Evaluation of the Effectiveness of Ivermectin in Combination With Standard Treatment in Suspected COVID-19 Patients: A Double-Blind Randomized Clinical Trial

Zohreh Akhoundi  Meybodi; Faezesadat  Heidari; Masoud  Nikonezhad; Seyed Ruhollah  Mousavinasab; Iman  Karimzadeh; Farimah  Shamsi; Akram  Astani

doi:10.18502/aptj.v5i2.19457

Zohreh Akhoundi Meybodi Department of Infectious Disease, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences,Yazd, Iran.
Faezesadat Heidari Department of Infectious Disease, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences,Yazd, Iran.
Masoud Nikonezhad Department of Infectious Disease, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences,Yazd, Iran.
Seyed Ruhollah Mousavinasab Department of Infectious Disease, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences,Yazd, Iran.
Iman Karimzadeh Department of Clinical Pharmacy, Faculty of Pharmacy,Shiraz University of Medical Sciences, Shiraz, Iran.
Farimah Shamsi Department of Biostatistics and Epidemiology, school of public health, shahid sadoughi university of medical sciences, Yazd, Iran.
Akram Astani Infectious Diseases Research Center, Shahid Sadoughi Hospital Shahid Sadoughi University of Medical Sciences,Yazd, Iran.

DOI: https://doi.org/10.18502/aptj.v5i2.19457

Keywords: COVID-19, Ivermectin, Shortness of Breath, SARS-CoV-2

Abstract

Background: The 2019 coronavirus is a highly contagious viral disease that causes acute respiratory syndrome and has a catastrophic impact on the world's demographics. Ivermectin may be associated with inhibition of nuclear transport, a mechanism that may be effective against SARS-CoV-2. In this study, we investigated the effectiveness of ivermectin in combination with standard treatment in suspected or probable COVID-19 patients.

Materials and Methods: This study was a prospective and double-blind randomized controlled clinical trial. This study was conducted on 50 patients aged 18 to 60 (25 in the intervention group and 25 in the control group) suspected of having COVID-19 based on clinical symptoms, blood oxygen percentage, and COVID PCR, who are candidates for outpatient treatment. Patients are randomly divided into two intervention groups, including ivermectin and standard treatment, and a control group, including placebo and standard treatment. Standard treatment includes 500 mg acetaminophen tablets and diphenhydramine syrup. The patients in the ivermectin group used oral ivermectin at a dose of 200 µg/kg once a day for two days in addition to the standard treatment. The patients were contacted on the first, third, seventh, and fourteenth days, and the symptoms were asked according to the questionnaire. In this study, the data was statistically analyzed using SPSS 22 software.

Results: Comparison of NYHA (New York Heart Association) classes between the first day and the fourteenth day using the Wilcoxon test showed that the NYHA classes in the fourteenth group had a significant decrease compared to the first day, and the effect of the group was also significant (P≤0.05). Changes in cough frequency between the two groups during 14 days were statistically significant (P≤0.05). Changes in the frequency of shortness of breath between the two groups during 14 days were statistically significant (P≤0.05). Changes in the frequency of fever, headache, dizziness, myalgia, and the need to receive painkillers between the two groups during 14 days were not statistically significant. Changes in the frequency of nausea and vomiting between the two groups during 14 days were statistically significant (P≤0.05).

Conclusion: In the end, we concluded that using ivermectin in patients with mild to moderate clinical conditions of COVID-19 effectively improved the clinical symptoms of patients who were also receiving standard treatment, and patient's symptoms improved in a shorter period. These findings can help specialists choose multidrug treatment, including ivermectin, in treating respiratory diseases such as COVID-19.