A COVID-19 Prophylaxis? Lower incidence associated with prophylactic administration of Ivermectin

Hellwig et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106248, Nov 2020
Case 78% improvement lower risk ← → higher risk Case b 80% Ivermectin  Hellwig et al.  PROPHYLAXIS Does ivermectin reduce COVID-19 infections? Ecological study in multiple countries Fewer cases with ivermectin (p=0.017) c19early.org Hellwig et al., Int. J. Antimicrobial .., Nov 2020 0 0.5 1 1.5 2+ RR
Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020, now with p < 0.00000000001 from 106 studies, recognized in 24 countries.
No treatment is 100% effective. Protocols combine treatments.
6,600+ studies for 220+ treatments. c19early.org
Analysis of COVID-19 cases vs. widespread prophylactic use of ivermectin for parasitic infections showing significantly lower incidence of COVID-19 cases.
This is the 22nd of 106 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001.
54 studies are RCTs, which show efficacy with p=0.00000004.
This study is excluded in the after exclusion results of meta-analysis: not a typical trial, analysis of African countries that used or did not use ivermectin prophylaxis for parasitic infections.
risk of case, 78.0% lower, RR 0.22, p < 0.02, African countries, PCTI vs. no PCT, relative cases per capita.
risk of case, 80.0% lower, RR 0.20, p < 0.001, worldwide, PCTI vs. no PCT, relative cases per capita.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Hellwig et al., 28 Nov 2020, retrospective, ecological study, multiple countries, peer-reviewed, 2 authors, dosage 200μg/kg, dose varied, typically 150-200μg/kg.
A COVID-19 prophylaxis? Lower incidence associated with prophylactic administration of ivermectin
Martin D Hellwig, Anabela Maia
International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106248
Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre -including this research content -immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Supplementary materials Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.ijantimicag.2020. 106248 .
References
Al-Tawfiq, Al-Homoud, Memish, Remdesivir as a possible therapeutic option for the COVID-19, Travel Med Infect Dis, doi:10.1016/j.tmaid.2020.101615
Allcott, Boxell, Conway, Gentzkow, Thaler et al., Polarization and public health: partisan differences in social distancing during the coronavirus pandemic, National Bureau of Economic Research, doi:10.3386/w26946
Caly, Druce, Catton, Jans, Wagstaff, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, Antiviral Res, doi:10.1016/j.antiviral.2020.104787
Cohen, Vaccine designers take first shots at COVID-19, Science, doi:10.1126/science.368.6486.14
Colson, Rolain, Lagier, Brouqui, Raoult, Chloroquine and hydroxychloroquine as available weapons to fight COVID-19, Int J Antimicrob Agents, doi:10.1016/j.ijantimicag.2020.105932
Fink, Porras, Pharmacokinetics of ivermectin in animals and humans, doi:10.1007/978-1-4612-3626-9_7
Greene, Taylor, Cupp, Murphy, White et al., Comparison of ivermectin and diethylcarbamazine in the treatment of onchocerciasis, N Engl J Med, doi:10.1056/NEJM198507183130301
Heidary, Gharebaghi, a systematic review from antiviral effects to COVID-19 complementary regimen, J Antibiot, doi:10.1038/s41429-020-0336-z
Munster, Koopmans, Van Doremalen, Van Riel, De, A novel coronavirus emerging in China-key questions for impact assessment, N Engl J Med, doi:10.1056/NEJMp2000929
Muñoz, Ballester, Antonijoan, Gich, Rodríguez et al., Safety and pharmacokinetic profile of fixed-dose ivermectin with an innovative 18mg tablet in healthy adult volunteers, PLoS Negl Trop Dis, doi:10.1371/journal.pntd.0006020
