TOP 4 ANTIVIRALS

Ivermectin Ivermectin looks interesting since it is very cheap and it is a pill. You can basically take 3 of the 3mg pills right after symptoms and that’s it. There are anecdotal amazing stories about its use, but it lacks serious studies to back up the claims. So it is in #5 right now due to the lack of solid data.

It had been suggested as being effective against the virus, but researchers thought unlikely to get adequate lung tissue levels. This is a problem because its a near certainty that the virus will have made its way to into the lungs by the time first external symptoms show up.

Here are some references:

Research paper is here.

Medium article by Bruce Yaffe MD.

Dominican Republic newspaper article, A paso de vencedor tratamiento de COVID-19 con ivermectina: Brought patient back from verge of death. 460 patients treated, none returned ill. * Stopped progression of covid-19. * Reduced length of stay. * Formal study coming.

Usefulness of Ivermectin in COVID-19 Illness observational study showing late treatment (given in hospital) concluding: “Of those requiring mechanical ventilation fewer patients died in the ivermectin group (7.3% versus 21.3%) and overall death rates were lower with ivermectin (1.4% versus 8.5%; HR 0.20 CI 95% 0.11-0.37, p<0.0001).”

University of Baghdad Launches Ivermectin Clinical Trial for COVID-19 Patients (late stage disease only which is too bad)

Bruce Yaffe MD wrote: “As a physician in Manhattan, I have treated 42 patients with Covid. It has been very difficult to diagnose this init’s very early stages, due to difficulty in being tested immediately. That being the case, I had one healthcare worker, a resident on a Covid floor, who on day seven of covid exposure developed 102 fever. The next morning I spoke with her and gave her 9 mg of ivermectin (so 3 of the 3mg tablets). She awakened the following morning without any further fever or subsequent symptoms at all. Obviously, this is a case load of one, but there is reason to believe the virus starts in the upper respiratory tract, before and may cause fever before it gets to the lungs. Given the Monash university test tube study where it completely suppressed viral replication, I think this suggests a study in healthcare workers who are diagnosed on day one of fever. In influenza, Tamiflu really only works if given in the first 48 hours of fever. Given that this medication is generic and safe, I find it astounding that this study has not been done.

The problem is as a primary care doctor I have no way to get early efficient diagnosis in New York City, but if treated with ivermectin in the first 48 hours before it gets to the lungs I think we can inhibit viral replication and significantly decrease progression. See my article in medium on ivermectin in the first 24 hrs of fever. Unfortunately a trial of one patient, but scientifically based on the Monash university test tube studies this makes sense. Why am I not seeing any articles on very early intervention, because other than in hospital workers, it’s never diagnosed very early because of lack of testing options. Very happy to discuss this.

See my article on medium on ivermectin written last month. I spoke with my friend who is Chancellor at university of Texas and proposed a study of ivermectin to healthcare workers on day 1 of fever vs placebo vs plaquenil vs combo ivermectin plaquenil. Easy study in giant healthcare system. He spoke with Texas health State commisioner of health and thought they would do a simple study. Easy to enlist 100 sick healthcare workers on day one of fever and do a 4 pronged study. Results available in 2 weeks. However, they took no action to test this.”

permalink

Kind of funny/weird. This appears in the ivermectin part of the article:

Dominican Republic newspaper article, A paso de vencedor tratamiento de COVID-19 con ivermectina: Brought patient back from verge of death. 460 patients treated, none returned ill. * Stopped progression of covid-19. * Reduced length of stay. * Formal study coming.

I recognize my tweet! It was formatted as bullet points, which is why the asterisks are there.

Brought patient back from verge of death. 460 patients treated, none returned ill.
Stopped progression of covid-19.
Reduced length of stay.
* Formal study coming.

They removed the asterisks I put before "Brought" and "460".

I guess at least one of my tweets got some attention. ;)

permalink