Role of ivermectin in the prevention of COVID-19 infection among healthcare workers in India: A matched case-control study

[-] massimaux | 6 points | Nov 03 2020 21:49:49

This is a wonderful day! Two great studies in one day: one from Dominican Republic and one from India.

[-] SwiftJustice88 | 5 points | Nov 03 2020 21:53:34

A 73% reduction in infection amongst HCW’s is huge! A wonderful day indeed!

[-] TrumpLyftAlles | 2 points | Nov 04 2020 12:02:29

This is actually a disappointing result, compared to the flawless 100% of the Argentina prophylaxis study: ZERO health workers infected over 10 months. In that trial, they were taking 12mg/week, plus carrageenan nasal spray 5 times a day. One of the researchers said that another protocol that was just ivermectin showed similar results, discounting the role of the carrageenan.

In this trial, they took 300mcg/kg on days 1 and 4 (72 hours apart).I think the implication is that weekly is better than the two doses and then nothing for the rest of the month. Makes total sense to me, given ivermectin's relatively brief half-life, 18 hours according to Merck (though others have put it as high as 50 hours).

It would have been nice if this trial reported when the health workers became infected. If there were more infections in week 3 than prior weeks, and more in week 4 than week 3, that would clearly indicate that the prophylaxis was wearing off.

The people who designed this trial probably weren't aware of the Argentina trial, which (after all) has only been reported in a couple news stories, AFAIK.

A couple weeks ago I contacted the lead researcher of the Argentina study on twitter. He said that a report is coming.

[-] SwiftJustice88 | 3 points | Nov 03 2020 21:43:05

Background: Ivermectin is one among several potential drugs explored for its therapeutic and preventive role in COVID-19 infection. The study was aimed to explore the association between ivermectin prophylaxis and development of COVID-19 infection among healthcare workers. Methods: A hospital-based matched case-control study was conducted among healthcare workers of AIIMS Bhubaneswar, India, from September to October 2020. Profession, gender, age and date of diagnosis were matched for 186 case-control pairs. Cases and controls were healthcare workers who tested positive and negative, respectively, for COVID-19 by RT-PCR. Exposure was defined as the intake of ivermectin and/or hydroxychloroquine and/or vitamin-C and/or other prophylaxis for COVID-19. Data collection and entry was done in Epicollect5, and analysis was performed using STATA version 13. Conditional logistic regression models were used to describe the associated factors for COVID-19 infection. Results: Ivermectin prophylaxis was taken by 77 controls and 38 cases. Two-dose ivermectin prophylaxis (0.27, 95% CI, 0.15-0.51) was associated with 73% reduction of COVID-19 infection among healthcare workers for the following one month, those who were involved in physical activity (3.06 95% CI, 1.18-7.93) for more than an hour/day were more likely to contract COVID-19 infection. Type of household, COVID duty, single-dose ivermectin prophylaxis, vitamin-C prophylaxis and hydroxychloroquine prophylaxis were not associated with COVID-19 infection. Conclusion: Two-dose ivermectin prophylaxis at a dose of 300 μg/kg with a gap of 72 hours was associated 73% reduction of COVID-19 infection among healthcare workers for the following one-month. Further research is required before its large scale use. Keywords: COVID-19, Ivermectin, Chemoprophylaxis, Healthcare workers, India