OPINIÃO

OPINIÃO: COV-19 tem tratamento: apelo de médica britânica pela ivermectina

Gilson Dantas

Brasília

sábado 13 de fevereiro| Edição do dia

[Essa é uma opinião do autor, e não representa a posição do MRT sobre o tema]
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Bolsonaro consegue levar adiante a política sanitária e social da pandemia com a mão de ferro da irracionalidade em todos os terrenos.

Sua irracionalidade começa pela crise das vacinas [ver aqui], passando pelo não amparo ao infectado/sintomático pobre, pela opressão e exploração contra a classe trabalhadora [perdas de postos de trabalho e precarização permanente], a carestia em escalada,degradação social e aumento da pobreza, até o elemento que focaremos aqui, a questão do tratamento da doença do COV-19.

Logo no início da pandemia a China, a França e outros países começaram a utilizar com êxito uma droga e em seguida apareceu outra [hidroxicloroquina e ivermectina], contra a doença do COV-19. [Ambos são medicamentos da lista da OMS][Sobre a OMS ver aqui artigo a respeito].

Ambas com poder clínico de derrubar a carga viral e oferecer ao paciente uma chance de sobreviver, de não ter que ir para a UTI.

Algum tempo depois, Bolsonaro, seguindo D. Trump, partiu para a mais vulgar demagogia com uma dessas drogas, a hidroxicloroquina. Armou um circo em torno da hidroxicloroquina, fundamentalmente para encobrir sua política desastrosa em relação à pandemia e, através do seu jogo de bravatas, terminou por queimar o medicamento em boa parte da opinião pública.

O pensamento binário de certa esquerda, por sua vez, confundiu a droga com o fascista Bolsonaro e o resultado - com o decisivo apoio da campanha da grande mídia de oposição a Bolsonaro e da burocracia médica [aliada da Big Pharma] foi que a hidroxicloroquina – e mais adiante a ivermectina – se tornaram drogas malditas.

E ficou politicamente inibido o debate nacional científico sobre o tratamento do COV-19.

Dessa forma, quem defende cientificamente tais medicamentos corre o risco a) de ser confundido com Bolsonaro e b) de ser alvo de deboche nas redes sociais.
Nos dois casos, por conta de um ardil dogmático: o método de, substituindo a ciência pela política, simplesmente cancelar a droga sem investigar para ver se – a despeito do circo bolsonarista – ela funciona ou não.

O resultado foi que hidroxicloroquina e ivermectina passaram a apanhar menos por razões científicas e mais por motivo ideológico sem qualquer conteúdo científico.

De nossa parte, desde o inicio dessa pandemia [ver matéria de 8 de abril de 2020: https://www.esquerdadiario.com.br/O-que-se-pode-dizer-cientificamente-sobre-a-hidroxicloroquina ], para além da denúncia do regime Bolsonaro por sua política homicida – vide Manaus que não é um fenômeno isolado – procuramos os dados científicos para não corrermos o risco [típico do pensamento binário] de jogarmos a água suja e também a criança fora]. Isto é, para enfrentar o reacionário Bolsonaro, enterrar o debate do tratamento.

O resultado disso materializou-se em um livro, publicado em setembro [ver aqui] que representa um postura de, ao mesmo tempo em que se leva o combate ao regime bolsonarista até o final, tratar de não abrir mão da busca de informações independentes sobre drogas baratas e sem patente que podem salvar vidas, mesmo que estejam sob fogo cerrado – e claramente suspeito - da OMS/Anvisa e da Globo/Uol e afins.

De lá para cá, mais evidências surgiram, não apenas em favor da hidroxicloroquina como também da droga mais simples de ser usada, a ivermectina. Ambas, reiteremos, não por acaso sem patente e de baixo custo; e, novamente, não por acaso, ambas combatidas pela Big Pharma e sua mídia e burocracia médica amestradas.

Na nota de hoje – primeira de uma série – voltaremos à carga, no sentido de reforçar o debate que já existe sobre o tratamento da doença do COV-19.

Para os bons observadores, que não lêem apenas a big mídia, já está evidente que materiais científicos e experiências médicas têm se acumulado, como regra mostrando o poder terapêutico das duas drogas [ desde que a experiência seja bem conduzida e não vinculada a conflito de interesses].

A verdade é que não se pode deixar de opinar nesse debate apenas porque ele vem contaminado politicamente; no real, o incontornavel é que ele envolve vidas humanas.

E, como diz a Dra Tess Lawrie, na nota de hoje, a maioria das pessoas que morrem em consequência do ataque direto do vírus não precisariam morrer se lhes fosse concedido o tratamento com essas drogas, com a ivermectina por exemplo.

Propomos que o leitor desta, também das notas anteriores e das que virão, se dispa um pouco de dogmas e, sem abandonar o combate ao regime Bolsonaro, entenda alguns pontos: a) que a ciência aplicada deve falar mais alto que qualquer pressuposto ideológico e b) que o regime Bolsonaro JAMAIS quis ir além da demagogia eleitoreira em torno do tratamento, JAMAIS fez política pública racional contra a pandemia o que teria que incluir tratamento. E que neste item, esse regime [que inclui o STF, o parlamento, os generais] nunca foi, de fato, além da bravata. E c) considere bemvindo o debate sobre o contraditório.

Portanto, atentem pra o depoimento da médica e pesquisadora britânica abaixo e, binarismos à parte [do tipo se meu inimigo defende o café eu passarei a combater o café], ouçam a voz da experiência.

Mais ainda em uma pandemia que interessa agudamente aos vendedores de vacinas, ao poder político da Big Pharma, que precisa intensamente que se acredite que para esse vírus não há tratamento sem patente e de baixo custo.

