The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial.

Anosmia COVID-19 Hyposmia Ivermectin SARS-CoV-2

Journal

EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 01 12 2020
revised: 28 12 2020
accepted: 28 12 2020
pubmed: 27 1 2021
medline: 27 1 2021
entrez: 26 1 2021
Statut: ppublish

Résumé

Ivermectin inhibits the replication of SARS-CoV-2 in vitro at concentrations not readily achievable with currently approved doses. There is limited evidence to support its clinical use in COVID-19 patients. We conducted a Pilot, randomized, double-blind, placebo-controlled trial to evaluate the efficacy of a single dose of ivermectin reduce the transmission of SARS-CoV-2 when administered early after disease onset. Consecutive patients with non-severe COVID-19 and no risk factors for complicated disease attending the emergency room of the Clínica Universidad de Navarra between July 31, 2020 and September 11, 2020 were enrolled. All enrollments occurred within 72 h of onset of fever or cough. Patients were randomized 1:1 to receive ivermectin, 400 mcg/kg, single dose ( All patients recruited completed the trial (median age, 26 [IQR 19-36 in the ivermectin and 21-44 in the controls] years; 12 [50%] women; 100% had symptoms at recruitment, 70% reported headache, 62% reported fever, 50% reported general malaise and 25% reported cough). At day 7, there was no difference in the proportion of PCR positive patients (RR 0·92, 95% CI: 0·77-1·09, Among patients with non-severe COVID-19 and no risk factors for severe disease receiving a single 400 mcg/kg dose of ivermectin within 72 h of fever or cough onset there was no difference in the proportion of PCR positives. There was however a marked reduction of self-reported anosmia/hyposmia, a reduction of cough and a tendency to lower viral loads and lower IgG titers which warrants assessment in larger trials. ISGlobal, Barcelona Institute for Global Health and Clínica Universidad de Navarra.

Sections du résumé

BACKGROUND BACKGROUND
Ivermectin inhibits the replication of SARS-CoV-2 in vitro at concentrations not readily achievable with currently approved doses. There is limited evidence to support its clinical use in COVID-19 patients. We conducted a Pilot, randomized, double-blind, placebo-controlled trial to evaluate the efficacy of a single dose of ivermectin reduce the transmission of SARS-CoV-2 when administered early after disease onset.
METHODS METHODS
Consecutive patients with non-severe COVID-19 and no risk factors for complicated disease attending the emergency room of the Clínica Universidad de Navarra between July 31, 2020 and September 11, 2020 were enrolled. All enrollments occurred within 72 h of onset of fever or cough. Patients were randomized 1:1 to receive ivermectin, 400 mcg/kg, single dose (
FINDINGS RESULTS
All patients recruited completed the trial (median age, 26 [IQR 19-36 in the ivermectin and 21-44 in the controls] years; 12 [50%] women; 100% had symptoms at recruitment, 70% reported headache, 62% reported fever, 50% reported general malaise and 25% reported cough). At day 7, there was no difference in the proportion of PCR positive patients (RR 0·92, 95% CI: 0·77-1·09,
INTERPRETATION CONCLUSIONS
Among patients with non-severe COVID-19 and no risk factors for severe disease receiving a single 400 mcg/kg dose of ivermectin within 72 h of fever or cough onset there was no difference in the proportion of PCR positives. There was however a marked reduction of self-reported anosmia/hyposmia, a reduction of cough and a tendency to lower viral loads and lower IgG titers which warrants assessment in larger trials.
FUNDING BACKGROUND
ISGlobal, Barcelona Institute for Global Health and Clínica Universidad de Navarra.

Identifiants

pubmed: 33495752
doi: 10.1016/j.eclinm.2020.100720
pii: S2589-5370(20)30464-8
pmc: PMC7816625
doi:

Banques de données

ClinicalTrials.gov
['NCT04390022']

Types de publication

Journal Article

Langues

eng

Pagination

100720

Informations de copyright

© 2021 The Author(s).

Déclaration de conflit d'intérêts

JLDP reports speaker fees from Pfizer and MSD as well as research grants from Novartis, outside the scope of the submitted work. No other competing interests were disclosed

Auteurs

Carlos Chaccour (C)

ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
Clínica Universidad de Navarra, Pamplona, Spain.
Ifakara Health Institute, Ifakara, Tanzania.

Aina Casellas (A)

ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain.

Andrés Blanco-Di Matteo (A)

Clínica Universidad de Navarra, Pamplona, Spain.

Iñigo Pineda (I)

Clínica Universidad de Navarra, Pamplona, Spain.

Alejandro Fernandez-Montero (A)

Clínica Universidad de Navarra, Pamplona, Spain.

Paula Ruiz-Castillo (P)

ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.

Mary-Ann Richardson (MA)

ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.

Mariano Rodríguez-Mateos (M)

Clínica Universidad de Navarra, Pamplona, Spain.

Carlota Jordán-Iborra (C)

Clínica Universidad de Navarra, Pamplona, Spain.

Joe Brew (J)

Databrew, Gainesville, FL, United States.

Francisco Carmona-Torre (F)

Clínica Universidad de Navarra, Pamplona, Spain.
IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.

Miriam Giráldez (M)

Clínica Universidad de Navarra, Pamplona, Spain.

Ester Laso (E)

Clínica Universidad de Navarra, Pamplona, Spain.

Juan C Gabaldón-Figueira (JC)

Clínica Universidad de Navarra, Pamplona, Spain.

Carlota Dobaño (C)

ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.

Gemma Moncunill (G)

ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
Harvard T.H. Chan School of Public Health, Boston, MA, United States.

José R Yuste (JR)

Clínica Universidad de Navarra, Pamplona, Spain.

Jose L Del Pozo (JL)

Clínica Universidad de Navarra, Pamplona, Spain.

N Regina Rabinovich (NR)

ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
Harvard T.H. Chan School of Public Health, Boston, MA, United States.

Verena Schöning (V)

Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.

Felix Hammann (F)

Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.

Gabriel Reina (G)

Clínica Universidad de Navarra, Pamplona, Spain.
Harvard T.H. Chan School of Public Health, Boston, MA, United States.

Belen Sadaba (B)

Clínica Universidad de Navarra, Pamplona, Spain.

Mirian Fernández-Alonso (M)

Clínica Universidad de Navarra, Pamplona, Spain.

Classifications MeSH