It's late, I'll write this up tomorrow.

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This study out of Eurnekian Public Hospital, Buenos Aires, Argentina was posted to ClinicalTrials.gov yesterday.

Brief Summary:

The associated use of Ivermectin, aspirin, dexamethasone, and enoxaparin (in different combinations and doses) will reduce the impact of COVID infection 19, the need of admission to the intensive care unit, and mortality.

Official Title:

EVALUATION of Ivermectin Aspirin Dexametasone and Enoxaparin as Treatment of covid19

This will be an observational study of a cohort of 10 participants, a prospective study that started 2020-05-01, with a primary completion date of 2020-06-20 and study completion date of 2020-07-30.

Condition or disease: Severe Acute Respiratory Syndrome, Ventilation Pneumonitis

Treatment (from the last paragraph of the long Detailed Description on the Tabular View):

Suspicious or confirmed case (lowest severity)

• Drug: Ivermectin 24mg orally at 200mcg/kg
• Two doses, a week apart
• Aspirin 250mg orally

Moderate clinical stage:

• Drug: Ivermectin 36mg orally at 400mcg/kg
• Two doses, a week apart
• Aspirin 250mg orally
• Dexamethasone 4 mg/day (parenteral)
• Low flow washed oxygen or oxygen concentrator

Severe case with bilateral pneumonia

• Drug: Ivermectin 48mg via gastric cannulae
• Two doses, a week apart
• Dexamethasone 4 mg/day (parenteral)
• Enoxaparin 100 UI/kg (1 mg/kg)
• Mechanical ventilation

The form of ivermectin is identified as Ivercass. If you follow the link, you'll see that one 20ml bottle costs about $19,000 Argentine dollars, which is about $275 US. I don't know how to translate 5 MG/ML into the usual mcg/kg dosing.

No control group.

Primary outcome measures: illness development, reduction in need for ICU, reduction in mortality rate

Secondary outcome measures: optimizing drug dosing, adverse effects.

Eligibles: 5 or older, not pregnant, test positive for COVID19

Thoughts:

1) Really cool study, looking at ivermectin in three different stages of severity/

2) Applying good-sized doses a week apart seems good.

3) I haven't seen Dexamethasone proposed before. There are 12 trials looking at Dexamethasone at ClinicalTrials, including this one. From here:

Uses Dexamethasone is used to treat conditions such as arthritis, blood/hormone/immune system disorders, allergic reactions, certain skin and eye conditions, breathing problems, certain bowel disorders, and certain cancers. It is also used as a test for an adrenal gland disorder (Cushing's syndrome).

This medication is a corticosteroid hormone (glucocorticoid). It decreases your body's natural defensive response and reduces symptoms such as swelling and allergic-type reactions.

So, anti-cytokine storm?

4) First ivermectin + Enoxaparin trial (there are 22 Enoxaparin trials at ClinicalTrials). From [here](https://www.drugs.com/mtm/enoxaparin.html#:~:text=Enoxaparin%20is%20an%20anticoagulant%20that,the%20lungs%20(pulmonary%20embolism):

Enoxaparin is an anticoagulant that helps prevent the formation of blood clots.

Enoxaparin is used to treat or prevent a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism). A DVT can occur after certain types of surgery, or in people who are bed-ridden due to a prolonged illness.

Enoxaparin is also used to prevent blood vessel complications in people with certain types of angina (chest pain) or heart attack.

Enoxaparin may also be used for purposes not listed in this medication guide.

Sounds like a good idea!

On the other hand, Only 10 participants

Hopefully the person who entered the data into ClinicalTrials left out at least one zero. :(

Also posted to /r/covid19.

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