Neste sentido, Bolsonaro e D. Trump terminaram sendo funcionais àquele poder: queimaram politicamente drogas que - por fora da politicalha da extrema-direita - estão salvando vidas em países como a Índia por exemplo, e que, lamentavelmente, no caso do Brasil, NUNCA viraram política de Estado.

Assista ao vídeo/carta da cientista, PhD e médica, Dra Tess Lawrie ao primeiro-ministro britânico reivindicando o uso da ivermectina globalmente no tratamento do COV-19. [Obviamente sem compartilhar de suas ilusões com o governo imperialista inglês].

Na sequência, teremos a tradução da sua carta/vídeo [1] e, logo abaixo, você pode assistir seu vídeo/carta [infelizmente, com legendas em francês].

Você também pode ler, caso lhe interesse, sobre hidroxicloroquina aqui.

A carta da pesquisadora:

Carta para o Sr. Boris Johnson da cientista do Reino Unido, Dra. Tess Lawrie, pedindo-lhe que comece a salvar vidas com ivermectina

Na sua carta ao primeiro-ministro, Dra. Lawrie, afirma,

“A boa notícia é que agora temos evidências sólidas de um tratamento eficaz contra o Covid-19. É chamado de ivermectina.

A ivermectina é um medicamento antiparasitário muito seguro e eficaz, amplamente utilizado em países de baixa e média renda para tratar vermes, piolhos e sarna em adultos e crianças. Já existe há décadas e não só está na lista da OMS de medicamentos essenciais, como também é um medicamento ganhador do Prêmio Nobel devido à sua crescente utilidade em uma série de doenças.

Entre o Natal e o ano novo, fiz uma revisão independente de 27 estudos apresentados pelo FLCCC [Frontline COV-19 Critical Care Alliance] como evidência da eficácia da ivermectina. A evidência resultante é consistente e inequívoca: a ivermectina funciona bem, tanto na prevenção de infecções viróticas, quanto na prevenção de mortes nas mesmas doses usadas para tratar piolhos e outras infecções parasitárias.

Tenho o prazer de informar que esta evidência fundamenta solidamente a recomendação do FLCCC de que a ivermectina deve ser adotada globalmente e sistematicamente para a prevenção e o tratamento de Covid-19.

Como sei que há muitas notícias falsas acontecendo, gostaria de garantir a você que pode confiar na integridade do meu relatório, pois sou uma consultora de pesquisa médica independente e experiente, cujo trabalho é rotineiramente usado para apoiar as diretrizes de prática clínica internacional. Além disso, não tenho conflitos de interesses e não recebi financiamento para este relatório.

Mas, acima de tudo, você pode confiar em mim porque sou uma médica, antes de mais nada, com o dever moral de ajudar as pessoas, de não fazer mal e de salvar vidas.

Por favor, podemos começar a salvar vidas agora.
Muito obrigado por sua ajuda”.

Seu vídeo:

Mais informações:

“A Dr. TESS LAWRIE, médica Phd é diretora da Consultoria de Medicina Baseada em Evidências em Bath, Reino Unido e tem uma empresa, a Evidence-Based Medicine Consultancy Ltd, que é especializada em meta-análises e revisões científicas.
[...]

E ela decidiu realizar, por sua própria conta, a revisão de 27 estudos sobre a ivermectina.

E, quando extraiu os dados, verificou que se tratava de uma droga com resultados maravilhosos no tratamento e cura do COVID-19.

Um dado importante da sua revisão mostrou [...] redução de 83% do risco de morte naqueles pacientes hospitalizados. Um dado nada desprezível.

E atualmente não se discute mais se a ivermectina diminui ou não a mortalidade, mas qual é o percentual dessa redução. E Dra. Tess disse que podemos afirmar que de cada 10 pessoas que estão morrendo de Covid-19, 8 morrerão desnecessariamente se não administrarmos a ivermectina. Ela apresentou suas evidências e que estão no web site que ela mantém.

Dra. Tess disse que é importante neste momento olhar em especial as evidências relativas às pessoas que receberam e as que não receberam o tratamento com a ivermectina e quais foram as consequências.

Veja na íntegra a entrevista que Dra. Tess Lawrie deu para Jennifer Hibberd sobre as inúmeras evidências favoráveis da Ivermecina no COVID-19 e as dificuldades de divulgá-las. Acesse o link aqui.

Depois de concluir a sua primeira revisão dos estudos de ivermectina, Dra. Tess constatou que tinha que comunicar imediatamente seus dados para as autoridades e comunidades científicas, mas que não conseguia divulgá-los.

Uma verdadeira barreira-censura midiática. Chegou a fazer um vídeo para o primeiro-ministro do Reino Unido, mas ficou sem resposta dele ou dos demais políticos. Infelizmente os políticos não responderam às inúmeras tentativas de contato.

Segundo a Dra. Tess, agora a questão é analisar quais são as consequências de continuaremos exigindo séries que irão utilizar pacientes controles com COVID-19 e que não irão receber a ivermectina, diante das evidências dos efeitos benéficos da droga na cura e risco de óbito para o paciente.

No grupo de cientistas que ela reuniu para uma conferência foi feita essa pergunta e a resposta foi unânime: ninguém deixaria de dar a ivermectina se tivesse um paciente ou um parente seu com COVID-19.

Ela agora juntou um grande time de cientistas e estão fazendo um estudo revisional extenso, adicionando mais pesquisas que surgiram recentemente e adotaram o sistema de revisão preconizado pela Cochrane, que tem metodologia e sistemática excelente e muito respeitada .

E vão distribuir essa revisão assim que for concluída, mas deixou bem claro a sua opinião: após agosto de 2020, as evidências favoráveis a ivermectina são muitas e que incluem vários estudos randomizados, controlados e duplo cegos de alta qualidade muito bem executados. E que atualmente que não existe mais a possibilidade de se exigir séries similares, pois já são conhecidos os efeitos curativos da ivermectina no paciente com COVID-19. Seria antiético.
[...]

