Letter to the editor
Ivermectin: potential candidate for the treatment of Covid 19
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array:23 [ "pii" => "S1413867020300817" "issn" => "14138670" "doi" => "10.1016/j.bjid.2020.06.002" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "992" "copyright" => "Sociedade Brasileira de Infectologia" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Braz J Infect Dis. 2020;24:369-71" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemAnterior" => array:19 [ "pii" => "S1413867020300829" "issn" => "14138670" "doi" => "10.1016/j.bjid.2020.06.003" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "993" "copyright" => "Sociedade Brasileira de Infectologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Braz J Infect Dis. 2020;24:368" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:9 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the editor</span>" "titulo" => "Mild and asymptomatic cases of COVID-19 are potential threat for faecal–oral transmission" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "368" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Samuel Cota Teixeira" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Samuel Cota" "apellidos" => "Teixeira" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1413867020300829?idApp=UINPBA00003Y" "url" => "/14138670/0000002400000004/v1_202009070610/S1413867020300829/v1_202009070610/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the editor</span>" "titulo" => "Ivermectin: potential candidate for the treatment of Covid 19" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "369" "paginaFinal" => "371" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Dhyuti Gupta, Ajaya Kumar Sahoo, Alok Singh" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Dhyuti" "apellidos" => "Gupta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] 1 => array:3 [ "nombre" => "Ajaya Kumar" "apellidos" => "Sahoo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] 2 => array:4 [ "nombre" => "Alok" "apellidos" => "Singh" "email" => array:1 [ 0 => "draloksingh@aiimsraipur.edu.in" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "fn0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Pharmacology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1200 "Ancho" => 1583 "Tamanyo" => 159793 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mechanism of ivermectin induced inhibition of importin α/β mediated coronavirus proteins transport. cNLS : classical Nuclear Localization Signal. *<span class="elsevierStyleBold">Image courtesy: CDC/Alissa Eckert, MS; Dan Higgins, MAMSA</span>.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Ivermectin, a well-known anti-helmintic agent from the late-1970s, causes stimulation of gamma amino butyric acid (GABA)-gated-Cl<span class="elsevierStyleSup">−</span> channels, leading to hyperpolarization, and resulting in paralysis of the infesting organism. Another mechanism that has been postulated for the same effect is the immunomodulation of host response. This is attained by the activation of neutrophils, increase in the levels of C-reactive protein and interleukin-6.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In recent times, the antiviral function of ivermectin has been discovered, which appears to be intriguing. Already its effectiveness against certain flavivirus (dengue fever, Japanese encephalitis and tick-borne encephalitis virus) and chikungunya virus has been demonstrated <span class="elsevierStyleItalic">in vitro</span>.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> Since then the same activity has been assessed in numerous other viral infections. Off lately its potency has been recognized in eliminating coronavirus <span class="elsevierStyleItalic">in vitro</span>. The exact mechanism to which this effect can be attributed to is yet to be validated, but the speculated method is inhibition of importin α/β1 mediated transport of viral proteins in and out of the nucleus.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Importins, a type of karyopherins, exemplify a major class of soluble transport receptors which are involved in nucleo-cytoplasmic transit of various substrates (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The speculated inhibitory action of ivermectin on importin α/β mediated transport system, Based on this conjecture, the role of ivermectin in eliminating Covid-19 can be assumed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Until now, in only single <span class="elsevierStyleItalic">in vitro</span> study, the efficacy of ivermectin against coronavirus has been demonstrated. Caly et al. tested for the viral RNA levels in both supernatant and cell pellets of the Vero/hSLAM cells which were infected with SARS-CoV-2 (isolate Australia/VIC01/2020), and were then treated with 5 μM ivermectin two hours later. After 24 h, they observed a decline of about 93% and 98% in viral RNA levels and cell-associated viral RNA, respectively. Later at 48 h, they detected further reduction (∼5000 fold) in the viral RNA load only. To ascertain this finding, the infected cells were treated with serial dilutions of ivermectin, and were then tested for viral RNA load by RT-PCR. With this research, the investigators could comment about the inhibitory concentration 50 (IC50) which was estimated to be ∼2 μM, and also that no toxicities were noticed for the various concentrations at which ivermectin was tested.