(01-19-2021) - The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial

[-] integral_triple | 7 points | Jan 19 2021 16:31:56

I took Ivermectin and recovered my senses of taste and smell in 7 days, I've known people who spent weeks and even more than a month with anosmia after covid.

[-] stereomatch | 4 points | Jan 19 2021 21:59:48

I have observed partial reversal of taste or smell in 5 patients within 24 hours of first dose of Ivermectin. These were people who had taste or smell loss for 5 days or so - and so for them to suddenly have improvement within 24 hours was interesting. And suggests something is happening.

Note that not all covid19 early patients have taste/smell loss. And of those who do - not all had taste/smell reversal within 24 hours of ivermectin. About 25 percent of early covid19 patients have taste or smell loss (from reports) - but a portion of these may show taste/smell reversal within 24 hours of first dose of Ivermectin.

Usually they took 2 weeks or so to get nearly full taste/smell back - but other folks (not taking Ivermectin) also do recover taste/smell - but it can take them a month perhaps in some cases.

So this is still somewhat hazy.

Generally I have noted that taste/smell loss happens around day 4-5 from first symptoms - and can happen a little later too.

And I have noted that those who have been taking Ivermectin as prophylaxis can still show taste/smell loss on day 4-5 - so it is not absolutely guaranteed. Though they may have a shorter recovery time for nearly full taste/smell recovery.

On the other hand, I know of one case (a golfer who is out in the sun a lot) who had taste/smell loss and then reversal next day (before he started ivermectin). So taste/smell reversal can occur otherwise too - but this individual was not your typical urban person - probably had high vitamin d levels.

There is a study on taste/smell reversal using Ivermectin/Aspirin - where they dose normally and then for those who do not respond they dose at double doses - and had majority recover in 2 weeks:

https://zenodo.org/record/4065802#.X7yuEh5RU0N

September 26, 2020

COVID-19 Persistent: TREATMENT WITH IVERMECTIN AND ACETYLSALICYLIC ACID OF PATIENTS WITH THE PERSISTENT SYMPTOM OF ANOSMIA OR HYPOSMIA. Gustavo Aguirre Chang

INTRODUCTION: Anosmia and Hyposmia, which is the loss or decrease of smell, is a symptom that occurs in 30 to 70% of patients with COVID-19 in its acute stage, but it also occurs frequently within the symptoms that persist for weeks after the acute stage of the disease. There is no consensus regarding a specific and effective treatment for this persistent symptom, and there is a lack of knowledge of its pathophysiology and the factors related to its persistence. Based on the previous experiences by our work team, regarding the use of drugs to reduce the load and viral replication for the treatment of persistent symptoms of COVID-19, we carried out new studies with the use of Ivermectin for these cases, and adding drugs to reduce thrombophilia, the state of hypercoagulability, hypoperfusion and nitric oxide production related to Endothelitis caused by SARS CoV-2 infection.

MATERIAL AND METHODS: In the present study, 21 adult patients with the persistent symptom of Anosmia or Hyposmia and who had been previously diagnosed and treated for COVID-19 were included.

The following treatment protocol was followed: Ivermectin was administered at a dose of 0.2 mg. per kilo of body weight per day for 2 days, it was indicated to take the drug after dinner.

If the patients still presented Anosmia or Hyposmia after the Ivermectin doses of the first 2 days, the following protocol was continued: take Acetylsalicylic Acid (Aspirin) 100 mg. after breakfast and dinner (200 mg per day) for 5 days (from 3rd to 7th day). In addition, after stopping taking ivermectin for 2 days (the 3rd and 4th day), take a dose of 0.4 mg. per kilo of weight per day for 2 days (the 5th and 6th day), indicating that you take half the dose after lunch and the remaining half after dinner.

In cases where, on the 8th day of treatment, the patient still presented Anosmia or Hyposmia, the 200 mg doses were continued. a day of Acetylsalicylic Acid and a treatment scheme with L-Lysine was indicated, starting with daily doses of 500 mg. and that they were increasing every 3 days by 500 mg. until reaching 2,000 mg. per day, it was also indicated that from the 8th day after starting treatment with L-Lysine, a new cycle of treatment with Ivermectin at a dose of 0.4 mg be administered per kilo of weight per day for 3 days.

During the treatment period, patients had to avoid consuming coffee, soft drinks, orange and other citrus fruits.

