Like with hydroxychloroquine, some countries began using ivermectin despite lacking evidence on its efficacy in treating or preventing infection. A small pilot study may add evidence that a meta-analysis cannot.
The research team gave one single dose of ivermectin or placebo to 24 patients with confirmed infection and mild symptoms, within the first 72 hours after the first symptoms started. Nasal swabs and blood samples were taken at the moment of enrollment and 1, 2 and/or 3 weeks after treatment.
SAINT Research team.
Seven days after treatments, no difference was observed in the percentage of PCR-positive patients (100% of patients were positive in both groups). However, the mean viral load in the ivermectin-treated group was lower (around 3x lower at 4 days and up to 18x lower at 7 days post-treatment), although the difference was not statistically significant. Treated patients also showed a reduced duration of certain symptoms (of 50% for loss of smell and taste and of 30% for cough). All patients developed virus-specific IgG but, again, the mean level of antibodies in the treated group was lower than in the placebo group.
There was no effect on duration of symptoms or makers associated with inflammation so ivermectin may act through mechanisms that do not involve a possible anti-inflammatory effect. The authors believe it could be interfering with viral entry in the cells, as suggested by another study using hamsters. As always, caution is warranted about a small pilot study just like with epidemiology or animal models.
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