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White paper on Ivermectin as a potential therapy for COVID-19

Vora et al., Indian Journal of Tuberculosis, doi:10.1016/j.ijtb.2020.07.031

Jul 2020

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Ivermectin for COVID-19

4th treatment shown to reduce risk in August 2020

^*, now known with p < 0.00000000001 from 102 studies, recognized in 22 countries.

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

No treatment is 100% effective. Protocols combine complementary and synergistic treatments. ^* >10% efficacy in meta analysis with ≥3 clinical studies.

4,100+ studies for 60+ treatments. c19ivm.org

Panel review of ivermectin reporting that "ivermectin in the dose of 12mg BD alone or in combination with other therapy for 5–7 days may be considered as safe therapeutic option for mild moderate or severe cases of Covid-19 infection. It is cost effective especially when the other drugs are very costly & not easily available".

Reviews covering ivermectin for COVID-19 include Adegboro, Al-kuraishy, Babalola, Behl, Bray, DiNicolantonio, DiNicolantonio (B), Elkholy, Fordham, Formiga, Heidary, Jagiasi, Jans, Jans (B), Kory, Kory (B), Kory (C), Kory (D), Kow, Lind, Liu, Loo, Low, Santin, Scheim, Schwartz, Semiz, Turkia, Turkia (B), Turkia (C), Vora, Wang, Wehbe, Yagisawa, Yagisawa (B), Yemeke, Zaidi.

Important missing comments or errors? Let us know.

1. Adegboro et al., A review of the anti-viral effects of ivermectin, African Journal of Clinical and Experimental Microbiology, doi:10.4314/ajcem.v22i3.2.ajol.info, doi.org.

2. Al-kuraishy et al., Central effects of Ivermectin in alleviation of Covid-19-induced dysautonomia, Current Drug Targets, doi:10.2174/1389450123666220810102406.eurekaselect.com, doi.org.

3. Babalola et al., The Place of Ivermectin in the Management of Covid-19: State of the Evidence, Medical Research Archives, doi:10.18103/mra.v11i4.3778.esmed.org, doi.org.

4. Behl et al., CD147-spike protein interaction in COVID-19: Get the ball rolling with a novel receptor and therapeutic target, Science of The Total Environment, doi:10.1016/j.scitotenv.2021.152072.sciencedirect.com, doi.org.

5. Bray et al., Ivermectin and COVID-19: A report in Antiviral Research, widespread interest, an FDA warning, two letters to the editor and the authors' responses, Antiviral Res., doi:10.1016/j.antiviral.2020.104805.nih.gov, doi.org.

6. DiNicolantonio et al., Anti-inflammatory activity of ivermectin in late-stage COVID-19 may reflect activation of systemic glycine receptors, Open Heart, doi:10.1136/openhrt-2021-001655.bmj.com, doi.org.

7. DiNicolantonio (B) et al., Ivermectin may be a clinically useful anti-inflammatory agent for late-stage COVID-19, Open Heart, doi:10.1136/openhrt-2020-001350.bmj.com, doi.org.

8. Elkholy et al., Ivermectin: A Closer Look at a Potential Remedy, Cureus, doi:10.7759/cureus.10378.cureus.com, doi.org.

9. Fordham et al., The uses and abuses of systematic reviews, OSF Preprints, doi:10.31219/osf.io/mp4f2.osf.io, doi.org.

10. Formiga et al., Ivermectin: an award-winning drug with expected antiviral activity against COVID-19, J. Control Release, doi:10.1016/j.jconrel.2020.10.009.nih.gov, doi.org.

11. Heidary et al., Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen, The Journal of Antibiotics, 73, 593–602, doi:10.1038/s41429-020-0336-z.nature.com, doi.org.

12. Jagiasi et al., Variation in therapeutic strategies for the management of severe COVID-19 in India- A nationwide cross-sectional survey, The International Journal of Clinical Practice, doi:10.1111/ijcp.14574.wiley.com, doi.org.

13. Jans et al., The broad spectrum host-directed agent ivermectin as an antiviral for SARS-CoV-2 ?, Biochemical and Biophysical Research Communications, doi:10.1016/j.bbrc.2020.10.042.sciencedirect.com, doi.org.

14. Jans (B) et al., Ivermectin as a Broad-Spectrum Host-Directed Antiviral: The Real Deal?, Cells 2020, 9:9, 2100, doi:10.3390/cells9092100.mdpi.com, doi.org.