RESULTS: Of the 21 adult patients with persistent Anosmia or Hyposmia treated with Ivermectin, 66.7% had a total clinical improvement (100%) after 2 days of treatment with Ivermectin, and this percentage rose to 85.7% after of administering 2 more doses of Ivermectin and Acetylsalicylic Acid for 5 days.

In 14.3% of the patients who did not present a total clinical improvement in Anosmia or Hyposmia after 4 doses of Ivermectin and Acetylsalicylic Acid for 5 days, L-Lysine was administered according to the established treatment scheme, in addition to Acid Acetylsalicylic and a new course of treatment with Ivermectin. With this, the total clinical resolution of the Anosmia or Hyposmia was achieved in 90.5% of the cases and a significant partial response of clinical improvement in the remaining cases.

In the 2 cases that did not obtain a total response, the partial response of the clinical improvement was 60% in one case and 75% in the other case, that is, the Anosmia was reduced in these 2 cases by 60 and 75 % since starting the established treatment.

CONCLUSION: In the present study, a total clinical improvement of the persistent symptom of Anosmia or Hyposmia is observed in a very high percentage of patients treated with Ivermectin and Acetylsalicylic Acid following the established protocol.

The fact that most cases respond favorably with a few days of treatment indicates the reversible nature of Anosmia in COVID-19 and suggests that its pathophysiology does not involve prolonged or permanent damage to the level of the nerves involved in the sense of olfaction, so it would be more of a problem located at the level of the olfactory epithelium and cells of the olfactory bulb

[-] Cherubbb | 1 points | Jan 20 2021 04:43:16

Paste?

[-] integral_triple | 1 points | Jan 20 2021 04:47:03

I don't understand your comment.

[-] Cherubbb | 1 points | Jan 20 2021 06:34:49

Was it pills or was it the paste you consumed?

[-] integral_triple | 1 points | Jan 20 2021 17:52:36

Liquid, for human use.

[-] Cherubbb | 1 points | Jan 20 2021 18:20:11

Where you prescribed it?

[-] integral_triple | 1 points | Jan 20 2021 18:50:17

No, although an MD told me the dosis.

[-] Cherubbb | 1 points | Jan 20 2021 19:02:55

How did you manage to get it then?

[-] integral_triple | 1 points | Jan 20 2021 19:04:30

Too many questions.

[-] Cherubbb | 1 points | Jan 20 2021 19:07:14

Too many questions? This could help people.

[-] DrTxn | 1 points | Jan 20 2021 06:36:07

Horse paste version of the drug as opposed to the prescribed version.

[-] No_Entertainment_764 | 3 points | Jan 19 2021 13:26:31

Findings

All patients recruited completed the trial (median age, 26 [IQR 19–36 in the ivermectin and 21–44 in the controls] years; 12 [50%] women; 100% had symptoms at recruitment, 70% reported headache, 62% reported fever, 50% reported general malaise and 25% reported cough). At day 7, there was no difference in the proportion of PCR positive patients (RR 0·92, 95% CI: 0·77–1·09, p = 1·0). The ivermectin group had non-statistically significant lower viral loads at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) and day 7 (p = 0·16 for gene E; p = 0·18 for gene N) post treatment as well as lower IgG titers at day 21 post treatment (p = 0·24). Patients in the ivermectin group recovered earlier from hyposmia/anosmia (76 vs 158 patient-days; p < 0.001).

Interpretation

Among patients with non-severe COVID-19 and no risk factors for severe disease receiving a single 400 mcg/kg dose of ivermectin within 72 h of fever or cough onset there was no difference in the proportion of PCR positives. There was however a marked reduction of self-reported anosmia/hyposmia, a reduction of cough and a tendency to lower viral loads and lower IgG titers which warrants assessment in larger trials.

[-] akaariai | 3 points | Jan 19 2021 13:28:10

This is now peer reviewed, and it's actually quite positive both on results and tone.

For days of anosmia reduction was significant with p<0.001. This is a very strong result in study of 24 subjects. Also, there's hints of viral reduction, but these results weren't strong as the size of the study was small.

As there wasn't severe cases this one can't say anything about ivermectin's effect on mortality. But it definitely says ivermectin is doing something.

[-] massimaux | 2 points | Jan 19 2021 14:05:14

The results are fascinating! Wow!

I wish there were multiple larger studies already done and showing large statistically significant reductions in transmission rates, hospitalization and mortality from using IVM for PrEP/PEP prophylaxis, early treatment and hospital treatment.