A Dra. Tess também comentou que a divulgação das informações sobre as qualidades terapêuticas da ivermectina no COVID-19 está sendo muito distorcida pela mídia sendo que a ivermectina é um remédio bom e barato, que poderia estar sendo distribuído mundialmente para debelar o COVID-19.

E que recentemente surgiram dados a respeito do mecanismo de ação da ivermectina mostrando que ela se concentra em grande quantidade no pulmão, atuando profilaticamente e no tratamento da doença”. [Informações do portal da Dra Lucy Kerr].

Por fim, vale reiterar que, no caso da ivermectina, mas também da hidroxicloroquina, a política do governo brasileiro ultrarreacionário de Bolsonaro tem sido, DE FATO, contrária ao tratamento do COV-19: faz demagogia e circo – muito circo - com a hidroxicloroquina e, no entanto, jamais adotou, de fato, uma política de Estado efetiva e consequente com quaisquer dessas duas drogas.

Ao mesmo tempo em que, a exemplo de Manaus, adota uma antipolítica sanitária [e de vacinas] e uma política social que vem favorecendo mortes por vírus e mortes por todas as causas. [Ver análise mais completa sobre o regime Bolsonaro hoje aquie também aqui.

[Esse artigo representa fundamentalmente a opinião do autor, não do MRT].

PS – Nestes dias a rede Globo divulgou com estardalhaço um comunicado da Merck, um dos fabricantes da ivermectina, informando que a ivermectina não funciona no COV-19. Naturalmente a Globo não vai informar que outro fabricante [Vitamedic] também tirou uma nota justamente na direção contrária: reafirmando o papel antiviral [anti-COV-19] do medicamento e também seguro; também menciona que “a comprovada segurança oferecida ao uso da ivermectina e mais dezenas de outros estudos desenvolvidos ao redor do mundo, especialmente nos Estados Unidos, Inglaterra, Egito, Argentina, Eslováquia, Peru, México, entre outros, deram ainda mais segurança e argumentos à comunidade médica, instituições de saúde pública para incluir a ivermectina nos protocolos de combate à doença”, que pode ser lido aqui. Ou seja, a notícia repercutida pela Globo e seus pares da grande mídia amestrada não passou de mais um dos seus artigos ideológicos, de fins escusos, provavelmente na intenção de enterrar a ivermectina para dar passagem a mercadorias de muito mais retorno na taxa de lucro.

NOTAS: [A seguir, procuramos reunir dezenas de artigos científicos que apontam, positivamente, para o uso clínico da ivermectina na doença do COV-19]

[1] Nosso agradecimento ao portal da Dra Lucy Kerr, médica em SP e grande divulgadora e defensora do tratamento da doença do COV-19 através da ivermectina, pela tradução da carta da Dra Lawrie.

[2] O livro do Dr G Dantas sobre o tratamento da doença do COV-19 pode ser solicitado - sem ônus - através do email [email protected], mencionado neste artigo.

[3] Tess Lawrie: Ivermectin reduces the risk of death from COVID-19 – a rapid review and meta-analysis in support of the recommendation of the Front Line COVID-19 Critical Care Alliance. 3 January 2021. Evidence-based Medicine Consultancy Ltd. Bath.

[4] Tess Lawrie to Boris Johnson. A letter to Mr. Boris Johnson from UK scientist Dr. Tess Lawrie calling on him to start saving lives with Ivermectin. Health Rising 2021. Forums. Health News

[5] Database of all ivermectin COVID-19 studies. 55 studies, 21 peer reviewed, 35 with results comparing treatment and control groups. Submit updates/corrections below. FLCCC provides treatment recommendations.

[6] Ivermectin is effective for COVID-19: real-time meta analysis of 35 studies - https://ivmmeta.com/ 100% of the 35 studies to date report positive effects. Early treatment is more successful, with an estimated reduction of 84% in the effect measured using a random effects meta-analysis, RR 0.16 [0.08-0.33]. Prophylactic use also shows.

[7] Chamie-Quintero et al., Preprint, doi:10.2139/ssrn.3765018 (Preprint) Sharp Reductions in COVID-19 Case Fatalities and Excess Deaths in Peru in Close Time Conjunction, State-By-State, with Ivermectin Treatments Analysis of ivermectin usage within states in Peru showing sharp reductions in COVID-19 deaths corresponding to the usage of ivermectin treatment. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3765018 21-1-2021— “ These sharp major reductions in COVID-19 mortality following IVM treatment thus occurred in each of Peru’s states, with such especially sharp reductions in close time conjunction with IVM treatments in each of the nine states of operation MOT.”

[8] Heidary et al., The Journal of Antibiotics, 73, 593–602, doi:10.1038/s41429-020-0336-z (Review) (Peer Reviewed) https://www.nature.com/articles/s41429-020-0336-z Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen Review of the antimicrobial, antiviral, and anti-cancer properties of ivermectin. Antiviral effects have been reported for Zika, dengue, yellow fever, West Nile, Hendra, Newcastle, Venezuelan equine encephalitis, chikungunya, Semliki For.. “In vivo studies of animal models revealed a broad range of antiviral effects of ivermectin, however, clinical trials are necessary to appraise the potential efficacy of ivermectin in clinical setting”.

