Ivermectin treatment may improve the prognosis of patients with COVID-19

Abstract: 828 Cartas Científicas / Arch Bronconeumol. 2020;56(12):816–830 María Teresa Gómez-Hernández a,∗ , Nuria M. Novoa a , Patricia Antúnez b , Marcelo F. Jiménez a ∗ Corresponding author. E-mail address: mteresa.gomez.hernandez@gmail.com (M.T. Gómez-Hernández). a Service of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain b Service of Anatomical Pathology, Salamanca University Hospital, Salamanca, Spain Ivermectin Treatment May Improve the Prognosis of Patients With COVID-19 El tratamiento con ivermectina puede mejorar el pronóstico de los pacientes con COVID-19 Dear Editor: The pandemic coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been spread rapidly worldwide with considerable morbidity and mortality. COVID-19 patients have various clinical presentations: asymptomatic, exhibit mild flu-like symptoms, be severely ill or death.1,2 In addition to elder age and comorbidities, higher levels of D-dimer and C-reactive protein (CRP) and lower levels of lymphocyte and eosinophil as well as a cytokine storm are associated with disease severity in COVID-19 patients.3–6 The virus load may be a main determinant underlying the pathological diversity in COVID-19 patients.1,2,6 Thus, an effective antiviral treatment is essential to improve the prognosis of patients with COVID-19.7 In the absence of specific anti-SARS-CoV-2 agents, various drugs with antiviral potential are now used to contain the virus in COVID-19 patients. Ivermectin, a US FDA-approved anthelminthic, has garnered enormous interest for treating COVID-19 as it is safe and cheap and has strong antiviral activities against board ranges of viruses including SARS-CoV-2 in vitro.8–10 Despite the widespread use of ivermectin, to our knowledge, there is currently no published clinical reports of ivermectin in COVID-19 patients. Here, we assessed the clinical efficacy of ivermectin in COVID-19 patients. This retrospective study enrolled a total of 325 consecutive patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) of nasal swabs in SK hospital, a unit dedicated to COVID-19 at Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh, from April to June 2020. Of these, the present study included 248 adult COVID-19 patients free from any other serious pathological conditions: 115 received ivermectin plus standard care (SC), while 133 received only SC. Remaining 77 patients who were under 18 years of age or transferred from other facilities and received different management approaches including partial hospital stays or treated with different therapeutic agents prior to hospital admission were excluded from the analysis. The two groups were compared in terms of time to SARS-CoV-2 negativity, disease progression (develop pneumonia to severe respiratory distress), duration of hospital stays, and mortality rate. Ivermectin was given once at dose of 12 mg within 24-h after hospital admission. SC was provided as required and included antipyretics for fever, anti-histamines for cough, and antibiotics to control secondary infection. The study was approved by MMCH and informed consent was obtained from all patients or their relatives before starting treatment. Categorical variables are shown as frequencies and percentages and continuous variables as the median and interquartile range (IQR). Differences with 95% confidence intervals (CI) were computed to show the level of certainty...