yup, need more academic comments like that

ivermectin saved me after six weeks when I thought nothing else could, I am so certain, just waiting for the science to prove it

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This is an editorial that was just published in Open Heart, a peer reviewed journal

Some highlights:

Moreover, there are two reports that ivermectin, administered either systemically or topically, exerts anti-inflammatory effects in murine models of allergic inflammation (asthma and atopic dermatitis).7 8 The systemic effect was achieved with a 2 mg/kg dose.
Although it is conceivable that these anti-inflammatory effects of ivermectin are restricted to LPS or toll-like receptor 4 (TLR4) signalling, it may well be the case that it works downstream in this signalling pathway in a way that would be pertinent to other proinflammatory signalling pathways. Moreover, there is reason to suspect that the damage-associated molecular pattern high mobility group box 1 (HMGB1), which is released by dying cells and acts as an agonist for the TLR4 receptor, is a mediator of the lung inflammation associated with COVID-19.9 Hence, it is reasonable to suspect that, in doses at or modestly above the standard clinical dose, ivermectin may have important clinical potential for managing disorders associated with life-threatening respiratory distress and cytokine storm—such as advanced COVID-19. Ivermectin may have been ‘flying under the radar’ in this regard during four decades of clinical use.

Two retrospective prepublication reports have appeared in which clinical outcomes were evaluated in hospitalised patients with COVID-19, some of whom received treatment with ivermectin. Rajter et al have reported that, in univariate analysis, mortality in 173 patients receiving one or more doses of ivermectin was significantly lower than in 107 patients not so treated (15% vs 25.2%, p=0.03); after multivariate adjustment for pertinent covariates, this mortality difference was confirmed (OR 0.27, p=0.03; HR 0.37, p=0.03).10 Gorial et al examined the mean time of hospital stay in patients who either received or did not receive on admission a standard clinical dose of ivermectin (200 μg/kg) as an adjunct to treatment with hydroxychloroquine/azithromycin. The 16 patients who received ivermectin had hospital stays averaging 7.62 days, notably lower than the average hospital stays of 71 patients not receiving ivermectin (13.22 days; p=0.00005). Two patients died in the control group, none in the ivermectin group. Note that these apparent therapeutic benefits were seen in hospitalised patients, in whom antiviral measures are suspected to be less effective than anti-inflammatory measures targeting cytokine storm.

As the impact of ivermectin on antiviral immunity has not been studied, it is unclear whether it would be prudent to withhold its use until later-stage COVID-19.

Open Heart is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart is an official journal of the British Cardiovascular Society.

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The editorial (copied in foggynotion's post below) speculates about possible ways the drug might have anti-inflammatory actions in advanced Covid-19. It reviews two retrospective reviews of clinical experience with ivermectin, certainly non-randomized, non-blinded, non-controlled "studies" - but both encouraging. This provides plenty of reason to initiate prospective RCTs of the drug, given late or given early.Until such studies are completed, patients in locations remote from study sites should probably be given the drug, unless they show signs of CNS effects of the infection (ivermectin is NOT good for neurons, which it normally will not reach because of the blood brain barrier, which can be damaged in advanced Covid-19. Rationale: when you don't have perfect evidence, you go with what evidence you DO have. You don't reject it because it is not perfect (as you might in a non-lethal disease).PS. A randomized study in around 350 subjects in Egypt has been submitted recently for review. While randomized, it was open label, non-placebo controlled, but the results were spectacular. Doses were quite high and drug administered early. Major reduction in clinical illness and clinical severity.

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