, p = 0.05) were more frequently reported by participants that used multiple doses of ivermectin. Conclusions: Although there was no evidence for differential disease severity upon ivermectin use for treatment of COVID-19 it was associated with more gastro-intestinal side-effects and impairment of anti-SARS-CoV2 antibodies production, in a dose dependent manner.
References
Amadori, De Rossi, Giaquinto, Faulkner-Valle, None
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Knirsch, The effect of azithromycin on ivermectin 229 pharmacokinetics − a population pharmacokinetic model
Rusconi, Santambrogio, Marco, Lack of in vitro 201 anti-gp160 antibody production is a correlate of 202 nonprogression among HIV type 1-infected individuals, AIDS
Tang, Hu, Wang, Ivermectin, a potential 213 anticancer drug derived from an antiparasitic drug, Pharmacol
Tay, Fraser, Chan, Nuclear localization of 217 dengue virus (DENV) 1-4 non-structural protein 5; protection 218 against all 4 DENV serotypes by the inhibitor Ivermectin
Wagstaff, Sivakumaran, Heaton, Harrich, Jans, None
Zacchello, Bianchi, In-vitro production of HIV-197 specific antibody in children at risk of AIDS, Lancet, doi:10.1016/s0140-6736(88)91603-0
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