[9] Mody et al., Communications Biology, doi:10.1038/s42003-020-01577-x (Peer Reviewed) (In Vitro) in vitro Identification of 3-chymotrypsin like protease (3CLPro) inhibitors as potential anti-SARS-CoV-2 agents Computational molecular modeling screening and in vitro analysis for inhibitory effects on SARS-CoV-2 specific 3CLpro enzyme, showing that ivermectin blocked more than 85% of 3CLpro activity of SARS-CoV-2. Antiviral activity of ivermectin. https://www.nature.com/articles/s42003-020-01577-x “In summary, these molecules [inclui a ivermectina] could be useful to develop highly specific therapeutically viable drugs to inhibit the SARS-CoV-2 replication either alone or in combination with drugs specific for other SARS-CoV-2 viral targets.”

[10] Prof Andrew Hill: See Whipple T. Ivermectin: Tests show cheap drug may reduce Covid-19 death toll. The TImes 2021 Jan 4. https://www.thetimes.co.uk/article/ivermectin-tests-show-cheap-drug-may-...

[11] Hill et al., Research Square, doi:10.21203/rs.3.rs-148845/v1 (Preprint) (meta analysis) meta-analysis Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection Meta analysis of 18 ivermectin RCTs with 2,282 patients showing faster viral clearance (dose and duration dependent), improved clinical recovery, and lower hospitalization and mortality. In six RCTs of moderate or severe infection, there .. ” This meta-analysis investigated ivermectin in 18 randomized clinical trials (2282 patients) identified through systematic searches of PUBMED, EMBASE, MedRxiv and trial registries. Ivermectin was associated with reduced inflammatory markers (C-Reactive Protein, d-dimer and ferritin) and faster viral clearance by PCR. Viral clearance was treatment dose- and duration-dependent. In six randomized trials of moderate or severe infection, there was a 75% reduction in mortality (Relative Risk=0.25 [95%CI 0.12-0.52]; p=0.0002); 14/650 (2.1%) deaths on ivermectin; 57/597 (9.5%) deaths in controls) with favorable clinical recovery and reduced hospitalization”. https://www.researchsquare.com/article/rs-148845/v1

[12] Paul Marik: The I-MASK+ protocol will revolutionize the treatment of COVID-19. The FLCCC Alliance press conference in Houston, Texas, Dec 4, 2020 , Front Line COVID-19 Critical Care Alliance.

[13] US Senate to the NIH. https://www.hsgac.senate.gov/imo/media/doc/40-317_Comm.%20Homeland%20Sec...

[14] Raad et al., ChiCTR2000033627 (Preprint) In vivo use of ivermectin (IVR) for treatment for corona virus infected patients (COVID-19): a randomized controlled Trial https://c19ivermectin.com/raad.html RCT in Lebanon showing significantly lower viral load at day 3, and lower hospitalization.

[15] Asghar et al., NCT04392713 (Preprint) Efficacy of Ivermectin in COVID-19 https://clinicaltrials.gov/ct2/show/NCT04392713 RCT with 103 patients in Pakistan comparing ivermectin and CQ, showing significantly lower PCR+ at day 7 with ivermectin.

[16] Kory et al., Frontiers in Pharmacology, doi:10.3389/fphar.2021.643369 (Review) (Peer Reviewed) review Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19 https://osf.io/wx3zn/?fbclid=IwAR1D8zI_SzOtaFAOG840QYFfdtvjcNxtd38-ej-hG_uj_RBIbkKYwCHnUbQ Meta analysis of ivermectin clinical studies and natural experiments where ivermectin has been widely used, showing efficacy of ivermectin in prophylaxis and treatment of COVID-19.” Although it is now standard practice for trials data from pré-print servers to immediately influence therapeutic practices during the pandemic, given the controversial therapeutics adopted as a result of this practice, the FLCCC argues that it is imperative that our major national and international health care agencies devote the necessary resources to more quickly validate these studies and confirm the major, positive epidemiological impacts that have been recorded when ivermectin is widely distributed among populations with a high incidence of COVID 19 infections”.

[17] Okumus et al., NCT04646109 (Preprint) Ivermectin for Severe COVID-19 Management https://clinicaltrials.gov/ct2/show/NCT04646109

[18] Ravikirti et al., medRxiv, doi:10.1101/2021.01.05.21249310 (Preprint) death, ?88.7%, p=0.12 Ivermectin as a potential treatment for mild to moderate COVID-19: A double blind randomized placebo-controlled Trial https://www.medrxiv.org/content/10.1101/2021.01.05.21249310v1 - “Conclusion There was no difference in the primary outcome i.e. negative RT-PCR status on day 6 of admission with the use of ivermectin. However, a significantly higher proportion of patients were discharged alive from the hospital when they received ivermectin”.

[19] Babalola et al., medRxiv, doi:10.1101/2021.01.05.21249131 (Preprint) viral+, ? Ivermectin shows clinical benefits in mild to moderate Covid19 disease: A randomised controlled double blind dose response study in Lagos https://www.medrxiv.org/content/10.1101/2021.01.05.21249131v1 “Conclusions 12 mg IV regime may have superior efficacy. IV should be considered for use in clinical management of SARS-Cov-2, and may find applications in community prophylaxis in high-risk áreas”. “CONCLUSIONS: Ivermectin use is associated with reduced duration of febrile illness in COVID-19 in outpatient setting, thus potentially saving precious lives, reducing direct load on healthcare facilities and preventing high cost of management in a community setting”.

[20] Hussain et al., International Journal of Molecular and Immuno Oncology, doi:10.25259/IJMIO_30_2020 (Peer Reviewed) Outcome of ivermectin and doxycycline in cancer patients with COVID-19: A positive experience in Bangladesh - “The World Health Organization estimated that the period of this viral shedding is up to 9 days and 20 days for the patients with mild symptoms and for those who are hospitalized, respectively.[1] We report data of eight SARSCoV-2-infected cancer patients who were treated with ivermectin and doxycycline combination and recovered in 6 days only. In addition, our patients remained non-infectious to other people in the hospital as the successive two PCR tests were negative”. https://covid19.cdmx.gob.mx/storage/app/media/Articulos/OutcomeofivermectinanddoxycyclineincancerpatientswithCOVID-19_ApositiveexperienceinBangladesh.pdf Small case study of ivermectin + doxycycline with 8 cancer patients, with all patients becoming PCR- by day 6 when tested again.