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:10.2139/ssrn.3631261
Richard-Lenoble, Chandenier, Gaxotte, Ivermectin and filariasis, Fundam Clin Pharmacol, doi:10.1046/j.1472-8206.2003.00170.x
Scheim, Ivermectin for COVID-19 treatment: clinical response at quasithreshold doses via hypothesized alleviation of CD147-mediated vascular occlusion, doi:10.2139/ssrn.3636557
Schmith, Zhou, Lohmer, The approved dose of ivermectin alone is not the ideal dose for the treatment of COVID-19, Clin Pharmacol Ther, doi:10.1002/cpt.1889
Singer, The COVID-19 pandemic: growth patterns, power law scaling, and saturation, Phys Biol, doi:10.1088/1478-3975/ab9bf5
Van Norman Gadrugs, Devices, and the FDA: Part 1: an overview of approval processes for drugs, JACC Basic Transl Sci, doi:10.1016/j.jacbts.2016.03.002
Wang, Horby, Hayden, Gao, A novel coronavirus outbreak of global health concern, Lancet, doi:10.1016/S0140-6736(20)30185-9
Zhou, Hou, Shen, Huang, Martin et al., Network-based drug repurposing for novel coronavirus 2019-nCoV/SARS-CoV-2, Cell Discov, doi:10.1038/s41421-020-0153-3
DOI record: { "DOI": "10.1016/j.ijantimicag.2020.106248", "ISSN": [ "0924-8579" ], "URL": "http://dx.doi.org/10.1016/j.ijantimicag.2020.106248", "alternative-id": [ "S0924857920304684" ], "article-number": "106248", "assertion": [ { "label": "This article is maintained by", "name": "publisher", "value": "Elsevier" }, { "label": "Article Title", "name": "articletitle", "value": "A COVID-19 prophylaxis? Lower incidence associated with prophylactic administration of ivermectin" }, { "label": "Journal Title", "name": "journaltitle", "value": "International Journal of Antimicrobial Agents" }, { "label": "CrossRef DOI link to publisher maintained version", "name": "articlelink", "value": "https://doi.org/10.1016/j.ijantimicag.2020.106248" }, { "label": "Content Type", "name": "content_type", "value": "article" }, { "label": "Copyright", "name": "copyright", "value": "© 2020 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved." } ], "author": [ { "ORCID": "http://orcid.org/0000-0001-8841-7545", "affiliation": [], "authenticated-orcid": false, "family": "Hellwig", "given": "Martin D.", "sequence": "first" }, { "affiliation": [], "family": "Maia", "given": "Anabela", "sequence": "additional" } ], "container-title": "International Journal of Antimicrobial Agents", "container-title-short": "International Journal of Antimicrobial Agents", "content-domain": { "crossmark-restriction": true, "domain": [ "clinicalkey.jp", "clinicalkey.com", "clinicalkey.es", "clinicalkey.com.au", "clinicalkey.fr", "elsevier.com", "sciencedirect.com" ] }, "created": { "date-parts": [ [ 2020, 11, 28 ] ], "date-time": "2020-11-28T16:15:37Z", "timestamp": 1606580137000 }, "deposited": { "date-parts": [ [ 2021, 3, 8 ] ], "date-time": "2021-03-08T09:41:34Z", "timestamp": 1615196494000 }, "indexed": { "date-parts": [ [ 2024, 3, 28 ] ], "date-time": "2024-03-28T16:36:50Z", "timestamp": 1711643810150 }, "is-referenced-by-count": 40, "issue": "1", "issued": { "date-parts": [ [ 2021, 1 ] ] }, "journal-issue": { "issue": "1", "published-print": { "date-parts": [ [ 2021, 1 ] ] } }, "language": "en", "license": [ { "URL": "https://www.elsevier.com/tdm/userlicense/1.0/", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 1, 1 ] ], "date-time": "2021-01-01T00:00:00Z", "timestamp": 1609459200000 } } ], "link": [ { "URL": "https://api.elsevier.com/content/article/PII:S0924857920304684?httpAccept=text/xml", "content-type": "text/xml", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://api.elsevier.com/content/article/PII:S0924857920304684?httpAccept=text/plain", "content-type": "text/plain", "content-version": "vor", "intended-application": "text-mining" } ], "member": "78", "original-title": [], "page": "106248", "prefix": "10.1016", "published": { "date-parts": [ [ 2021, 1 ] ] }, "published-print": { "date-parts": [ [ 2021, 1 ] ] }, "publisher": "Elsevier BV", "reference": [ { "DOI": "10.1016/S0140-6736(20)30185-9", "article-title": "A novel coronavirus outbreak of global health concern", "author": "Wang", "doi-asserted-by": "crossref", "first-page": "470", "journal-title": "Lancet", "key": "10.1016/j.ijantimicag.2020.106248_bib0001", "volume": "395", "year": "2020" }, { "DOI": "10.1056/NEJMp2000929", "article-title": "A novel coronavirus emerging in China—key questions for impact assessment", "author": "Munster", "doi-asserted-by": "crossref", "first-page": "692", "journal-title": "N Engl J Med", "key": "10.1016/j.ijantimicag.2020.106248_bib0002", "volume": "382", "year": "2020" }, { "key": "10.1016/j.ijantimicag.2020.106248_bib0003", "series-title": "COVID-19 coronavirus pandemic", "year": "2020" }, { "article-title": "Polarization and public health: partisan differences in social distancing during the coronavirus pandemic. Working Paper 26946", "author": "Allcott", "journal-title": "National Bureau of Economic Research", "key": "10.1016/j.ijantimicag.2020.106248_bib0004", "year": "2020" }, { "DOI": "10.1088/1478-3975/ab9bf5", "article-title": "The COVID-19 pandemic: growth patterns, power law scaling, and saturation", "author": "Singer", "doi-asserted-by": "crossref", "journal-title": "Phys Biol", "key": "10.1016/j.ijantimicag.2020.106248_bib0005", "volume": "17", "year": "2020" }, { "DOI": "10.1126/science.368.6486.14", "article-title": "Vaccine designers take first shots at COVID-19", "author": "Cohen", "doi-asserted-by": "crossref", "first-page": "14", "journal-title": "Science", "key": "10.1016/j.ijantimicag.2020.106248_bib0006", "volume": "368", "year": "2020" }, { "DOI": "10.1016/j.jacbts.2016.03.002", "article-title": "Drugs, devices, and the FDA: Part 1: an overview of approval processes for drugs", "doi-asserted-by": "crossref", "first-page": "170", "journal-title": "JACC Basic Transl Sci", "key": "10.1016/j.ijantimicag.2020.106248_bib0007", "volume": "1", "year": "2016" }, { "DOI": "10.1038/s41421-020-0153-3", "article-title": "Network-based drug repurposing for novel coronavirus 2019-nCoV/SARS-CoV-2", "author": "Zhou", "doi-asserted-by": "crossref", "first-page": "14", "journal-title": "Cell Discov", "key": "10.1016/j.ijantimicag.2020.106248_bib0008", "volume": "6", "year": "2020" }, { "DOI": "10.1016/j.ijantimicag.2020.105932", "article-title": "Chloroquine and hydroxychloroquine as available weapons to fight COVID-19", "author": "Colson", "doi-asserted-by": "crossref", "journal-title": "Int J Antimicrob Agents", "key": "10.1016/j.ijantimicag.2020.106248_bib0009", "volume": "55", "year": "2020" }, { "DOI": "10.1016/j.tmaid.2020.101615", "article-title": "Remdesivir as a possible therapeutic option for the COVID-19", "author": "Al-Tawfiq", "doi-asserted-by": "crossref", "journal-title": "Travel Med Infect Dis", "key": "10.1016/j.ijantimicag.2020.106248_bib0010", "volume": "34", "year": "2020" }, { "DOI": "10.1016/j.antiviral.2020.104787", "article-title": "The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro", "author": "Caly", "doi-asserted-by": "crossref", "journal-title": "Antiviral