Comparison of Viral Clearance between Ivermectin with Doxycycline and Hydroxychloroquine with Azithromycin in COVID-19 Patients
Introduction: The whole world is on the brink of collapse due to the outbreak of COVID-19 with no solution to treat these cases with any specific drug. Extensive search for the Vaccine or effective treatment is going on while alarming infection and death toll is rising every day.
Aim: The study will compare the effect of Ivermectin with Doxycycline and Hydoxychloroquine with Azythromicin on a selective group of COVID -19 positive patients.
Method: This is a comparative study that included 400 patients of COVID 19 positive patient who were divided in to two groups. Group-A Received Ivermectin with Doxycycline and the other group-B received hydroxichloroquine(HCQ) with azithromycin.
Result: Viral clearance is 132 ( 66%) on day 5 and 167( 83.5% ) on day 6. Among them 33(16.5%) remain PCR positive after 6th day of Ivermectin ingestion in Group A. Whereas there is154 ( 77.0%) viral clearance at 11th day and 163(81.5%) viral clearance at 12th day of Hydroxychloroquine ingestion in Group B. Among them 37 (18.5%) remain PCR positive after 12 day in group B. The P value is 0.000427 which is significant considering 5th day viral clearance of Ivermectin ingestion and 11th day of Hydroxychloroquine ingestion. But considering 6th day and 12th day the P-value is 0.59 which is not significant.
Conclusion: It appears Ivermectin and Doxycycline is safeand effective combination drug therapy in COVID-19infected patients but need further extensive study to find out the scope of application on other groups of patients.
Caly, Druce, Catton, Jans, Wagstaff, The FDA-approved Drug Ivermectin inhibits the replication of SARSCoV-2 in vitro, Antiviral Res
Dh Tran, Sugamata, Hirose, Suzuki, Noguchi et al., Azithromycin, a 15-membered macrolide antibiotic, inhibits influenza A(H1N1)pdm09 virus infection by interfering with virus internalization process, J Antibiot
Frieman, Severe acute respiratory syndrome corona virus ORF6 antagonizes STAT1 function by sequestering nuclear import factors on the rough endoplasmic reticulum / Golgi membrane, J. Virol
Gautret, Lagier, Parola, Hoang, Meddeb et al., Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label nonrandomized clinical trial, International Journal of Antimicrobial Agents
Gautret, Lagier, Parola, Hydroxychloroquine and azithromycinasa treatment of COVID-19: results of an open-labelnon-randomized clinical trial, Int. J. Antimicrob. Agents, doi:10.1016/j.ijantimicag.2020.105949
Gonzalez Canga, The pharmacokinetics and interactions of ivermectinin humans-amini review, AAPS J
Gotz, Inûuenza A viruses escape from MxA restriction at the expense of eûcient nuclear vRNP import, Sci. Rep
Guzzo, Furtek, Porras, Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects, J Clin Pharmacol
Henehan, Montuno, Benedetto, Doxycycline as an anti-inflammatory agent: updates in dermatology, J EurAcadDermatolVenereol
Hiscox, The corona virus infectious bronchitis virus nucleoprotein localizes to the nucleolus, J. Virol
Lund Berg, Nuclear import and export inhibitors alter capsid protein distribution in mammalian cells and reduce Venezuelan Equine Encephalitis Virus replication, Antivir. Res
Mauthe, Orhon, Rocchi, Zhou, Luhr et al., Chloroquine inhibits autophagic flux by decreasing autophagosome-lysosome fusionAutophagy
Menozzi, Bertini, Turin, Serventi, Kramer et al., Doxycy-cline levels and anti Wolbachia antibodies in sera from dogs experimentallyinfected with Diroûlaria immitis and treated with a combination of ivermectin/doxycycline, Vet Parasitol
Rowland, Intra cellular localization of the severe acute respiratory syndrome corona virus nucleocapsidprotein : absence of nucleolar accumulation during infection and after expression as a recombinant protein in verocells, J. Virol
Shrikrushna, A review on corona virus (covid-19), wjpls
Tay, Nuclear localization of dengue virus (DENV) 1-4 non-structural protein 5; protection against all 4 DENV serotypes by the inhibitor Ivermectin, Antivir. Res
Timani, Nuclear / nucleolar localization properties of C-terminal nucleocapsid protein of SARS corona virus, Virus Res
Wagstaû, An Alpha Screen (R)-based assay for high-through put screening for speciûc inhibitors of nuclear import, J. Biomol. Screen
Wagstaû, Ivermectin is a speciûc inhibitor of importin alpha/beta-mediated nuclear importable to inhibit replication of HIV-1 and dengue virus, Biochem. J
Wulan, Nucleocytoplasmic transport of nucleocapsid proteins of enveloped RNA viruses, Front. Microbiol
Wurm, Localization to the nucleolus is a common feature of corona virus nucleoproteins, and the protein may disrupt host cell division, J. Virol
Zakeri, Wright, Chemical biology of tetracycline antibiotics, Biochem Cell Biol
Zhou, Dai, Tong, COVID-19:a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression, J Antimicrobechemother