15. Kory, P., The Global War on Ivermectin, International Covid Summit III, European Parliament, Brussels, covid19criticalcare.com/wp-content/uploads/2023/05/GLOBAL-WAR-ON-IVERMECTIN-PARLIAMENT.pdf.covid19criticalcare.com.

16. Kory (B), P., The Criminal Censorship of Ivermectin's Efficacy By The High-Impact Medical Journals - Part 1, Pierre Kory’s Medical Musings, pierrekory.substack.com/p/the-criminal-censorship-of-ivermectins.substack.com.

17. Kory (C) et al., Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19, American Journal of Therapeutics, doi:10.1097/MJT.0000000000001377.lww.com, doi.org.

18. Kory (D) et al., Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19, Frontiers in Pharmacology, doi:10.3389/fphar.2021.643369.archive.org, doi.org.

19. Kow et al., Pitfalls in Reporting Sample Size Calculation Across Randomized Controlled Trials Involving Ivermectin for the treatment of COVID-19, American Journal of Therapeutics, doi:10.1097/MJT.0000000000001441.lww.com, doi.org.

20. Lind et al., Increase in Outpatient Ivermectin Dispensing in the US During the COVID-19 Pandemic: A Cross-Sectional Analysis, Journal of General Internal Medicine, doi:10.1007/s11606-021-06948-6.springer.com, doi.org.

21. Liu et al., Crosstalk between neutrophil extracellular traps and immune regulation: insights into pathobiology and therapeutic implications of transfusion-related acute lung injury, Frontiers in Immunology, doi:10.3389/fimmu.2023.1324021.frontiersin.org, doi.org.

22. Loo et al., Recent Advances in Inhaled Nanoformulations of Vaccines and Therapeutics Targeting Respiratory Viral Infections, Pharmaceutical Research, doi:10.1007/s11095-023-03520-1.springer.com, doi.org.

23. Low et al., Repositioning Ivermectin for Covid-19 treatment: Molecular mechanisms of action against SARS-CoV-2 replication, Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, doi:10.1016/j.bbadis.2021.166294.sciencedirect.com, doi.org.

24. Santin et al., Ivermectin: a multifaceted drug of Nobel prize-honored distinction with indicated efficacy against a new global scourge, COVID-19, New Microbes and New Infections, doi:10.1016/j.nmni.2021.100924.sciencedirect.com, doi.org.

25. Scheim et al., Sialylated Glycan Bindings from SARS-CoV-2 Spike Protein to Blood and Endothelial Cells Govern the Severe Morbidities of COVID-19, International Journal of Molecular Sciences, doi:10.3390/ijms242317039.mdpi.com, doi.org.

26. Schwartz, E., Does ivermectin have a place in the treatment of mild Covid-19?, New Microbes and New Infections, doi:10.1016/j.nmni.2022.100989.sciencedirect.com, doi.org.

27. Semiz, S., SIT1 transporter as a potential novel target in treatment of COVID-19, Biomolecular Concepts, doi:10.1515/bmc-2021-0017.degruyter.com, doi.org.

28. Turkia, M., A Continuation of a Timeline of Ivermectin-Related Events in the COVID-19 Pandemic [June 30, 2021], ResearchGate, doi:10.13140/RG.2.2.16973.36326.researchgate.net, doi.org.

29. Turkia (B), M., A timeline of ivermectin-related events in the COVID-19 pandemic, Research Gate, www.researchgate.net/publication/350610718_A_Timeline_of_Ivermectin-Related_Events_in_the_COVID-19_Pandemic_April_3_2021.researchgate.net.

30. Turkia (C), M., FLCCC Alliance MATH+ ascorbic acid and I-MASK+ ivermectin protocols for COVID-19 — a brief review, ResearchGate, www.researchgate.net/profile/Mika_Turkia/publication/345694745_FLCCC_Alliance_MATH_ascorbic_acid_and_I-MASK_ivermectin_protocols_for_COVID-19_-_A_Brief_Review/links/5fab010f4585150781078260/FLCCC-Alliance-MATH-ascorbic-acid-and-I-MASK-ivermectin-protocols-for-COVID-19-A-Brief-Review.pdf.researchgate.net.

31. Vora et al., White paper on Ivermectin as a potential therapy for COVID-19, Indian Journal of Tuberculosis, doi:10.1016/j.ijtb.2020.07.031.sciencedirect.com, doi.org.

32. Wang et al., Minimum manufacturing costs, national prices and estimated global availability of new repurposed therapies for COVID-19, medRxiv, doi:10.1101/2021.06.01.21258147.medrxiv.org, doi.org.

