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Article
Efficacy and Safety of Ivermectin for Treatment and prophylaxis of COVID-19 Pandemic
Ahmed Elgazzar
Banha University
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Up-to-date, there is no recognized effective treatment or vaccine for the treatment of COVID-19 that emphasize urgency around distinctive effective therapies. This study aims to evaluate the anti-parasitic medication efficacy "Ivermectin" plus standard care in the treatment of mild/moderate and severely ill cases with COVID 19 infection, as well as prophylaxis of health care and/ or household contacts.
Subject and methods: 600 subjects; 400 symptomatic confirmed COVID-19 patients and 200 health care and household contacts distributed over 6 groups; Group I: 100 patients with mild/moderate COVID-19 infection received a 4-days course of Ivermectin plus standard of care; Group II: 100 patients with mild/moderate COVID-19 infection received hydroxychloroquine plus standard care; Group III: 100 patients with severe COVID-19 infection received Ivermectin plus standar care; Group IV: 100 patients with Severe COVID-19 infection received hydroxychloroquine plus standard care. Routine laboratory investigations and rT-PCR, were reported before and after initiation of treatment. Group V stick to personal protective measures (PPM ) plus Ivermectin o.4mg / kg on empty stomach to be repeated after one week, and group VI stick to PPM only .Both groups V&VI were followed for two weeks ..
Results: Patients received ivermectin early reported substantial recovery of laboratory investigations; and significant reduction in rT-PCR conversion days. A substantial improvement and reduction in mortality rate in Ivermectin treated groups; group I (99% & 0.0%, respectively) and group III (94% & 2.0% respectively) versus hydroxychloroquine plus standard care treated groups; group II (74% and 4%, respectively) and group IV (50% and 20%, respectively). Ivermectin had significantly reduced the incidence of infection in health care and household contacts up to 2% compared to 10% in non ivermectin group when used as a prophylaxis.
Conclusion: Early addition of Ivermectin to standard care is very effective drug for treatment of COVID-19 patients with significant reduction in mortality,rt-PCR conversion days , recovery time hospital stay compared to Hydroxychloroquine plus standard care. Early use of Ivermectin is very useful for controlling COVID 19 infections; prophylaxis and improving cytokines storm
Keywords
Ivermectin, COVID-19, Hydroxychloroquine
Figure 1
HC
commented on 12 January, 2021
How come you do not provide a flowchart describing the enrollment process for randomization and the excluded individuals? What exactly do you mean by "Any patient demonstrates worsening of symptoms; radiological progression with virologically persistence within at least 7 days of the therapeutic evaluation period of the study after exclusion of cytokine storm was considered as a clinical failure and was shifted to the other management"? Do you mean these patients were shifted to the control group?
HC
commented on 12 January, 2021
How come tables 2 and 3, reporting results one week after starting treatment, mention "RT-PCR days" much greater than one week?
HC
commented on 12 January, 2021
Do I understand correctly that you followed patients for two weeks? Follow-up in covid-19 studies reporting mortality results usually last 3-4 weeks. Could you also detail how you define prognosis as "improved" or "progressed" in tables 4 and 6? Are these evaluated after two weeks? Thanks for your replies.
HC
commented on 12 January, 2021
One last thing: you report "After the calculation of each of the test statistics, the corresponding distribution tables were counseled to get the “P” (probability value)". Isn't the p-value provided by the statistical software you used?
Radwan Derbala
commented on 21 January, 2021
Very proud to have such clinical trials in Egypt! Congratulation to the research team and Benha University👏
Jacki Graham
commented on 24 January, 2021
I have a liquid, 1% solution of ivermectin. What would be the correct single dose for the standard 150-200 ug/kg daily when using the 1% solution. I have a syringe that measures from .1 to 3 milligrams.
View 1 reply
Marco Camion
commented on 26 January, 2021
Yes, well done to Brazillian and other doctors who are saving lives rather than promoting their own interests. Unfortunately, the conclusion of this study contradicts the evidence it presents and calls for more studies to be done before approval. Why on earth would it do that with a reported 75% success rate against Covid-19 fatalities and it is one of the safest drugs on earth! Something is wrong here!
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This is a preprint. It has not completed peer review.
Article
Efficacy and Safety of Ivermectin for Treatment and prophylaxis of COVID-19 Pandemic
Ahmed Elgazzar
Banha University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 3
Posted 28 Dec, 2020
Community comments: 8
Community comments: 55
Community comments: 6
Metrics
Comments: 8
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Up-to-date, there is no recognized effective treatment or vaccine for the treatment of COVID-19 that emphasize urgency around distinctive effective therapies. This study aims to evaluate the anti-parasitic medication efficacy "Ivermectin" plus standard care in the treatment of mild/moderate and severely ill cases with COVID 19 infection, as well as prophylaxis of health care and/ or household contacts.
Subject and methods: 600 subjects; 400 symptomatic confirmed COVID-19 patients and 200 health care and household contacts distributed over 6 groups; Group I: 100 patients with mild/moderate COVID-19 infection received a 4-days course of Ivermectin plus standard of care; Group II: 100 patients with mild/moderate COVID-19 infection received hydroxychloroquine plus standard care; Group III: 100 patients with severe COVID-19 infection received Ivermectin plus standar care; Group IV: 100 patients with Severe COVID-19 infection received hydroxychloroquine plus standard care. Routine laboratory investigations and rT-PCR, were reported before and after initiation of treatment. Group V stick to personal protective measures (PPM ) plus Ivermectin o.4mg / kg on empty stomach to be repeated after one week, and group VI stick to PPM only .Both groups V&VI were followed for two weeks ..
