A Comparison of Ivermectin and Non Ivermectin Based Regimen for COVID-19 in Abuja: Effects on Virus Clearance, Days-to-discharge and Mortality

Thairu et al., Journal of Pharmaceutical Research International, doi:10.9734/jpri/2022/v34i44A36328 (date from preprint)

Feb 2022

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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.

Lower risk for mortality, ventilation, ICU admission, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments.

5,100+ studies for 109 treatments. c19ivm.org

PSM retrospective 87 patients in Nigeria, 61 treated with ivermectin, showing lower mortality, faster recovery, and faster viral clearance with ivermectin treatment. All patients received zinc and vitamin C. A synergistic effect was seen for viral clearance when ivermectin and remdesivir were combined, as predicted by In Vitro research1. Subject to confounding by time, with ivermectin patients from April-June 2021, and non-ivermectin patients from September-November 2021.

This is the 79th of 105 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 774 quintillion).

52 studies are RCTs, which show efficacy with p=0.00000021.

This study is excluded in the after exclusion results of meta analysis: significant confounding by time possible due to separation of groups in different time periods.

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risk of death, 87.9% lower, RR 0.12, p = 0.12, treatment 0 of 21 (0.0%), control 4 of 26 (15.4%), NNT 6.5, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), propensity score matching.

risk of death, 93.0% lower, RR 0.07, p = 0.007, treatment 0 of 61 (0.0%), control 4 of 26 (15.4%), NNT 6.5, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), all patients.

time to discharge, 54.6% lower, relative time 0.45, p < 0.001, treatment 61, control 26, propensity score matching.

risk of no viral clearance, 94.8% lower, RR 0.05, p = 0.001, treatment 0 of 21 (0.0%), control 10 of 26 (38.5%), NNT 2.6, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), propensity score matching, day 21.

risk of no viral clearance, 95.2% lower, RR 0.05, p < 0.001, treatment 1 of 21 (4.8%), control 26 of 26 (100.0%), NNT 1.1, propensity score matching, day 14.

risk of no viral clearance, 28.6% lower, RR 0.71, p = 0.005, treatment 15 of 21 (71.4%), control 26 of 26 (100.0%), NNT 3.5, propensity score matching, day 5.

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1. Jeffreys et al., Remdesivir-ivermectin combination displays synergistic interaction with improved in vitro activity against SARS-CoV-2, International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2022.106542.sciencedirect.com, doi.org.

Thairu et al., 25 Feb 2022, retrospective, Nigeria, peer-reviewed, mean age 41.7, 6 authors, study period April 2021 - November 2021, dosage 200μg/kg days 1-5. Contact: bablo57@gmail.com.

This Paper Ivermectin All

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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Late treatment
is less effective

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