THERAPEUTIC USE OF IVERMECTIN FOR THE EARLY TREATMENT OF COVID-19 Leila Romão Capitani dos Santos, José Eduardo Pandini Cardoso Filho

Abstract

There were many challenges faced in the pandemic caused by Covid-19, such as the rapid spread of SARS-CoV-2 (severe acute respiratory syndrome coronavirus type 2) and the emergence of new variants. This led the WHO (World Health Organization) to declare a state of emergency in public health, remaining so until, due to the high levels of antibodies acquired by the population, through vaccines or naturally (by patients previously infected with the coronavirus), there was a reduction in the number of cases and deaths, causing the WHO to remove Covid-19 from the state of emergency. However, although at a lower intensity, the virus will continue to circulate, with the possibility of the emergence of new variants, whose antibodies acquired by the population may be ineffective, highlighting the importance of identifying accessible, safe and effective drugs against the virus. Thus, ivermectin presents itself as a strong candidate, as in addition to being affordable and having an excellent safety profile, it has antiviral and anti-inflammatory action. Its potential effects occur in the viral replication phase, therefore, it should be used as early as possible. That said, this literature review was carried out to evaluate the randomized studies available on the PubMed website database platform, which sought to somehow evaluate the effectiveness of ivermectin for early treatment for Covid-19. A total of 4 articles meeting the methodological requirements were included, totaling 1381 patients with mild to moderate symptoms, for up to 7 days before randomization and with Covid-19 confirmed by the RT-PCR test. The studies presented important limitations, mainly regarding the dose, which was lower than recommended, and regarding the young population with few comorbidities, a profile that usually recovers naturally. Still, ivermectin had an advantage in most outcomes, compared to placebo. Furthermore, the drug was able to reduce viral load and culture viability with statistical significance, proving its anti-SARS-CoV-2 activity expressed in vitro. For these reasons, the present study assessed that the use of ivermectin for the early treatment of Covid-19 is beneficial, but highlights the importance of new, well-structured studies, with higher doses of ivermectin and starting treatment as early as possible, in order to better evaluate its pharmacological potential.