33. Wehbe et al., Repurposing Ivermectin for COVID-19: Molecular Aspects and Therapeutic Possibilities, Front. Immunol., doi:10.3389/fimmu.2021.663586.frontiersin.org, doi.org.

34. Yagisawa et al., Global trends in clinical trials of ivermectin for COVID-19—Part 2, The Japanese Journal of Antibiotics, doi:10.11553/antibiotics.77.1_45.doi.org, doi.org.

35. Yagisawa (B) et al., Global trends in clinical studies of ivermectin in COVID-19, The Japanese Journal of Antibiotics, 74-1, Mar 2021, jja-contents.wdc-jp.com/pdf/JJA74/74-1-open/74-1_44-95.pdf.wdc-jp.com.

36. Yemeke et al., Impact of the COVID-19 pandemic on the quality of medical products in Zimbabwe: a qualitative study based on key informant interviews with health system stakeholders, BMJ Open, doi:10.1136/bmjopen-2022-068923.bmj.com, doi.org.

37. Zaidi et al., The mechanisms of action of ivermectin against SARS-CoV-2—an extensive review, The Journal of Antibiotics, doi:10.1038/s41429-021-00491-6.nature.com, doi.org.

Vora et al., 31 Jul 2020, peer-reviewed, 4 authors.

This Paper Ivermectin All

White paper on Ivermectin as a potential therapy for COVID-19

Agam Vora, V K Arora, D Behera, Surya Kant Tripathy

Indian Journal of Tuberculosis, doi:10.1016/j.ijtb.2020.07.031

A group of senior doctors with vast clinical experience met on 19th July'20 under the aegis of Academy of Advanced Medical Education. The panel looked at Ivermectin, one of the old molecule and evaluated it's use in COVID 19 (Novel Coronavirus Disease 2019) management. After critical panel discussion, all the attending doctors came to a conclusion that Ivermectin can be a potential molecule for prophylaxis and treatment of people infected with Coronavirus, owing to its anti-viral properties coupled with effective cost, availability and good tolerability and safety.

Author's contributions All authors provided critical feedback and contributed to the final manuscript. Declaration of Competing Interest The authors have none to declare.

References

Banerjee, Nandy, Dalai, Ahmed, The battle against COVID 19 pandemic: what we need to know before we "test fire, Ivermectin. Drug Res, doi:10.1055/a-1185-8913

Caly, Druce, Catton, Jans, Wagstaff, The FDAapproved drug ivermectin inhibits the replication of SARS

Cherian, Agrawal, Basu, Abraham, Gangakhedkar et al., Perspectives for repurposing drugs for the coronavirus disease 2019, Indian J Med Res, doi:10.4103/ijmr.IJMR_585_20

Chowdhury, Shahbaz, Karim, Islam, Dan et al., A comparative observational study on Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin therapy on COVID19 patients

David, What is the role of antiparasitic drug ivermectin in the treatment of corona virus disease

Gupta, Sahoo, Singh, Ivermectin: potential candidate for the treatment of Covid 19, Braz J Infect Dis

Guzzo, Furtek, Porras, Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects, J Clin Pharmacol, doi:10.1177/009127002401382731

Heidary, Gharebaghi, Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen, J Antibiot, doi:10.1038/s41429-020-0336-z

Mah Evas, Tran, Roumier, Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data, BMJ, doi:10.1136/bmj.m1844

Pal, Yadav, COVID-19 pandemic in India: present scenario and a steep climb ahead, J Prim Care Commun Health, doi:10.1177/2150132720939402

Patel, Desai, Grainger, Mehra, Usefulness of Ivermectin in COVID-19 Illness

Rajter, Sherman, Fatteh, Vogel, Sacks et al., ICON (Ivermectin in COvid Nineteen) study: use of ivermectin is associated with lower mortality in hospitalized patients with COVID-19, doi:10.1101/2020.06.06.20124461

Romagnoli, Peris, Gaudio, Geppetti, SARS-CoV-2 and COVID-19: from the Bench to the bedside, Physiol Rev, doi:10.1152/physrev.00020.2020

Sharun, Dhama, Patel, Ivermectin, a new candidate therapeutic against SARS-CoV-2/COVID-19, Ann Clin Microbiol Antimicrob, doi:10.1186/s12941-020-00368-w

Sinhaa, Sehgalb, Sehgala, Ivermectin: is it to Be a potent therapeutic option for COVID-19?, Clin Infect Immun, doi:10.14740/cii106

Vora, Arora, Behera Academy of Advanced Medical Education

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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.

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