Current best evidence for clinical care (more info)
Researchers around the world are working at record speed to find the best ways to treat and prevent coronavirus disease 2019 (COVID-19). This study aimed to evaluate the efficacy of ivermectin for the treatment of hospitalized mild to moderate COVID-19 infected patients. This was a randomized open-label controlled study that included 164 patients with COVID-19. Patients were randomized into two groups where Group 1 (Ivermectin group) included patients who received ivermectin 12 mg once daily for 3 days with standard care and Group 2 (control group) included patients who received standard protocol of treatment alone for 14 days. The main outcomes were mortality, the length of hospital stay, and the need for mechanical ventilation. All patients were followed up for 1 month. Overall, 82 individuals were randomized to receive ivermectin plus standard of care and 82 to receive standard of care alone. Patients in the ivermectin group had a shorter length of hospital stay (8.82 ± 4.94 days) than the control group (10.97 ± 5.28 days), but this was not statistically significant (p = 0.085). Three patients (3.7%) in each group required mechanical ventilation (p = 1.00). The death rate was three patients in the ivermectin group (3.7%) versus four patients (4.9%) in the control group without any significant difference between the two groups (p = 1.00). Although there was no statistically significant difference in any endpoints by ivermectin doses (12 mg/day for 3 days); there was an observed trend to reducing hospital stay in the ivermectin-treated group.
| Discipline / Specialty Area | Score |
|---|---|
| Hospital Doctor/Hospitalists | |
| Internal Medicine | |
| Infectious Disease | |
Since the early days the COVID-19 pandemic, physicians have attempted multiple medications for the treatment of patients. Ivermectin was touted as one of those miracle medicines especially outside the US. Case reports and non-randomized trials swore by it. Finally, this randomized controlled trial clearly demonstrates a lack of mortality benefit from Ivermectin. EBM 1: Expert opinion 0.
Although there was no difference in mortality or intubation, patients in the ivermectin group had a shorter length of hospital stay (8.82 ± 4.94 days) than the control group (10.97 ± 5.28 days), but this was not statistically significant (p = 0.085). An open-label study would be expected to bias results to shorter stay, if providers knew those patients were on ivermectin.
This is the second published (with peer review) study on ivermectin in COVID-19, and it's negative (this time, with hard end-points). However, although the authors give a sample size calculation which I did not understand very well, the study had only a few patients who suffered the end-point.