Results: Patients received ivermectin early reported substantial recovery of laboratory investigations; and significant reduction in rT-PCR conversion days. A substantial improvement and reduction in mortality rate in Ivermectin treated groups; group I (99% & 0.0%, respectively) and group III (94% & 2.0% respectively) versus hydroxychloroquine plus standard care treated groups; group II (74% and 4%, respectively) and group IV (50% and 20%, respectively). Ivermectin had significantly reduced the incidence of infection in health care and household contacts up to 2% compared to 10% in non ivermectin group when used as a prophylaxis.
Conclusion: Early addition of Ivermectin to standard care is very effective drug for treatment of COVID-19 patients with significant reduction in mortality,rt-PCR conversion days , recovery time hospital stay compared to Hydroxychloroquine plus standard care. Early use of Ivermectin is very useful for controlling COVID 19 infections; prophylaxis and improving cytokines storm
Figure 1
HC
commented on 12 January, 2021
How come you do not provide a flowchart describing the enrollment process for randomization and the excluded individuals? What exactly do you mean by "Any patient demonstrates worsening of symptoms; radiological progression with virologically persistence within at least 7 days of the therapeutic evaluation period of the study after exclusion of cytokine storm was considered as a clinical failure and was shifted to the other management"? Do you mean these patients were shifted to the control group?
HC
commented on 12 January, 2021
How come tables 2 and 3, reporting results one week after starting treatment, mention "RT-PCR days" much greater than one week?
HC
commented on 12 January, 2021
Do I understand correctly that you followed patients for two weeks? Follow-up in covid-19 studies reporting mortality results usually last 3-4 weeks. Could you also detail how you define prognosis as "improved" or "progressed" in tables 4 and 6? Are these evaluated after two weeks? Thanks for your replies.
HC
commented on 12 January, 2021
One last thing: you report "After the calculation of each of the test statistics, the corresponding distribution tables were counseled to get the “P” (probability value)". Isn't the p-value provided by the statistical software you used?
Radwan Derbala
commented on 21 January, 2021
Very proud to have such clinical trials in Egypt! Congratulation to the research team and Benha University👏
Jacki Graham
commented on 24 January, 2021
I have a liquid, 1% solution of ivermectin. What would be the correct single dose for the standard 150-200 ug/kg daily when using the 1% solution. I have a syringe that measures from .1 to 3 milligrams.
View 1 reply
Warren P Jessop
replied on 25 January, 2021
Aloha Jacki, Without knowing the weight of the being that will take the Ivermectin, your question cannot be answered. As you might surmise, the more the patient weighs, the more Ivermectin the patient will need. I am not a doctor or mathematician, but I DO know my math...and I've had to figure this out before. But here is the math...so you can figure it out. I used the same method you are using when I treated my dog for heartworms with 1% Ivermectin about 10 years ago. Those skinny insulin syringes do a good job for measuring small amounts of the 1% liquid. A 1% solution contains 1/100 gr of Ivermectin in every ml of the liquid. Accordingly, 1/10 cc of the solution will contain 1/1000 gr (or 1 milligram) of Ivermectin. So, one cubic centimeter (ml) of the 1% Ivermectin solution will yield 10 milligrams of Ivermectin. To figure the dosage...If the patient weighs 135 pounds (61.36 kg), and you use the dosage rate of 200 micrograms per kilogram, then the dosage equals 200 x 61.36, or 12,272 micrograms, or 12.27 milligrams. To measure that dosage using your syringe, you would measure 1.27 cc of the solution. I simply dripped it from the syringe onto my dog's food and then made sure she ate all of it. A simpler way of stating it is found on the NIH site for Ivermectin dosage in cattle (https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=40b9d864-3ad3-4d43-9868-c380f5977d9f&type=display): 1 ml per 110 lbs of weight Work carefully, I wish you well...
Marco Camion
commented on 26 January, 2021
Yes, well done to Brazillian and other doctors who are saving lives rather than promoting their own interests. Unfortunately, the conclusion of this study contradicts the evidence it presents and calls for more studies to be done before approval. Why on earth would it do that with a reported 75% success rate against Covid-19 fatalities and it is one of the safest drugs on earth! Something is wrong here!
Warren P Jessop
replied on 25 January, 2021
Aloha Jacki, Without knowing the weight of the being that will take the Ivermectin, your question cannot be answered. As you might surmise, the more the patient weighs, the more Ivermectin the patient will need. I am not a doctor or mathematician, but I DO know my math...and I've had to figure this out before. But here is the math...so you can figure it out. I used the same method you are using when I treated my dog for heartworms with 1% Ivermectin about 10 years ago. Those skinny insulin syringes do a good job for measuring small amounts of the 1% liquid. A 1% solution contains 1/100 gr of Ivermectin in every ml of the liquid. Accordingly, 1/10 cc of the solution will contain 1/1000 gr (or 1 milligram) of Ivermectin. So, one cubic centimeter (ml) of the 1% Ivermectin solution will yield 10 milligrams of Ivermectin. To figure the dosage...If the patient weighs 135 pounds (61.36 kg), and you use the dosage rate of 200 micrograms per kilogram, then the dosage equals 200 x 61.36, or 12,272 micrograms, or 12.27 milligrams. To measure that dosage using your syringe, you would measure 1.27 cc of the solution. I simply dripped it from the syringe onto my dog's food and then made sure she ate all of it. A simpler way of stating it is found on the NIH site for Ivermectin dosage in cattle (https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=40b9d864-3ad3-4d43-9868-c380f5977d9f&type=display): 1 ml per 110 lbs of weight Work carefully, I wish you well...