[21] Chaccour et al., EClinicalMedicine, doi:10.1016/j.eclinm.2020.100720 (preprint 12/7) (Peer Reviewed) The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial - https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30464-8/fulltext Tiny RCT for early treatment of mild COVID-19 in low risk patients, with 12 400mcg/kg single dose ivermectin patients and 12 control patients, showing significantly faster viral load reduction and symptom improvement with ivermectin. “Among patients with non-severe COVID-19 and no risk factors for severe disease receiving a single 400 mcg/kg dose of ivermectin within 72 h of fever or cough onset there was no difference in the proportion of PCR positives. There was however a marked reduction of self-reported anosmia/hyposmia, a reduction of cough and a tendency to lower viral loads and lower IgG titers which warrants assessment in larger trials”.

[22] Ahmed et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.11.191 (Peer Reviewed) A five day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness” - There were no severe adverse drug events recorded in the study. A 5-day course of ivermectin was found to be safe and effective in treating adult patients with mild COVID-19. Larger trials will be needed to confirm these preliminary findings”.

[23] Chamie, J. (News) The effect of using ivermectin to control COVID-19 in Chiapas https://c19ivermectin.com/chamie.html After starting to distribute ivermectin in drug kits in July, the Mexican state of Chiapas has seen a dramatic divergence from other states with much lower mortality [1, 2].

[24] Alonso et al., (Preprint) https://c19ivermectin.com/ Observational study in Argentina showing significantly lower mortality in the 60 days after adopting ivermectin compared to the 60 days before,

[25] Bernigaud et al., Annals of Dermatology and Venereology, doi:10.1016/j.annder.2020.09.231 (Peer Reviewed) Ivermectin benefit: from scabies to COVID-19, an example of serendipity https://c19ivermectin.com/bernigaud.html

[26] Hellwig et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106248 (Peer Reviewed) A COVID-19 Prophylaxis? Lower incidence associated with prophylactic administration of Ivermectin https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698683/ “ It is suggested that ivermectin be evaluated for potential off-label prophylactic use in certain cases to help bridge the time until a safe and effective vaccine becomes available.”

[27] Heidary, Fatemeh; Gharebaghi, Reza (2020-09). Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen. The Journal of Antibiotics, 73 (9): 593-602. http://www.nature.com/articles/s41429-020-0336-z

[28] Crump A. Ivermectin: enigmatic multifaceted ‘wonder’ drug continues to surprise and exceed expectations. J Antibiot. 2017;70:495–505. https://dx.doi.org/10.1038 /ja.2017.11

[29] Barrows, N. J., Campos, R. K., et al. (2016). A Screen of FDA-Approved Drugs for Inhibitors of Zika Virus Infection. Cell host & microbe, 20(2), 259–270. https://doi.org/10.1016/j.chom.2016.07.004

[30] Tay, M. Y., Fraser, J. E., et al. (2013). Nuclear localization of dengue virus (DENV) 1-4 non-structural protein 5; protection against all 4 DENV serotypes by the inhibitor Ivermectin. Antiviral research, 99(3), 301–306. https://doi.org/10.1016/j.antiviral.2013.06.002

[31] Mastrangelo, E., Pezzullo, M., et al. (2012). Ivermectin is a potent inhibitor of flavivirus replication specifically targeting NS3 helicase activity: new prospects for an old drug. The Journal of antimicrobial chemotherapy, 67(8), 1884–1894. https://doi.org/10.1093/jac/dks147

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[63] Elgazzar, A., Hany, B., et al., Efficacy and Safety of Ivermectin for Treatment and prophylaxis of COVID-19 Pandemic, 13 November 2020, Research Square preprint, https://doi.org/10.21203/rs.3.rs-100956/v1

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[81] Smit M, Ochomo E, et al., Safety and mosquitocidal efficacy of high-dose ivermectin when co-administered with dihydroartemisinin-piperaquine in Kenyan adults with uncomplicated malaria (IVERMAL): a randomised, double-blind, placebo-controlled trial, The Lancet Infectious Diseases, March 27, 2018, ISSN: 1473-3099, Vol: 18, Issue: 6, Page: 615-626 DOI: https://doi.org/10.1016/S1473-3099(18)30163-4

[82] Guzzo CA, Furtek CI, et al. Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects. J Clin Pharmacol. 2002 Oct;42(10):1122-33. doi: 10.1177/009127002401382731. PMID: 12362927.

[83]https://www.reddit.com/r/COVID19/comments/hk75iz/ivermectin_for_covid19_treatment_clinical/

[84] https://www.infobae.com/salud/ciencia/2020/09/25/los-detalles-del-estudio-con-ivermectina-para-uso-humano-que-demostro-reducir-la-carga-viral-y-la-contagiosidad-en-pacientes-con-covid-19/

[85] FDA contra a ivermectina: The FDA’s Center for Veterinary Medicine, FDA Letter to Stakeholders: Do Not Use Ivermectin Intended for Animals as Treatment for COVID-19 in Humans, April 10, 2020. Em espanhol: https://www.fda.gov/animal-veterinary/product-safety-information/carta-de-la-fda-las-partes-interesadas-no-use-ivermectina-destinada-animales-como-tratamiento-para 80 https://www.isglobal.org/healthisglobal/-/custom-blog-portlet/questions-and-answers-about-ivermectin-and-covid-19/2877257/0

[86] Ogbuokiri et al. PO. Ivermectin levels in human breast milk. Eur J Clin Pharmacol. 1994;46:89-90. Letter. https://www.ncbi.nlm.nih.gov/pubmed/8005194

[87] Niaee et al., Research Square, doi:10.21203/rs.3.rs-109670/v1 (Preprint) Analysis of COVID-19 cases vs. widespread prophylactic use of ivermectin for parasitic infections showing significantly lower incidence of COVID-19 cases. https://www.researchsquare.com/article/rs-109670/v1 “ Ivermectin as an adjunct reduced the rate of mortality, low O2 duration, and duration of hospitalization in adult COVID 19 patients. The improvement of other clinical parameters showed that the ivermectin, with a wide margin of safety, had a high therapeutic effect on COVID-19”.

