Abstract: ARTICLE IN PRESS braz j infect dis. 2021;xxx(xx):101603 The Brazilian Journal of INFECTIOUS DISEASES w w w. e l s e v i e r. c o m / l o c a t e / b j i d Brief Communication Self-prescribed Ivermectin use is associated with a lower rate of seroconversion in health care workers diagnosed with COVID, in a dose-dependent response Q1 1X XCXD
elia Pedroso D2XaX , D3X XSara Vaz aD4X X , D5X XEduardo Martins Netto aD6X X , D7X XDaniele Souza D8XaX , D9X XFelice Deminco aD10X X , D1X XRafaela Mayoral D12XaX , D13X XEliana Menezes aD14X X , D15X XAna Patricia Amancio da Cunha aD16X X , D17X XAndres Moreira-Soto D18XbX , D19X XIan Felix Drexler D20Xb,c X , a, D21X XCarlos Brites D2X X *
rio Professor Edgard Santos, Laborato
rio de Pesquisa em Federal University of Bahia, Complexo Hospitalar Universita Infectologia (LAPI), Bahia, BA, Brazil b € tsmedizin Berlin, corporate member of Freie Universita € t Berlin, Humboldt-Universita € t zu Berlin, Charit
e-Universita a Institute of Virology, Berlin, Germany German Centre for Infection Research, Berlin, Germany c A R T I C L E I N F O A B S T R A C T Article history: Background: Over-the-counter use of ivermectin amongst other drugs as SARS-CoV-2 treat- Received 19 May 2021 ment has been increasingly common, despite the lack of evidence on its clinical efficacy. Accepted 5 July 2021 Objective: To evaluate the effect of ivermectin use on production of antibodies against SARS- Available online xxx 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
rio Professor Edgard Santos (Salvaproduction in HCW at Complexo Hospitalar Universita dor, 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). PBMC
s 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. * Corresponding author. E-mail address: crbrites@gmail.com (C. Brites). https://doi.org/10.1016/j.bjid.2021.101603 1413-8670/Ó 2021 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Please cite this article as: C. Pedroso..