Ask the Experts: What About Ivermectin and COVID-19?
Much has been written about various treatments to help patients with COVID-19 since the beginning of the pandemic. Currently, our colleagues at several major hospitals around the nation have been involved in trials involving antiviral drugs like Remdesivir, steroids, and convalescent plasma infusion (a treatment where patients who have recovered from COVID donate plasma which is then given to patients who are sick with the disease).
Our Passion: Hope, and Healing Through Education
We feel strongly about providing people with the best and newest information on the pandemic. Many of you may remember that we were among the first to do extensive research in April 2020 on the use of natural compounds with potential benefits in COVID like vitamin D, quercetin, zinc, glutathione, vitamin C (including high dose IV administration), and melatonin. Our original work may be found here.
Subsequent peer-reviewed research internationally has confirmed much of what we had written about these compounds – especially the vital role of zinc and vitamin D in the treatment of COVID. In fact, one study from Spain demonstrated administering vitamin D to hospitalized patients resulted in lower ICU admissions and lower death rates. Recently, one of the oldest prescription medications, ivermectin, has shown promise in some trials. As always, never start any new medication* or supplement without checking with your doctor first.
*Ivermectin is an FDA approved medication but has not been approved specifically for COVID treatment or prevention.
What Is Ivermectin?
Ivermectin is an oral medication that has been used for many years to treat parasitic infections like worms (gross!) in both people and animals. It is inexpensive, widely available, and has no significant medication interactions (unlike azithromycin and hydroxychloroquine). As with any medication, adverse reactions may occur, but with ivermectin, they are rare.
But, What Does It Do in Viral Infections?
Antiparasitic medication for a viral infection — seems strange, right? Well, read on to discover the potential benefits of this medication. It is thought that ivermectin acts at different viral protein binding sites, reducing viral replication (the process by which viruses multiply — although they are not really alive). It has been shown in an in vitro (in the lab but not in people) study that ivermectin stops the transport of some proteins required for viral entry into the nucleus (the “brain center”) of the cell. This entry is vital to viral function and reproduction.
This particular study showed that ivermectin reduced reproduction of the HIV virus and dengue fever virus. Similar results were found with West Nile virus and other RNA viruses. Ivermectin has also been shown in a mouse study to reduce interleukin 6 (IL-6) and TNF-α (two inflammatory chemicals which are elevated in patients with COVID and “cytokine storm”). Cytokine storm is a condition of extreme inflammation which occurs in some patients with COVID-19 and is associated with poor outcomes.
What About SARS-CoV-2 (the Virus That Causes COVID-19)?
In June 2020, a well-done in vitro study showed that ivermectin reduced viral copies 5000 times (virtually eliminating all viral RNA) by 48 hours.
What About Clinical Studies of Ivermectin in People With COVID-19?
Several studies have shown potential benefits of ivermectin in patients with COVID-19. In a study done by physicians in Egypt, a group of patients receiving standard care (including hydroxychloroquine) was compared to a group that received standard care plus ivermectin. The ivermectin group had better survival rates and their labs showed decreased inflammation. There were no safety issues.
Another double-blind, placebo controlled study (the most scientifically validated level of evidence) compared ivermectin plus standard care to placebo plus standard care. The elimination of virus (known as “clearance”) from the bloodstream was significantly reduced in the ivermectin group. C-reactive protein levels (a lab test we use which measures inflammation) was also lower in the ivermectin group (indicating less inflammation). No adverse effects were seen in the ivermectin group in this study either.
Another study of 248 patients compared ivermectin plus standard care versus standard care alone. Significantly fewer patients in the ivermectin group required oxygen, developed respiratory distress, or required ICU care. The time it took for the patients to test negative was shortened in the ivermectin group (confirming what was seen in other studies) and less patients in the ivermectin group died. Time to hospital discharge was less in the ivermectin group as well. No problems related to use of the drug were seen in the treatment group. A randomized study from Iraq also showed lower time to recovery, progression to severe disease, and lower mortality.
In October 2020, a study of 288 hospitalized patients from Florida showed significantly lower mortality in the group treated with ivermectin. This was a retrospective study (chart review after patients were treated) and the authors pointed out that further randomized studies were required. There are currently 38 ongoing clinical trials in the US (and others worldwide) looking at the use of ivermectin in COVID-19.
What Should We Do With This Information?
As with our last paper on potential new treatments that we referenced above, we hope this information will educate patients and give them something to discuss with their doctors. Be on the lookout for more research results in the future. We will be sure to remain on the cutting edge of the latest research and update you as more information becomes available.