Ivermectin compared with placebo in the clinical course in Mexican patients with asymptomatic and mild COVID-19: a randomized clinical trial
Carmen de la Rocha, Marco A. Cid-López, Blanca I. Venegas-López, Sandra C. Gómez-Méndez, Adriana Sánchez-Ortíz, Alma Minerva Pérez-Ríos, Ricardo A. Llamas-Velázquez, Aidé I. Meza-Acuña, Bárbara Vargas-Íñiguez, Daniela Rosales-Galván, Alejandra Tavares-Váldez, Nizdali Luna-Gudiño, Cinthia V. Hernández-Puente, Jovana Milenkovic, Cecilia Iglesias-Palomares, Miriam Méndez-del Villar, Gerardo A. Gutiérrez-Dieck, Carlos G. Valderrábano-Roldán, Jennefer Mercado-Cerda, Jocelyn G. Robles-Bojórquez, Arieh R. Mercado-Sesma
Abstract
BACKGROUND: Despite the development and application of vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) around the world, the scientific community is still trying to find some therapies to avoid or ameliorate the fatal evolution of the Coronavirus disease 2019 (COVID-19). Since the publication of the potential use of ivermectin as a treatment against the disease, a pleiad of information about it has been published. However, the evidence is not strong or weak enough to conclude its usefulness in the clinical evolution of patients infected with SARS-CoV-2. We evaluate the efficacy and safety of ivermectin in the treatment of Mexican patients with asymptomatic and mild COVID-19 in a three-day administration in comparison to placebo. METHODS: A randomized, double-blind, placebo-controlled trial was carried out in 66 adults with asymptomatic and mild COVID-19. Patients were randomly assigned 1:1 ratio to ivermectin plus acetaminophen or placebo plus acetaminophen. The primary endpoint was the proportion of subjects without a disease progression to severity according to COVID-19 guidelines by the National Institutes of Health (NIH) since randomization to 14 days. RESULTS: None of the participants presented progression to a severe state in either group. Viral load was measured on Days 1, 5, and 14. No significant differences were observed in baseline or 14-day between groups (p = 0.720 and 0.362, respectively). However, on Day 5, a significant difference in viral load was observed between groups (p = 0.039). The frequency of symptoms was similar between groups, and no significant differences were observed. The most frequent symptom was cough. One severe adverse event associated with SARS-CoV-2 infection was observed in the ivermectin group. CONCLUSIONS: At standard doses, ivermectin is not effective to prevent progression to a severe state or reducing symptoms in adults with asymptomatic and mild COVID-19. Trial registration The study was registered with ClinicalTrial.gov (NCT04407507) on May 29, 2020.