Throughout the COVID-19 pandemic, numerous therapeutic agents have been repurposed and applied empirically and within clinical trials. Prophylactic medications for COVID-19 could have a huge benefit, but studies to date haven’t panned out. Initially many therapeutic medications were used late in the illness, and one of the criticisms of these negative studies was that the drugs were applied too late in the disease and therefore did not show any benefit. There were also numerous studies showing associations of benefit, but subsequent randomized clinical trials have failed to prove effectiveness in reducing mortality (i.e. Remdesivir, hydroxychloroquine, lopinavir/ritonavir, convalescent plasma, monoclonal antibody therapy).
Ivermectin is an interesting medication that had fallen off my radar until recently. It is an anti-parasitic medication, with potential anti-viral, and anti-inflammatory properties against SARS-CoV-2 and COVID-19. In this post, we will review some of the current evidence in using Ivermectin as a prophylactic and therapeutic agent in COVID-19.
In Vitro Evidence
Cells infected with SARS-CoV-2 RNA
Added Ivermectin or nothing (control) to cells and analyzed RT-PCR for replication of SARS-CoV-2 RNA at days 0 to 3
24h = 93% reduction in viral RNA present
48h = 99.8% reduction in viral RNA present
By 48hrs there was a ≈5000-fold reduction in viral RNA in Ivermectin treated cells compared to control samples
With a single dose of Ivermectin viral replication was controlled effectively eliminating all viral material by 48hrs
No toxicity was observed at anytime
Proposed anti-viral mechanism of action
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