[88 ] Spoorthi et al., IAIM, 2020, 7:10, 177-182 (Peer Reviewed) Utility of Ivermectin and Doxycycline combination for the treatment of SARSCoV-2 https://pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-896543 100 patient prospective trial of ivermectin + doxycycline showing reduced time to symptom resolution and shorter hospital stay with treatment. “Our study supports the benefits of utilization of combination of Doxycycline and Ivermectin in mild to moderate COVID-19 infection in terms of early recovery based on the time for symptom resolution and the mean duration of hospital stay”

[89 ] Elgazzar et al., Research Square, doi:10.21203/rs.3.rs-100956/v2 (Preprint) Efficacy and Safety of Ivermectin for Treatment and prophylaxis of COVID-19 Pandemic https://www.researchsquare.com/article/rs-100956/v2 ” Conclusion: Addition of Ivermectin to standard care is very effective drug for treatment of COVID-19 patients with significant reduction in mortality compared to Hydroxychloroquine plus standard treatment only. Early use of Ivermectin is very useful for controlling COVID 19 infections; prophylaxis and improving cytokines storm”.

[90] Cadegiani et al., medRxiv, doi:10.1101/2020.10.31.20223883 (Preprint) death, ? Early COVID-19 Therapy with Azithromycin Plus Nitazoxanide, Ivermectin or Hydroxychloroquine in Outpatient Settings Significantly Reduced Symptoms Compared to Known Outcomes in Untreated Patients https://www.medrxiv.org/content/10.1101/2020.10.31.20223883v1 Comparison of HCQ, nitazoxanide, and ivermectin showing similar effectiveness for overall clinical outcomes in COVID-19 when used before seven days of symptoms, and overwhelmingly superior compared to the untreated COVID-19 population, ev.. ” Early pharmacological approaches including azithromycin in combination with any of the options between nitazoxanide, ivermectin or optionally hydroxychloroquine should be considered for those diagnosed with COVID-19 presenting less than seven days of symptoms. Of the three drugs, we opted for nitazoxanide, due to more extensive demonstration of in vitro and in vivo antiviral activity, proven efficacy against other viruses in humans, and steadier safety profile”.

[91] Behera et al., medRxiv, doi:10.1101/2020.10.29.20222661v1 (Preprint) cases, ? Role of ivermectin in the prevention of COVID-19 infection among healthcare workers in India: a matched case-control study https://www.medrxiv.org/content/10.1101/2020.10.29.20222661v1 Retrospective prophylaxis study for HCQ, ivermectin, and vitamin C with 372 healthcare workers, showing lower COVID-19 incidence for all treatments, with statistical significance reached for ivermectin. HCQ OR 0.56, p = 0.29 Ivermectin O.. - “Conclusion - Two-dose ivermectin prophylaxis at a dose of 300 μg/kg with a gap of 72 hours was associated 73% reduction of COVID-19 infection among healthcare workers for the following one-month. Further research is required before its large scale use”.

[92] Arévalo et al., bioRxiv, doi:10.1101/2020.11.02.363242 (Preprint) animal study - Ivermectin reduces coronavirus infection in vivo: a mouse experimental model https://pesquisa.bvsalud.org/portal/resource/pt/ppbiorxiv-363242

[93] Raja Bhattacharya, View ORCID ProfileSampurna Chowdhury - Pre exposure hydroxychloroquine prophylaxis for covid-19 in healthcare workers: a retrospective cohort - https://www.medrxiv.org/content/10.1101/2020.06.09.20116806v3.full - “CONCLUSIONS This study demonstrated that voluntary HCQ consumption as pre-exposure prophylaxis by HCWs is associated with a statistically significant reduction in risk of SARS-CoV-2”.

[94 ] Hashim et al., medRxiv, doi:10.1101/2020.10.26.20219345 (Preprint) death, ? Controlled randomized clinical trial on using Ivermectin with Doxycycline for treating COVID-19 patients in Baghdad, Iraq https://www.medrxiv.org/content/10.1101/2020.10.26.20219345v1 ” Conclusions Ivermectin with doxycycline reduced the time to recovery and the percentage of patients who progress to more advanced stage of disease; in addition, Ivermectin with doxycycline reduced mortality rate in severe patients from 22.72% to 0%; however, 18.2% of critically ill patients died with Ivermectin and doxycycline therapy. Taken together, the earlier administered Ivermectin with doxycycline, the higher rate of successful therapy

[95] Guerrero et al., Colombia Médica, doi:10.25100/cm.v51i4.4613 (Peer Reviewed) COVID-19: The Ivermectin African Enigma - Study of African Programme for Onchocerciasis Control (APOC) countries, which used ivermectin, with non-APOC countries in Africa, showing 28% lower mortality for APOC countries, https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4613 “Conclusions: The incidence in mortality rates and the number of cases is significantly lower among the APOC countries compared to non-APOC countries. That a mass public health preventive campaign against COVID-19 may have taken place, inadvertently, in some African countries with massive community ivermectin use is an attractive hypothesis. Additional studies are needed to confirm it”.

