Ivermectin as a possible treatment for COVID-19: a review of the 2022 protocols

DOI record: { "DOI": "10.1590/1519-6984.258325", "ISSN": [ "1678-4375", "1519-6984" ], "URL": "http://dx.doi.org/10.1590/1519-6984.258325", "abstract": "<jats:p>Abstract Ivermectin is a safe and effective drug in humans and has been approved for use in numerous parasitic infections for over 50 years. In addition, many studies have already shown its antiviral activity. Ivermectin is generally well tolerated, with no indication of central nervous system-associated toxicity at doses up to 10 times the highest FDA-approved dose of 200 µg/kg. The in vitro results of ivermectin for reducing SARS-CoV-2 viral load are promising and show that Ivermectin kills SARS-CoV-2 within 48 hours. A hypothesized mechanism of action for this drug is a likely inhibition of IMPα/β1-mediated nuclear import of viral proteins as demonstrated for other RNA viruses. However, controlled and randomized studies are needed to prove its effectiveness in COVID-19 in humans. In a single in vivo study with published results, patients confirmed to be infected with SARS-CoV-2 received at least one dose of ivermectin at any time during hospitalization. The use of ivermectin was associated with lower mortality during treatment with COVID-19, especially in patients who required increased inspired oxygen or ventilatory support. Additionally, 81 studies with the clinical use of ivermectin in humans are being carried out worldwide according to ClinicalTrials.gov. However, none of these data has been published so far. However, private and public entities in Brazil have been adopting this drug in their protocols as prophylaxis and in the initial phase of the disease. In addition, ivermectin has been used in mass treatment to prevent onchocerciasis and lymphatic filariasis in sub-Saharan Africa for many years. Surprisingly, this region has the lowest proportional mortality rate among the continents, despite the increasing numbers of infected people released by the World Health Organization.</jats:p>", "alternative-id": [ "S1519-69842024000100303" ], "author": [ { "ORCID": "http://orcid.org/0000-0002-5024-0542", "affiliation": [ { "name": "Universidade Tecnológica Federal do Paraná, Brasil" } ], "authenticated-orcid": false, "family": "Marques", "given": "L. L. M.", "sequence": "first" }, { "ORCID": "http://orcid.org/0000-0001-7888-5820", "affiliation": [ { "name": "Universidade Tecnológica Federal do Paraná, Brasil" } ], "authenticated-orcid": false, "family": "Beneti", "given": "S. C.", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-5719-5633", "affiliation": [ { "name": "Universidade Tecnológica Federal do Paraná, Brasil" } ], "authenticated-orcid": false, "family": "Pinzon", "given": "C.", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-0432-9191", "affiliation": [ { "name": "Universidade Tecnológica Federal do Paraná, Brasil" } ], "authenticated-orcid": false, "family": "Cardoso", "given": "F. A. R.", "sequence": "additional" } ], "container-title": "Brazilian Journal of Biology", "container-title-short": "Braz. J. Biol.", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2022, 5, 13 ] ], "date-time": "2022-05-13T12:33:35Z", "timestamp": 1652445215000 }, "deposited": { "date-parts": [ [ 2022, 5, 13 ] ], "date-time": "2022-05-13T12:34:12Z", "timestamp": 1652445252000 }, "indexed": { "date-parts": [ [ 2024, 7, 31 ] ], "date-time": "2024-07-31T18:35:45Z", "timestamp": 1722450945579 }, "is-referenced-by-count": 3, "issued": { "date-parts": [ [ 2024 ] ] }, "license": [ { "URL": "http://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 1, 1 ] ], "date-time": "2024-01-01T00:00:00Z", "timestamp": 1704067200000 } }, { "URL": "http://creativecommons.org/licenses/by/4.0/", "content-version": "am", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 1, 1 ] ], "date-time": "2024-01-01T00:00:00Z", "timestamp": 1704067200000 } }, { "URL": "http://creativecommons.org/licenses/by/4.0/", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 1, 1 ] ], "date-time": "2024-01-01T00:00:00Z", "timestamp": 1704067200000 } } ], "link": [ { "URL": "http://www.scielo.br/scielo.php?script=sci_pdf&pid=S1519-69842024000100303&tlng=en", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "530", "original-title": [ "Ivermectina como um possível tratamento para COVID-19: uma revisão dos protocolos de 2022" ], "prefix": "10.1590", "published": { "date-parts": [ [ 2024 ] ] }, "published-online": { "date-parts": [ [ 2024 ] ] }, "publisher": "FapUNIFESP (SciELO)", "reference": [ { "key": "ref1", "series-title": "Bulário eletrônico", "year": "2021" }, { "key": "ref2", "series-title": "Secretaria de Saúde de Natal recomenda usar ivermectina para prevenir e tratar coronavírus", "year": "2020" }, { "article-title": "The chemotherapy of onchocerciasis XIX: the clinical and laboratory tolerance of-high dose ivermectin", "author": "AWADZI K.", "first-page": "131", "issue": "2", "journal-title": "Tropical Medicine and Parasitology", "key": "ref3", "volume": "46", "year": "1995" }, { "DOI": "10.1007/s002280050131", "article-title": "Ivermectin distribution in the plasma and tissues of patients infected with Onchocerca volvulus", "author": "BARAKA O.Z.", "doi-asserted-by": "crossref", "first-page": "407", "issue": "5", "journal-title": "European Journal of Clinical Pharmacology", "key": "ref4", "volume": "50", "year": "1996" }, { "author": "BEZERRA H.M.", "key": "ref5", "series-title": "Protocolo de manejo para síndromes gripais frente à pandemia de coronavírus (COVID-19).", "year": "2020" }, { "key": "ref6", "series-title": "Decreto no 11.940, de 07 de Julho de 2020, que regulamenta a distribuição do medicamento ivermectina no Município de Itajaí", "year": "2020" }, { "key": "ref7", "series-title": "Portaria no 022/2020. 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