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Evidence from Egypt For ivermectine

  • RCT of 600 patients (400 symptomatic confirmed COVID-19 & 200 healthcare and household contacts)


Evidence from Egypt For ivermectine

Group 1: 100 pts with mild/moderate COVID-19 infection + 4d course of 400ug/kg Ivermectin qD (max dose 24mg) + standard of care

  • Group 2: 100 pts with mild/moderate COVID-19 infection + 400mg hydroxychloroquine BID x1d, then 200mg BID for 5d + standard of care

  • Group 3: 100 pts with severe COVID-19 + 4d course of 400ug/kg Ivermectin qD (max dose 24mg) + standard of care

  • Group 4: 100 pts with severe COVID-19 + 400mg hydroxychloroquine BID x1d, then 200mg BID for 5d + standard of care

  • Group 5: 100 healthcare and/or household contacts PPE + ivermectin 400mcg/kg x1 and repeated in 1 week

  • Group 6: 100 healthcare and/or household contacts PPE only


  • Excluded pregnant, lactating, and critical cases (respiratory failure requiring mechanical ventilation, presence of shock, other organ failure)

  • Mild Cases = Mild symptoms such as anosmia, loss of taste, fever, respiratory or GI tract symptoms

  • Moderate Cases = Symptoms such as fever, respiratory tract or GI symptoms + pneumonia manifestations on chest imaging

  • Severe Cases =

    • RR >30/min

    • O2 sat <93%

    • PaO2/FiO2 < 200

    • Lung infiltrates >50% of lung fields or rapid progression within 24 – 48hrs

    • Respiratory support (i.e. HFNC or NIV or IMV)


  • Primary Endpoint: Improvement in clinical/laboratory investigations and/or 2 consecutive negative PCR tests taken at least 48hours apart, and hospital LOS

  • Results:

    • In mild, moderate and severe COVID-19 patients there was improvement in lymphocyte count, CRP, ferritin, d-dimer and RT-PCR conversion days in Ivermectin group compared to hydroxychloroquine group after one week of treatment

    • Mortality:


  • Mean Hospital LOS:


  • Prevention of COVID-19 Infection in Healthcare or Household Contacts of COVID-19:


  • Limitations:

    • Multiple primary endpoints with many being subjective/soft

    • Trial not registered at clinicaltrials.gov so can’t really check on what outcomes were originally set as primary outcomes and what was added or found through analysis

credited to Rebelem


  • Conclusion: Ivermectin in addition to standard care was more effective in treatment and prophylaxis compared to hydroxychloroquine in addition to standard care according to the authors. Without a placebo arm, we do not know if ivermectin is superior to standard care alone. Additionally, the methodology has concerning issues including multiple primary outcomes.

credited to rebelem


 



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