Current best evidence for clinical care (more info)
BACKGROUND: Levamisole has shown clinical benefits in the management of COVID-19 via its immunomodulatory effect. However, the exact role of Levamisole effect in clinical status of COVID-19 patients is unknown. We aimed to evaluate the efficacy of Levamisole on clinical status of patients with COVID-19 during their course of the disease.
METHODS: This prospective, double-blind, randomized controlled clinical trial was performed in adult patients with mild to moderate COVID-19 (room-air oxygen saturation > 94%) from late April 2020 to mid-August 2020. Patients were randomly assigned to receive a 3-day course of Levamisole or placebo in combination with routine standard of care.
RESULTS: With 25 patients in each arm, 50 patients with COVID-19 were enrolled in the study. Most of the study participants were men (60%). On days 3 and 14, patients in Levamisole group had significantly better cough status distribution when compared to the placebo group (P-value = 0.034 and 0.005, respectively). Moreover, there was significant differences between the two groups in dyspnea at follow-up intervals of 7 (P-value = 0.015) and 14 (P-value = 0.010) days after receiving the interventions. However, no significant difference in fever status was observed on days 1, 3, 7, and 14 in both groups (P-value > 0.05).
CONCLUSION: The results of the current study suggest that Levamisole may improve most of clinical status of patients with COVID-19. The patients receiving Levamisole had significantly better chance of clinical status including cough and dyspnea on day 14 when compared to the placebo. However, the effect-size of this finding has uncertain clinical importance.
TRIAL REGISTRATION: The trial was registered as IRCT20190810044500N7 (19/09/2020).
| Discipline / Specialty Area | Score |
|---|---|
| Infectious Disease | |
| Family Medicine (FM)/General Practice (GP) | |
| General Internal Medicine-Primary Care(US) | |
Levamisole is a medication to treat helminths and is no longer available in the US. This is an Iranian study of 50 patients given levamisole in a double blind manner showing that the medication is helpful in decreasing cough and other symptoms in patients with mild to moderate Covid-19.
It must be stressed that this is a very small and very preliminary study that requires much additional evaluation before beginning to consider it for clinical use. Let's hope that this potential does bear fruit, but certainly it does not mean we should do anything at this point.