A Comparison of Ivermectin and Non Ivermectin Based Regimen for COVID-19 in Abuja: Effects on Virus Clearance, Days-to-discharge and Mortality
Y Thairu, O E Babalola, A A Ajayi, Y Ndanusa, J O Ogedengbe, Omede O.
Journal of Pharmaceutical Research International, doi:10.9734/jpri/2022/v34i44a36328
Aim: To compare outcomes from ivermectin (IVM) -and non-ivermectin (NIVM)-based treatments for COVID-19 in Abuja, Nigeria. Methods: Sixty-one consecutive virology-proven cases were recruited and managed with IVMbased regimes. A subsequent cohort of 26 patients was treated with NIVM due to physician preference, with varying combinations of lopinavir/ritonavir (Alluvia), remdesivir, azithromycin, and enoxapramin. All patients received zinc sulfate, vitamin C and supportive therapy. Propensity matching was carried out as indicated, and Repeat Measures Analysis of Variance (RMANOVA) allowing for time*treatment interaction was carried out for time dependent variables, deriving Likelihood Ratio (LR) and P values.
Original Research Article Main Outcome Measures: Change in cycle threshold (viral load) over time, positivity status by day 5, improvement in clinical status using myalgia scores, days to discharge (DTD), change in SpO2 and death. Results: IVM was associated with a greater and faster reduction in viral clearance (LR=64.2 p< 0.0001 for the N gene): 31% and 95% were negative by days 5 and 14, respectively, versus 0% on NIVM. The mean DTD on IVM was 8.8 days versus 19.4 days, p< 0.0001. IVM proved significantly superior for Myalgia scores, LR= 23.45, P=0.0007. The mortality rate was 0/61 (0%) in IVM but 4/26 (15.3%) in NIVM. Three of the 4 deaths were in females, and 2 had been vaccinated, one fully. The SP02% increased significantly more on IVM (p < 0.0001 RMANOVA) than the NIVM group. C-reactive protein and D-dimer levels dropped significantly more sharply during IVM (P= 0.0068, 0.063), suggesting anti-inflammatory and antifibrinolytic activity. Conclusions: The IVM-based regimen caused earlier discharge from treatment and reduced mortality, in addition to clinical and laboratory improvements. Vaccination did not protect some patients from SARS-CoV-2 breakthrough infection and mortality.
ETHICS APPROVAL AND CONSENT The Project was approved by the University of Abja Teaching Hospital Human Research Ethics Committee. The Approval number was UATH/HREC/PR/2020/015/10. Consent to participate was obtained from each individual patient using a standard consent form in which the project was explained.
COMPETING INTERESTS Authors have declared that no competing interests exist.
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