Ivermectin and COVID-19 – Revision

Please refer to the original post here:
(Ivermectin as a Prophylactic and Treatment for COVID-19)

Because of flawed information flowing in on the efficacy or inefficiency of ivermectin, I have added some further research to this blog. Please refer to the original blog here for more details:

BBC, Science Wire, and several other media outlets discrediting ivermectin by stating “ALL” the research is flawed. While interesting, they use this SINGLE study from June 2021[i] to back the point that ivermectin does not work. The conclusion of this study states “Compared with the standard of care or placebo, IVM did not reduce all-cause mortality, LOS, or viral clearance in RCTs in patients with mostly mild COVID-19. IVM did not have an effect on AEs or SAEs and is not a viable option to treat patients with COVID-19.” With my further research into their own study, it is clear that it is their own referenced study that is flawed. Three of the papers that hadn’t yet been published when they carried out their study do not support what they claim, and in fact, they state the opposite.

Study #1 titled “Antiviral effect of high-dose ivermectin in adults with COVID-19: a pilot randomised, controlled, open label, multicentre trial”[ii] wasn’t published until June 2021 and showed that ivermectin (IVM) was beneficial – “45 participants were recruited (30 to IVM and 15 controls) between May 18 and September 9, 2020. There was no difference in viral load reduction between groups, but a significant difference was found in patients with higher median plasma IVM levels versus untreated controls. Mean ivermectin plasma concentration levels correlated with viral decay rate.”

A second study titled “ivermectin for Prevention and Treatment of COVID-19 Infection: a Systematic Review and Meta-analysis”[iii] was also referenced to support the bottom line stance that ivermectin is ineffective, which based on their own research, is a flawed statement.  Here is what the study actually stated, “When the analysis was limited to patients with baseline mild or moderate disease (8 reports, 1283 patients), there were no differences in mortality between ivermectin and control groups (low level of certainty); in patients with baseline severe diseases (3 reports, 304 patients), the use of ivermectin significantly decreased mortality compared to the controls.” “Three studies (736 subjects) indicated that prophylaxis with ivermectin increased the likelihood of preventing COVID-19 compared to controls (low quality of evidence). Serious adverse events were rarely reported.”

A third study titled “The association between the use of ivermectin and mortality in patients with COVID-19: a meta-analysis”[iv] that was just published in October 2021, concluded with this statement, “We observed a preliminary beneficial effect on mortality associated with ivermectin use in patients with COVID-19 that warrants further clinical evidence in appropriately designed large-scale randomized controlled trials.” This meta-analysis study involved six randomized controlled trials and were included in this analysis with a total of 658 patients who were randomized to receive ivermectin and 597 patients randomized in the control group who did not receive ivermectin.

According to another study (Hill et al), “ivermectin was associated with reduced inflammatory markers (C-Reactive Protein, d-dimer and ferritin) and faster viral clearance by PCR. Viral clearance was treatment dose- and duration-dependent. In six randomized trials of moderate or severe infection, there was a 75% reduction in mortality (Relative Risk=0.25 [95%CI 0.12-0.52]; p=0.0002); 14/650 (2.1%) deaths on ivermectin; 57/597 (9.5%) deaths in controls) with favorable clinical recovery and reduced hospitalization.”[v]  

The one meta-analysis study (Castañeda-Sabogal A et al) that actually states that ivermectin is not useful against Covid ends the paper with this statement. “All of the studies had a high risk of bias and showed a very low certainty of the evidence.”[vi]

Another popular article circulating[vii] by  Jim HoftPearson Sharp, and Gateway PunditOne America News Network, 2 Oct. 2021 states that, “After a second devastating COVID-19 wave, India experienced a sharp decline in the number of COVID-19 cases in many regions, some of them promoting ivermectin use. However, no evidence suggests that ivermectin recommendations are behind the drop in COVID-19 cases.”

In the meantime, in India, people are  clamoring to get their hands on ivermectin, Vitamin D and Zinc, the key components of the Covid-19 medicine kits used in Uttar Pradesh for treatment.

On August 6, 2021, India’s ivermectin media blackout ended with the media finally acknowledging what was contained in those Uttar Pradesh medicine kits. Among the medicines were Doxycycline and ivermectin. https://trialsitenews.com/msn-showcases-the-amazing-uttar-pradesh-turnaround-the-ivermectin-basedhome-medicine-kits/.