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Based on the efficacy evidenced in <span class="elsevierStyleItalic">in vitro</span> study, various clinical studies have been planned and started, though none of them have yet been completed (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">in vitro</span> potency of ivermectin against Covid-19 virus is a testimony that this drug can be utilized to manage those patients who have been infected with SARS-CoV-2. Since the conditions in which the virus replicates and infects the cells <span class="elsevierStyleItalic">in vivo</span> and <span class="elsevierStyleItalic">in vitro</span> differs, a decisive comment about how ivermectin may prove to be beneficial to the patients cannot be constructed yet. Similarly, any disparity in the pharmacokinetic properties of this drug and the unidentified drug interactions which may occur under such conditions are yet to be recognized and remarked on. Nevertheless if compared with the other pharmacotherapeutic options for the management of Covid-19 infection, ivermectin may prove to have leverage over them. In addition to a different mechanism of action, there are other facets as well in which this drug may have an upper hand. For instance, the adverse effects associated with hydroxychloroquine (irreversible retinal damage, prolong QT interval, myopathy, neuropathy) or with lopinavir + ritonavir combination (hypertriglyceridemia, hypercholesterolemia) are not seen in patients who are on ivermectin. Furthermore, the treatment regimen with ivermectin may turn out to be more cost-effective. The therapeutic regimen with hydroxychloroquine and azithromycin combination comes out to be ∼5−6 times more expensive than the one with ivermectin. The same can be commented about the patent antivirals which are priced at exorbitant rates. Another worthwhile issue to be addressed is the over-utilization of hydroxychloroquine in managing the Covid-19 patients, may create an apparent shortage of this drug which is a standard treatment for patients with auto-immune diseases.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Taking into account these lacunae and merits, it becomes imperative that clinical trials with ivermectin be conducted in patients of Covid-19, to comprehend whether this drug can provide beneficial effect to those patients who have already developed complications due to this infection.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">No funding received.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-05-21" "fechaAceptado" => "2020-06-14" "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">All authors contributed equally.</p>" "identificador" => "fn0005" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1200 "Ancho" => 1583 "Tamanyo" => 159793 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mechanism of ivermectin induced inhibition of importin α/β mediated coronavirus proteins transport. cNLS : classical Nuclear Localization Signal. *<span class="elsevierStyleBold">Image courtesy: CDC/Alissa Eckert, MS; Dan Higgins, MAMSA</span>.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">All the details mentioned, have been obtained from <span class="elsevierStyleInterRef" id="intr0005" href="https://clinicaltrials.gov/">https://clinicaltrials.gov/</span>.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">S. No \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Intervention \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Phase \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No. of Participants \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Primary End Point(s) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinical TrialIdentifier \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ivermectin 0.2 mg /kg (single dose at once = 2 tablets of 6 mg/weekly)Hydroxychloroquine 400 mg/dailyAzithromycin capsules 500 mg dailyPlacebo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of patients cured assessed by Nasopharyngeal swab, oropharyngeal swab, and blood aspiration for covid19 (PCR) in addition to chest x-ray in 14 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04343092 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ivermectin 600 µg / kg once daily plus standard care.Control: Standard Care \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of patients in whom the SARS-CoV-2 viral load decreases after ivermectin treatment in 1−5 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04381884 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bicalutamide 150 mg by mouth daily for 7 daysIvermectin 