[96] Rajter et al., Chest, doi:10.1016/j.chest.2020.10.009 (Peer Reviewed) death, ? Use of Ivermectin is Associated with Lower Mortality in Hospitalized Patients with COVID-19 (ICON study) https://pubmed.ncbi.nlm.nih.gov/33065103/ ” Ivermectin treatment was associated with lower mortality during treatment of COVID-19, especially in patients with severe pulmonary involvement”. Retrospective 280 hospitalized patients showing lower mortality with ivermectin (13.3% vs 24.5%), propensity matched odds ratio OR 0.47 [0.22-0.99], p=0.045.

[97] Mahmud et al., Clinical Trial Results, NCT04523831 (Preprint) Clinical Trial of Ivermectin Plus Doxycycline for the Treatment of Confirmed Covid-19 Infection https://clinicaltrials.gov/ct2/show/results/NCT04523831?view=results RCT for ivermectin+doxycycline showing improvements in mortality, recovery, progression, and virological cure. There is no paper yet, results are reported on clinicaltrials.gov. 183 treatment and 180 control patients.

[98] Francés-Monerris et al., ChemRxiv, doi:10.26434/chemrxiv.12782258.v1 (Preprint) (Theory) Has Ivermectin Virus-Directed Effects against SARS-CoV-2? Rationalizing the Action of a Potential Multitarget Antiviral Agent https://chemrxiv.org/articles/preprint/Has_Ivermectin_Virus-Directed_Effects_against_SARS-CoV-2_Rationalizing_the_Action_of_a_Potential_Multitarget_Antiviral_Agent/12782258/1 “Hence, the wide spectrum of actions involving i) the interference with cell infection, ii) the inhibition of viral replication, and iii) elusion of the host immune system, could point to an unprecedented synergy between host- and virus-directed effects explaining the high anti-SARS-CoV-2 activity observed for this compound”.

[99] Khan et al., Archivos de Bronconeumología, doi:10.1016/j.arbres.2020.08.007 (Letter) Ivermectin treatment may improve the prognosis of patients with COVID-19 - https://www.archbronconeumol.org/es-ivermectin-treatment-may-improve-prognosis-articulo-S030028962030288X - “Therefore, given the urgent need to manage the COVID-19 patients with a safe, cheap and widely available drug, the present findings suggest that ivermectin can be considered as a first-line treatment for containing SARS-CoV-2 to prevent severe irreversible respiratory complications and community transmission. A multicenter, double-blind, drug-controlled study will strengthen our findings”.

[100] Leon Caly, Julian D Druce et al - The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro – “We report here that Ivermectin, an FDA-approved anti-parasitic previously shown to have broad-spectrum anti-viral activity in vitro, is an inhibitor of the causative virus (SARS-CoV-2), with a single addition to Vero-hSLAM cells 2 h post infection with SARS-CoV-2 able to effect 5000-fold reduction in viral RNA at 48 h. Ivermectin therefore warrants further investigation for possible benefits in humans”.
“ - https://www.sciencedirect.com/science/article/pii/S0166354220302011

[101] Ivermectin as a Broad-Spectrum Host-Directed Antiviral: The Real Deal? - Review of ivermectin as a host-directed broad-spectrum antiviral agent for a range of viruses, including SARS-CoV-2. Cell culture experiments show robust antiviral action towards HIV-1, dengue virus (DENV), Zika virus, West Nile virus, V.. https://pubmed.ncbi.nlm.nih.gov/32942671/ - “This mini-review discusses the case for ivermectin as a host-directed broad-spectrum antiviral agent for a range of viruses, including SARS-CoV-2”. -

[102] Effects of Ivermectin-azithromycin-cholecalciferol combined therapy on COVID-19 infected patients: A proof of concept study https://www.alliedacademies.org/abstract/effects-of-ivermectinazithromycincholecalciferol-combined-therapy-on-covid19-infected-patients-a-proof-of-concept-study-14435.html
Small study with 28 patients treated with ivermectin + AZ + cholecalciferol and 7 control patients. All treated patients were PCR- at day 10 while all control patients remained PCR+. “This study found that the combination treatment might mitigate disease progression without significant adverse effects. Further studies are needed in order to extrapolate these findings to moderate and severe COVID-19”.

[103] Bhattacharya et al., Int. J. Scientific Research, doi:10.36106/ijsr/7232245 (Peer Reviewed) Observational Study on Clinical Features, Treatment and Outcome of COVID 19 in a tertiary care Centre in India- a retrospective case series - Retrospective 148 hospitalized patients showing triple therapy with ivermectin + atorvastatin + N-acetylcysteine resulted in a 1.35% case fatality rate which was well below the national average. ” Conclusions: Triple therapy with ivermectin + atorvastatin + N-acetylcysteine can be an useful adjunct to standard of care”. https://www.researchgate.net/publication/343660942_Observational_Study_on_Clinical_Features_Treatment_and_Outcome_of_COVID_19_in_a_tertiary_care_Centre_in_India-_a_retrospective_case_series

[104] Chang et al., ResearchGate (Preprint) Post-acute or prolonged COVID-19: ivermectin treatment for patients with persistent symptoms or post-acute symptoms Report on 33 patients with persistent or post-acute symptoms treated with ivermectin, showing a high rate of clinical improvement. “CONCLUSION: The result of the present study demonstrates that clinical improvement is observed in high percentage of patients with Persistent or Post-Acute Symptoms of COVID-19 who are treated with Ivermectin. Given the high number of patients with Persistent Symptoms and a favorable clinical response seen after receiving this specific treatment, we recommend that additional clinical studies be carried out on the use of Ivermectin and other drugs to reduce and eliminate the viral load in these cases”. https://www.researchgate.net/publication/344318845_POST ACUTE_OR_PROLONGED_COVID-19_IVERMECTIN_TREATMENT_FOR_PATIENTS_WITH_PERSISTENT_SYMPTOMS_OR_POST-ACUTE