But Dr. Chaccour is optimistic. He finally paved the way for larger RCTs on IVM to be completed by 2024 or later. We are so happy!

[-] TrumpLyftAlles | 2 points | Jan 19 2021 14:47:25

He finally paved the way for larger RCTs on IVM to be completed by 2024 or later.

Let's pray that we don't look back on that comment and laugh bitterly, 4 years from now. Presuming the sub hasn't been banned.

RemindMe! 4 years

[-] stereomatch | 1 points | Jan 19 2021 21:40:26

Some media coverage:

https://www.eurekalert.org/pub_releases/2021-01/bifg-act011421.php 19-Jan-2021 A clinical trial provides encouraging results on ivermectin for reducing mild COVID-19 Barcelona Institute for Global Health (ISGlobal)

A small pilot study suggests that early administration of ivermectin can reduce viral loads and symptom duration in patients with mild COVID-19, which in turn could help reduce viral transmission. The study, which is part of the SAINT project and has been led by the University of Navarra Clinic and the Barcelona Institute for Global Health (ISGlobal), an institution supported by the "la Caixa" Foundation, warrants further exploration in larger clinical trials. The findings of the pilot study have been published in EClinicalMedicine, a clinical journal published by The Lancet.

We already have two approved COVID-19 vaccines in the European Union, but immunising enough people worldwide to stop viral spread will require at least two years. Meanwhile, finding drugs that can treat or prevent infections remains a priority. "Many efforts are focusing on developing treatments for COVID-19, but few are addressing how to reduce viral transmission," affirms study coordinator Carlos Chaccour, researcher at ISGlobal and physician at the University of Navarra Clinic.

In this pilot study performed with patients from the Clinic and in facilities of the University of Navarra, Chaccour and his team evaluated whether the maximal dose of ivermectin recommended in Europe could have an impact on viral transmission when administered within the first days after symptom onset.

Ivermectin is an antiparasitic drug that has been shown to reduce SARS-CoV-2 replication in vitro (in cell lines), albeit at concentrations that exceed those recommended for human use. This, together with preliminary results from a trial in humans which used data of dubious origin and was never peer-reviewed, prompted the use of ivermectin in many Latin-American countries despite the lack of reliable evidence on its efficacy in treating or preventing infection.

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 enrolment and 1, 2 and/or 3 weeks after treatment.

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. "This could be the result of a lower viral load in these patients," explains Chaccour.

The fact that there was no effect on duration of symptoms or makers associated with inflammation suggests that 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 performed in hamsters at the Pasteur Institute.

"Our findings are in line with those from recent assays conducted in Bangladesh and Argentina," says Chaccour. "Although our study is small and it is too early to draw conclusions, the trends observed in viral loads, symptom duration and antibody levels are encouraging and warrant further exploration in larger clinical trials with a higher diversity of patients," he adds.

Reference

Chaccour C, Casellas A, Blanco-Di Matteo A, et al. The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with mild COVID-19: a pilot, double-blind, placebo-controlled, randomized clinical trial. EClinicalMedicine. 2021. DOI: 10.1016/j.eclinm.2020.100720

About ISGlobal

The Barcelona Institute for Global Health, ISGlobal, is the fruit of an innovative alliance between the "la Caixa" Foundation and academic and government institutions to contribute to the efforts undertaken by the international community to address the challenges in global health. ISGlobal is a consolidated hub of excellence in research that has grown out of work first started in the world of health care by the Hospital Clínic and the Parc de Salut MAR and in the academic sphere by the University of Barcelona and Pompeu Fabra University. The pivotal mechanism of its work model is the transfer of knowledge generated by scientific research to practice, a task undertaken by the institute's Education and Policy and Global Development departments. ISGlobal has been named a Severo Ochoa Centre of Excellence and is a member of the CERCA system of the Generalitat de Catalunya.

About the Clínica Universidad de Navarra

With over 2,800 professionals working exclusively at its headquarters in Pamplona and Madrid, the Clínica Universidad de Navarra is a leading research hospital in Spain in the sector of personalised medicine. A recognised institution for both its teaching and research work, the prestige of its professionals, and its trajectory in the diagnosis and treatment of highly complex pathologies, the Clínica Universidad de Navarra is a high resolution hospital characterised by its diagnostic speed owing to its multidisciplinary work and the acquisition of the latest technology to offer care in 46 different medical and surgical specialties.