On August 25, 2021, the Indian media noticed the discrepancy between Uttar Pradesh’s massive success compared to other states like Kerala’s comparative failure. Although Uttar Pradesh was only 5% vaccinated to Kerala’s 20%, Uttar Pradesh had (only) 22 new COVID cases, while Kerala was overwhelmed with 31,445 in one day. It became apparent that whatever was contained in those treatment kits  was  effective. News18 reported, “Let’s look at the contrasting picture. Kerala, with its 3.5 crore population – or 35 million, on August 25 reported 31,445 new cases, the bulk of the total cases reported in the country. Uttar Pradesh, the biggest state with a population of nearly 24 crore – or 240 million – meanwhile reported just 22 cases in the same period. Uttar Pradesh had given over 6.5 crore – or 65 million – doses, the maximum in the country, but only 25% of people have got their first dose while less than 5% of people are fully vaccinated. Given the present COVID numbers, Uttar Pradesh seems to be trumping Kerala for the tag of the most successful model against COVID.”[viii] 

It seems that everywhere we turn  we are being steered away from safe and effective treatments.[ix] In the meantime, interest in ivermectin in India is increasing and has now reached an all-time high.

Please refer to the rest of the original blog here:

[i] Roman YM, Burela PA, Pasupuleti V, Piscoya A, Vidal JE, Hernandez AV. ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials. Clin Infect Dis. 2021 Jun 28:ciab591. doi: 10.1093/cid/ciab591

[ii] Alejandro Krolewiecki, Adrián Lifschitz, Matías Moragas, Marina Travacio, et. al.,  Antiviral effect of high-dose ivermectin in adults with COVID-19: a pilot randomised, controlled, open label, multicentre trial. RESEARCH PAPER| VOLUME 37, 100959, JULY 01, 2021, Published:June 17, 2021DOI:https://doi.org/10.1016/j.eclinm.2021.100959

[iii] Cruciani M, Pati I, Masiello F, Malena M, Pupella S, De Angelis V. ivermectin for Prophylaxis and Treatment of COVID-19: A Systematic Review and Meta-Analysis. Diagnostics (Basel). 2021 Sep 8;11(9):1645. doi: 10.3390/diagnostics11091645.

[iv] Kow CS, Merchant HA, Mustafa ZU, Hasan SS. The association between the use of ivermectin and mortality in patients with COVID-19: a meta-analysis. Pharmacol Rep. 2021 Oct;73(5):1473-1479. doi: 10.1007/s43440-021-00245-z. Epub 2021 Mar 29. 

[v] Hill A; International ivermectin Project Team . Preliminary meta-analysis of randomized trials of ivermectin to treat SARSCoV-2 infection. Res Sq January 19, 2021. Available from: https://www.researchsquare.com/article/rs-148845/v1.

[vi] Castañeda-Sabogal A, Chambergo-Michilot D, Toro-Huamanchumo CJ, et al. . Outcomes of ivermectin in the treatment of COVID-19: a systematic review and meta-analysis. medRxiv [Preprint: not peer reviewed]. January 27, 2021. Available from: https://www.medrxiv.org/content/10.1101/2021.01.26.21250420v1

[vii] https://www.thedesertreview.com/opinion/columnists/indias-ivermectin-blackout—part-v-the-secret-revealed/ article_9a37d9a8-1fb2-11ec-a94b-47343582647b.html, retrieved 10/15/2021

[viii] https://www.thedesertreview.com/opinion/columnists/indias-ivermectin-blackout—part-v-the-secret-revealed/ article_9a37d9a8-1fb2-11ec-a94b-47343582647b.html India’s ivermectin Blackout – Part V: The Secret Revealed by Justus R. Hope, MD Sep 27, 2021

[ix] https://www.thedesertreview.com/opinion/columnists/the-ivermectin-deworming-hoax—part-ii-eric-claptons-human-rights-warning/article_284902bc-14be-11ec-8d43-43e98275cff8.html

[x] https://www.who.int/india/news/feature-stories/detail/uttar-pradesh-going-the-last-mile-to-stop-covid- 19, retrieved 10/15/2021

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