[105] Chang et al., ResearchGate, doi:10.13140/RG.2.2.34561.48483/2 (Preprint) COVID-19: Post-exposure prophylaxis with ivermectin in contacts. At Homes, Places of Work, Nursing Homes, Prisons, and Others - “The inclusion of Acetylsalicylic Acid (ASA) or Aspirin in the PEP Schedule should be considered for men over 55 years of age and in persons with Increased Risk of developing
severe illness. Recommended dose is 1 tablet of 100 mg after lunch for 6 to 10 days.
Contacts should remain under observation in case they begin to show characteristic symptoms
of COVID-19, in which case they should move to therapeutic doses of Ivermectin”.
https://www.researchgate.net/publication/344781515_COVID-19_POST-EXPOSURE_PROPHYLAXIS_WITH_IVERMECTIN_IN_CONTACTS_At_Homes_Places_of_Work_Nursing_Homes_Prisons_and_Others

[106] Alam et al., Journal of Bangladesh College of Physicians and Surgeons, doi:10.3329/jbcps.v38i0.47512 (Peer Reviewed) A Case Series of 100 COVID-19 Positive Patients Treated with Combination of Ivermectin and Doxycycline “All patients tested negative and their symptoms improved within 72 hours. There were no noticeable side effects. Conclusion: Combination of Ivermectin and doxycycline was found to be very effective in viral clearance in mild and moderately sick COVID-19 patients. Medical societies and institutions should undertake larger multi center studies to validate and recommend this combination therapy to include in national guidelines”. Case study of 100 patients treated with ivermectin and doxycycline, with no ICU admission, deaths, or serious side effects reported. https://www.researchgate.net/publication/343305357_A_Case_Series_of_100_COVID-19_Positive_Patients_Treated_with_Combination_of_Ivermectin_and_Doxycycline

[107] Rahman et al., J. Bangladesh Coll. Phys. Surg. 38, 5-9, doi:10.3329/jbcps.v38i0 (Peer Reviewed) Comparison of Viral Clearance between Ivermectin with Doxycycline and Hydroxychloroquine with Azithromycin in COVID-19 Patients - “Conclusion: It appears Ivermectin and Doxycycline is safeand effective combination drug therapy in COVID- 19infected patients but need further extensive study to find out the scope of application on other groups of patients”. https://www.banglajol.info/index.php/JBCPS/article/view/47514

[108] Chowdhury et al., Research Square, doi:10.21203/rs.3.rs-38896/v1 (Preprint) A Randomized Trial of Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin therapy on COVID19 patients - “Conclusion The Ivermectin-Doxycycline combination showed a trend toward superiority to the Hydroxychloroquine-Azithromycin combination therapy in the case of patients with mild to moderate COVID19 disease, though the difference in time to becoming symptom-free and the difference in time to negative PCR was not statistically significant”. https://www.researchsquare.com/article/rs-38896/v1

[109] Gorial et al., medRxiv, doi:10.1101/2020.07.07.20145979 (Preprint) death, Effectiveness of Ivermectin as add-on Therapy in COVID-19 Management (Pilot Trial) - “ConclusionsAdd-on use of IVM to HCQ and AZT had better effectiveness, shorter hospital stay, and relatively safe compared with controls. however, a larger prospective study with longer follow up may be needed to validate these results”. https://pesquisa.bvsalud.org/portal/resource/pt/ppmedrxiv-20145979

[110] Lehrer et al., In Vivo, 34:5, 3023-3026, doi:10.21873/invivo.12134 (Theory) Ivermectin Docks to the SARS-CoV-2 Spike Receptor-binding Domain Attached to ACE2 https://www.x-mol.com/paper/1302073874220027904?recommendPaper=5812856 In silico analysis showing ivermectin docking which may interfere with the attachment of the spike to the human cell membrane.

[111] Rezai et al., IRCT20111224008507N3 (Preprint) Effectiveness of Ivermectin in the Treatment of Coronavirus Infection in Patients admitted to Educational Hospitals of Mazandaran in 2020 RCT in Iran showing shorter time to clinical recovery with Ivermectin. Results are from: [1] https://c19study.com/rezai.html

[112] Afsar et al., SSRN (Preprint) Ivermectin Use Associated with Reduced Duration of COVID-19 Febrile Illness in a Community Setting Small 95 patient study in Pakistan adding ivermectin to standard of care (HCQ+AZ) for outpatients with mild/moderate suspected COVID-19, showing faster resolution of fever with ivermectin. https://c19hcq.com/afsar.html

[113] Lacey Newlin - Could Ivermectin be an answer to both parasites and pandemics? https://www.hpj.com/ag_news/could-ivermectin-be-an-answer-to-both-parasites-and-pandemics/article_0b578c96-5529-11eb-b6bc-f78e273cbf37.html

[114]https://www.reddit.com/r/ivermectin/comments/l7iwld/ivermectin_to_save_belgium_belgium_20201222/

[115] Bangladesh: ivermectin shows promise in treating vírus - https://www.aa.com.tr/en/asia-pacific/bangladesh-ivermectin-shows-promise-in-treating-virus/2068885

[116] Ivermectin medicine to be used for Covid-19 treatment in Uttar Pradesh
https://www.knocksense.com/lucknow/ivermectin-medicine-to-be-used-for-covid-19-treatment-in-uttar-pradesh

[117] Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19): a structured summary of a study protocol for a randomized controlled Trial https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-020-04813-1

[118] Un estudio demuestra la respuesta antiviral de la ivermectina en pacientes con COVID-19 - https://www.argentina.gob.ar/noticias/un-estudio-demuestra-la-respuesta-antiviral-de-la-ivermectina-en-pacientes-con-covid-19

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