Res", "key": "10.1016/j.ijantimicag.2020.106248_bib0011", "volume": "178", "year": "2020" }, { "DOI": "10.1046/j.1472-8206.2003.00170.x", "article-title": "Ivermectin and filariasis", "author": "Richard-Lenoble", "doi-asserted-by": "crossref", "first-page": "199", "journal-title": "Fundam Clin Pharmacol", "key": "10.1016/j.ijantimicag.2020.106248_bib0012", "volume": "17", "year": "2003" }, { "DOI": "10.1056/NEJM198507183130301", "article-title": "Comparison of ivermectin and diethylcarbamazine in the treatment of onchocerciasis", "author": "Greene", "doi-asserted-by": "crossref", "first-page": "133", "journal-title": "N Engl J Med", "key": "10.1016/j.ijantimicag.2020.106248_bib0013", "volume": "313", "year": "1985" }, { "DOI": "10.2139/ssrn.3636557", "article-title": "Ivermectin for COVID-19 treatment: clinical response at quasi-threshold doses via hypothesized alleviation of CD147-mediated vascular occlusion", "author": "Scheim", "doi-asserted-by": "crossref", "journal-title": "SSRN", "key": "10.1016/j.ijantimicag.2020.106248_bib0014", "year": "2020" }, { "DOI": "10.2139/ssrn.3631261", "article-title": "ICON (Ivermectin in COvid Nineteen) Study: use of ivermectin is associated with lower mortality in hospitalized patients with COVID-19", "author": "Rajter", "doi-asserted-by": "crossref", "journal-title": "SSRN", "key": "10.1016/j.ijantimicag.2020.106248_bib0015", "year": "2020" }, { "DOI": "10.1038/s41429-020-0336-z", "article-title": "a systematic review from antiviral effects to COVID-19 complementary regimen", "author": "Heidary", "doi-asserted-by": "crossref", "first-page": "593", "journal-title": "J Antibiot (Tokyo)", "key": "10.1016/j.ijantimicag.2020.106248_bib0016", "volume": "73", "year": "2020" }, { "DOI": "10.1371/journal.pntd.0006020", "article-title": "Safety and pharmacokinetic profile of fixed-dose ivermectin with an innovative 18mg tablet in healthy adult volunteers", "author": "Muñoz", "doi-asserted-by": "crossref", "journal-title": "PLoS Negl Trop Dis", "key": "10.1016/j.ijantimicag.2020.106248_bib0017", "volume": "12", "year": "2018" }, { "key": "10.1016/j.ijantimicag.2020.106248_bib0018", "series-title": "PCT Databank", "year": "2020" }, { "DOI": "10.1002/cpt.1889", "article-title": "The approved dose of ivermectin alone is not the ideal dose for the treatment of COVID-19", "author": "Schmith", "doi-asserted-by": "crossref", "first-page": "762", "journal-title": "Clin Pharmacol Ther", "key": "10.1016/j.ijantimicag.2020.106248_bib0019", "volume": "108", "year": "2020" }, { "article-title": "Pharmacokinetics of ivermectin in animals and humans", "author": "Fink", "first-page": "113", "key": "10.1016/j.ijantimicag.2020.106248_bib0020", "series-title": "Ivermectin and abamectin", "year": "1989" }, { "key": "10.1016/j.ijantimicag.2020.106248_bib0021", "series-title": "COVID-19 and ivermectin intended for animals", "year": "2020" } ], "reference-count": 21, "references-count": 21, "relation": {}, "resource": { "primary": { "URL": "https://linkinghub.elsevier.com/retrieve/pii/S0924857920304684" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [ "Pharmacology (medical)", "Infectious Diseases", "Microbiology (medical)", "General Medicine" ], "subtitle": [], "title": "A COVID-19 prophylaxis? Lower incidence associated with prophylactic administration of ivermectin", "type": "journal-article", "update-policy": "http://dx.doi.org/10.1016/elsevier_cm_policy", "volume": "57" }
Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ 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. IMA and WCH provide treatment protocols.
Submit