600 µg/kg (up to a maximum dose of 60 mg) by mouth daily for 3 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of participants who have clinical improvement at day 7 after randomization \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04374279 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hydroxychloroquine:Days 1−14: 3 tabs (600 mg total daily dose)Azithromycin:Day 1: 2 tabs (500 mg total daily dose) Days 2−5: 1 tab (250 mg total daily dose)Ivermectin:Days 1−2: Weight < 75 kg: 4 tabs (12 mg total daily dose) Days 1−2: Weight > 75 kg: 5 tabs (15 mg total daily dose)Camostat MesilateDays 1−14: 2 tab TID after a meal (600 mg total daily dose) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">240 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Proportion of patients experiencing clinical deterioration in 14 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04374019 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ivermectin 200 μg/kg once orally plus Nitazoxanide 500 mg twice daily orally with meal for 6 daysControl: Standard Care \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II/III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of Patients with COVID-19-negative PCR in 10 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04360356 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ChloroquineChloroquine with NitazoxanideChloroquine with ivermectin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IIIII \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of patients with virological cure in six months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04351347 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ChloroquineFavipiravirNitazoxanideIvermectinNiclosamideOther drugs (oselatamivir or combination of any of above treatment) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II / III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">120 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of patients with decreased viral load in six months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04345419 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NitazoxanideIvermectinChloroquineAzithromycin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Number of patients with virological cure in six months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04382846 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ivermectin 200–400 μg per kg body weightControl: Standard Care \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Test for virus at 1, 3 & 5 days from beginning of trial drug started for the patient in the hospital in 03 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NCT04373824 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2373491.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Dose of the drugs not available.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Salient features of ongoing clinical trials of ivermectin for COVID-19.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "C-reactive protein and interleukin-6 are elevated in onchocerciasis patients after ivermectin treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.L. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 57 | 21 | 78 |
| 2024 September | 121 | 32 | 153 |
| 2024 August | 165 | 31 | 196 |
| 2024 July | 178 | 38 | 216 |
| 2024 June | 181 | 42 | 223 |
| 2024 May | 148 | 38 | 186 |
| 2024 April | 195 | 45 | 240 |
| 2024 March | 171 | 46 | 217 |
| 2024 February | 213 | 42 | 255 |
| 2024 January | 882 | 36 | 918 |
| 2023 December | 285 | 53 | 338 |
| 2023 November | 347 | 56 | 403 |
| 2023 October | 358 | 60 | 418 |
| 2023 September | 399 | 67 | 466 |
| 2023 August | 314 | 38 | 352 |
| 2023 July | 243 | 29 | 272 |
| 2023 June | 327 | 30 | 357 |
| 2023 May | 443 | 48 | 491 |
| 2023 April | 298 | 39 | 337 |
| 2023 March | 393 | 53 | 446 |
| 2023 February | 472 | 49 | 521 |
| 2023 January | 382 | 29 | 411 |
| 2022 December | 364 | 65 | 429 |
| 2022 November | 593 | 44 | 637 |
| 2022 October | 452 | 31 | 483 |
| 2022 September | 647 | 47 | 694 |
| 2022 August | 394 | 62 | 456 |
| 2022 July | 452 | 51 | 503 |
| 2022 June | 404 | 65 | 469 |
| 2022 May | 374 | 56 | 430 |
| 2022 April | 465 | 64 | 529 |
| 2022 March | 393 | 85 | 478 |
| 2022 February | 521 | 79 | 600 |
| 2022 January | 1263 | 124 | 1387 |
| 2021 December | 886 | 104 | 990 |
| 2021 November | 583 | 52 | 635 |
| 2021 October | 1284 | 105 | 1389 |
| 2021 September | 1860 | 114 | 1974 |
| 2021 August | 2662 | 106 | 2768 |
| 2021 July | 2818 | 138 | 2956 |
| 2021 June | 3545 | 242 | 3787 |
| 2021 May | 6461 | 209 | 6670 |
| 2021 April | 14103 | 604 | 14707 |
| 2021 March | 9835 | 380 | 10215 |
| 2021 February | 3684 | 226 | 3910 |
| 2021 January | 15072 | 693 | 15765 |
| 2020 December | 11781 | 551 | 12332 |
| 2020 November | 2322 | 185 | 2507 |
| 2020 October | 2009 | 174 | 2183 |
| 2020 September | 2543 | 212 | 2755 |
| 2020 August | 2137 | 216 | 2353 |
| 2020 July | 9487 | 1074 | 10561 |
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