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0 0.5 1 1.5 2+ Case 100% Improvement Relative Risk Iota-carrageenan  Carvallo et al.  Prophylaxis Does iota-carrageenan + ivermectin reduce COVID-19 infections? Prospective study of 1,195 patients in Argentina Fewer cases with iota-carrageenan + ivermectin (p<0.000001) Carvallo et al., J. Biomedical Researc.., Nov 2020 Favors carrageenan Favors control

Study of the Efficacy and Safety of Topical Ivermectin + Iota-Carrageenan in the Prophylaxis against COVID-19 in Health Personnel

Carvallo et al., Journal of Biomedical Research and Clinical Investigation, doi:10.31546/2633-8653.1007
Nov 2020  
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Prophylaxis study using ivermectin and iota-carrageenan showing 0 of 788 cases from treated healthcare workers, compared to 237 of 407 control.
See for discussion of issues with this trial.
Targeted administration to the respiratory tract provides treatment directly to the typical source of initial SARS-CoV-2 infection and replication, and allows for rapid onset of action, higher local drug concentration, and reduced systemic side effects.
This study is excluded in meta analysis: combined treatment may significantly contribute to efficacy, concern about potential data issues.
Study covers iota-carrageenan and ivermectin.
risk of case, 99.9% lower, RR 0.001, p < 0.001, treatment 0 of 788 (0.0%), control 237 of 407 (58.2%), NNT 1.7, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Carvallo et al., 17 Nov 2020, prospective, Argentina, peer-reviewed, 4 authors, this trial uses multiple treatments in the treatment arm (combined with ivermectin) - results of individual treatments may vary.
This PaperIota-carragee..All
Study of the Efficacy and Safety of Topical Ivermectin + Iota-Carrageenan in the Prophylaxis against COVID-19 in Health Personnel
Carvallo Héctor, Hirsch Roberto, Alkis Psaltis, Contreras Veronica
Journal of Biomedical Research and Clinical Investigation, doi:10.31546/2633-8653.1007
The severe acute respiratory syndrome-coronavirus-2 pandemic has had devastating health and socio-economic implications worldwide. Epidemiologic data indicate that SARS-CoV2 is spread by respiratory droplets and contact. The lack of acquired human immunity to the virus and the absence of a vaccine, has meant that current management strategies aimed at virus containment through mask wearing, social distancing and enforced lockdowns. Although the World Health Organization recommends 1,5 meters distancing to minimize transmission, recent studies have demonstrated high stability in aerosols and transmission distances up to 10 meters from emission sources . Health care workers are at particular risk from SARS-CoV-2. At present, no reliable prophylactic therapy exists to minimize their risk of acquiring SARS-CoV-2, and so they rely solely upon hand hygiene and the wearing of appropriate personal protective equipment (PPE), which is often in limited supply. Several studies have shown that the salivary gland and tongue express the ACE2 receptor, suggesting that the oral cavity is a perfect host for the invasion of COVID. Theoretically, agents that can inhibit viral adhesion and replication within the primary sites of viral entry (the nasal and oral cavity), may have a role in preventing SARS-CoV-2 transmission. Use of these agents prophylactically, would be especially beneficial in health care workers, particularly given the delay in results from viral RNA detection diagnostic test and the fact that many infected patients may have mild or no symptoms of the virus in the early stages. Two possible substances have been identified as candidate prophylactic agents in the fight against SARS-CoV-2. Carrageenans are naturally occurring extracts from the Rhodophyceas seaweed. Recently, the viricidal capacity of carrageenan has been reported, through inhibition of viral-host cell adhesion and early replication. Iota-carrageenan demonstrates potent antiviral activity in vitro, reducing rhinovirus, herpes simplex virus and the Japanese encephalitis virus reproduction and their cytopathic effects. Similarly, ivermectin has also been shown to posess antiviral activity against a whole host of RNA viruses (Zika, dengue, yellow fever, human immunodeficiency virus type 1). Thus, the combination of both products can provide an extra protection for those at risk of contagion.
Conflicts of Interest: The authors declare no conflict of interest.
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