Conversation with a liberal about ivermectin

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Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic of the highest priority (Johns Hopkins University of Medicine, 2020). Eighty-one percent of cases are categorized as mild, for whom symptomatic management at home and monitoring of clinical deterioration is recommended (Centers for Disease Control and Prevention, 2020). Despite providing symptomatic management, a therapeutic drug that would limit the course of infection is greatly needed.

Ivermectin, a popular anti-parasitic drug, acts on SARS-CoV-2 by preventing viral proteins from entering the host cell nucleus (Caly et al., 2020). Recent virtual drug screening identified doxycycline as a potential inhibitor of SARS-CoV-2 papain-like protease (Wu et al., 2020). An observational study in which patients were treated with a single-dose of ivermectin and multiple doses of doxycycline for the treatment of COVID-19 yielded considerable improvements in symptoms and the viral response (Alam et al., 2020). A recent retrospective study found that hospitalized patients given ivermectin with other treatments (e.g., azithromycin and hydroxychloroquine) had a lower mortality than those who did not receive ivermectin (Rajter et al., 2020).

Further studies are needed to verify these findings. This need is further underscored by the observation that SARS-CoV-2 multiplies rapidly in the respiratory tract and that evidence from animal models shows three-fold higher levels of ivermectin in pulmonary tissue than in the plasma at 1 week after oral dosing (Chiu and Lu, 1989; Lespine et al., 2005).

This pilot study was performed to evaluate the rapidity of viral clearance and safety of a 5-day course of ivermectin or a single-dose of ivermectin + a 5-day course of doxycycline in the treatment of mild COVID-19 in adults.

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(dvm)

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board certified physician (dvm)

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