Efficacy and safety of ivermectin in patients with mild and moderate COVID-19: A randomized controlled trial
Mohammadhamed Ersi, Alireza Malektojari, Sara Ghazizadeh, Elham Brahimi, Soheil Hassanipour, Mohammad Fathalipour, Mehdi Hassaniazad
Asian Pacific Journal of Tropical Medicine, doi:10.4103/1995-7645.364007
Methods: This study was a single-center, randomized, open-label, controlled trial with a 2-arm parallel-group design on 68 patients with COVID-19. According to the 1:1 ratio between the study groups (ivermectin group and standard treatment group), patients were randomly admitted to each intervention arm.
Results: The mean age of the participants in the ivermectin group was (48.37±13.32) years. Eighteen of them were males (54.5%) and the participants in the control group had a mean age of (46.28±14.47) years, with nineteen of them being males (59.4%). As a primary outcome, after 5 days of randomization, there was no significant difference between the ivermectin group and the control group in the length of stay in the hospital (P=0.168). ICU admission (P=0.764), length of stay in ICU (P=0.622), in-hospital mortality (P=0.427), adverse drug reactions, and changes in the mean difference of laboratory data had not any significant difference between the two groups (except for urea change). In addition, the radiologic findings of the two groups of patients were not significantly different. Linear regression analysis showed that for every 10 years increase of age, 0.6 day of hospitalization duration was increased. There was no statistically significant association between other variables and clinical outcomes. Conclusions: Among adult hospitalized patients with moderate to severe COVID-19, there was no significant relationship between the administration of ivermectin single dose in a five-day course and clinical improvement, and mortality of the participants.
Conflict of interest statement The authors declare that they have no competing interests. Authors' contributions EB, MH, and MF designed the study; AM and SG recruited the subjects and followed them up; SH analyzed the data; MHE wrote the manuscript; MHE, AM and SG edited and revised the manuscript according to the journal's instructions. All authors read and approved the final manuscript.
Publisher's note The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
Ahmed, Karim, Ross, Hossain, Clemens et al., A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness, Int J Infect Dis
Arabi, Gordon, Derde, Nichol, Murthy et al., Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial, Intensive Care Med
Caly, Druce, Catton, Jans, Wagstaff, The FDAapproved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Res
Cao, Wang, Wen, Liu, Wang et al., A trial of lopinavirritonavir in adults hospitalized with severe Covid-19, N Engl J Med
Dzieciatkowski, Szarpak, Filipiak, Jaguszewski, Ladny et al., COVID-19 challenge for modern medicine, Cardiol J
Hermine, Tharaux, Resche-Rigon, Porcher, Ravaud, Effect of tocilizumab vs. usual care in adults hospitalized with COVID-19 and moderate or severe pneumonia: A randomized clinical trial, JAMA Intern Med
Horby, Lim, Emberson, Mafham, Bell et al., Dexamethasone in hospitalized patients with Covid-19, N Engl J Med
Hosseini, Malektojari, Ghazizadeh, Hassaniazad, Davoodian et al., The efficacy and safety of ivermectin in patients with mild and moderate COVID-19: A structured summary of a study protocol for a randomized controlled trial, Trials
Hu, Guo, Zhou, Shi, Characteristics of SARS-CoV-2 and COVID-19, Nat Rev Microbiol
López-Medina, López, Hurtado, Dávalos, Ramirez et al., Effect of ivermectin on time to resolution of symptoms among adults with mild COVID-19: A randomized clinical trial, JAMA
Mahase, Covid-19: Pfizer's paxlovid is 89% effective in patients at risk of serious illness, company reports, BMJ
Meo, Klonoff, Akram, Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19, Eur Rev Med Pharmacol Sci
Mitjà, Corbacho-Monné, Ubals, Alemany, Suñer et al., A cluster-randomized trial of hydroxychloroquine for prevention of Covid-19, N Engl J Med
Niaee, Namdar, Allami, Zolghadr, Javadi et al., Ivermectin as an adjunct treatment for hospitalized adult COVID-19 patients: A randomized multi-center clinical trial, Asian Pac J Trop Med
Rajter, Sherman, Fatteh, Vogel, Sacks et al., Use of ivermectin is associated with lower mortality in hospitalized patients with coronavirus disease 2019: The ivermectin in COVID nineteen study, Chest
Ranjbar, Moghadami, Mirahmadizadeh, Fallahi, Khaloo et al., Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: A triple-blinded randomized controlled trial, BMC Infect Dis
Reis, Silva, Silva, Thabane, Singh et al., Effect of early treatment with hydroxychloroquine or lopinavir and ritonavir on risk of hospitalization among patients with COVID-19: The TOGETHER randomized clinical trial, JAMA Netw Open
Salvarani, Dolci, Massari, Merlo, Cavuto et al., Effect of tocilizumab vs. standard care on clinical worsening in patients hospitalized with COVID-19 pneumonia: A randomized clinical tTrial, JAMA Intern Med
Singh, Sheth, Dhaneria, Gupta, Efficacy and safety of ivermectin for COVID-19: A systematic review and meta-analysis, Asian Pac J Trop Med
Valencia, Brief review on COVID-19: The 2020 pandemic caused by SARS-CoV-2, Cureus
Wu, Chen, Chan, The outbreak of COVID-19: An overview, J Chin Med Assoc
Wölfel, Corman, Guggemos, Seilmaier, Zange et al., Virological assessment of hospitalized patients with COVID-2019, Nature
Zou, Ruan, Huang, Liang, Huang et al., SARS-CoV-2 viral load in upper respiratory specimens of infected patients, N Engl J Med
