Ivermectin Prophylaxis Used for Covid-19 (Peer-Reviewed)
cureus.com
cureus.com
This is at best an indication of the need for better studies about the subject, but considering that Brazil's president is rabid pro-ivermectin and this was made in a medium city in a region favorable at the president, take this with a grain of salt.
I don't have a position on ivermectin, but it's pretty clear that any actual pre-treatmwent repurposing of drugs for any future pandemic should be the tip of the spear, but will be oppressed, underfunded, attacked, false-flagged, strawmanned, degraded, and doctor prescribers attacked.
This is totally, totally backwards. Even at $100,000,000 a clinical trial, funding 100 drugs with repurpose potential should have been step 1.
There were a few cases of fraud (most notably one of the biggest ivermectin studies last summer) but it’s not necessary to resort to allegations of ubiquitous fraud to conclude that the research doesn’t really support use of these drugs as effective Covid therapeutics
0: https://www.science.org/content/blog-post/what-s-ivermectin
So if you're from the US and your aunt from Florida/Louisiana tells you Ivermectin work, you can honestly respond: Yes.
The only thing I can think off is that (some) parasites tend to have a suppressive impact on the immune system but it also seem that could also prevent the cytokine storm that initially was reported as a major cause of severe illness and death.
The size and location of the study suggests that reporting of COVID-19 infections was by presentation, meaning asymptomatic or minimal infections were probably not counted.
tl;dr: These results will probably not translate well to places without pervasive parasite infestation. Wearing an N95 mask has a much larger protective effect than taking ivermectin, in any case, even there.
I just don't see how parasites would explain all these results. I do see how monetary incentives would play into maligning them though.
Also, the problem with these types of studies is that bad outcomes are sometimes not published. Nobody want to write an article with the title "We used Ivermectin and we killed an additional statistical significant number of coworkers" https://en.wikipedia.org/wiki/Reporting_bias For a RCT it's necessary more paperwork and authorizations and ideally preregistering. So that increase the chance of that they must write the final paper.
Also, as the PG noted the "peer review" of this site is not the traditional peer review of a normal journal. For example, the title says "Observational Study of 223,128 Subjects" but later it says "a total of 159,561 subjects were included in the analysis". The main part of the difference is that they report in the title the total number of inhabitants, but for the analysis they use only the ones that have more than 18 years old. It's not a smoking gun, but at least it's a small red flag.
I found the other study I wanted to reference: https://media.marinomed.com/8b/7a/c7/nota-journal-of-biomedi...
> No patients of the 788 treated with IVERCAR tested positive for CoVid 19 during the study.
Again, I don't know, but it smells like SOMETHING
What I "believe" about this is prophylaxis, I think this is why there are no results once symptoms are really apparent. This might be why the point about Ivermectin being antiviral only at very high doses doesn't hold, maybe it provides protection when there is only a tiny exposure to the virus. Heck, there's even a result circulating that cannabis was protective... Who knows?
Unfortunately almost all retail products that claim to have CBD don't. CBD from the pharmacy, which does, costs more than people usually want to pay.
Still, pretty amazing CBD would "block" entry of the virus in cells, or something like that (I only read the headlines, not pretending to understand)... But maybe this is somehow how Ivermectin can have antiviral properties at normal doses too. I suppose CBD once the infection sets in is less effective (though surely harmless).
CBD's effect on COVID-19 is to suppress the over-reaction of the immune system causing congestion and breathing problems. It does not interfere with the viral life cycle. So, it is useless to prevent COVID-19 infection.
In vitro analysis suggested that, in principle, ivermectin ought to help block COVID-19 virus in several ways. That generated interest to see if it would help.
The more reliable each study has been, the less effect it has shown. Something working great in test tubes (and even in mice) and failing when prescribed to actual people is totally unsurprising to anybody who works in medical research. Something promising that actually turns out to work clinically is always astonishing.
So, discounting promotion by people do lack long experience interpreting medical research results is not corrupt SUPPRESSION OF THE TRUTH. It is simple honest reporting, is doing you a favor, and you should welcome it.
Typical preparations, most especially those sold for vaping, turn out on examination to have ~2% of the amount of CBD advertised, where they have any. I.e., they have just enough that a crude test of presence shows something present.
I read one good-quality paper that reported an effect, and suggested plausible mechanisms. But the authors cautioned it needed more work before it could be recommended clinically. In particular, there was no hint it might prevent infection, or be useful to treat mild cases. The perhaps surprising bit was that THC interfered with the effect of the CBD.
The US NIH says that fluvoxamine is useful to treat serious cases. Any doctor can prescribe that.
That said, I buy from a premium dispensary and I have no idea what's vended in smoke shops.
As they say, it's not a double-blind randomized controlled trial.
I like more the pilot study because they try to match the age and pupation of the both groups. The problem is that they perhaps involuntary cherry picked the sublets in the experimental group. For example if there are 50 nurses and they want to recruit some of them, they may go first with with the ones that fill all the paperwork so they don't mess with the data for the study, or they skip the one that is drunk every other Monday or the one that is 15 minutes late everyday. Do these involuntary selection affect the result? Perhaps. Did they do this involuntary selection? Perhaps??? How can it be solved...
Make a double-blind randomized controlled trial. They can involuntary cherry pick and this is fixed by the randomization.
Also double-blind, because if you are the subject of the study, you don't want to "fail" and you are more careful. Or not. But just in case double-blind.
In the first study it's not clear how they got the control group. Perhspa go to HR, ask for the complete list, and then choose some randomly.
The second one is more weird, because
> A total of 1,195 health care workers were recruited from 4 major hospitals ... 788 participants received IVERCAR and PPEs, while the remaining 407 simply adhered to standard PPEs.
It's very unclear how they split them.
Another weird details is that
> Received date: November 09, 2020; Accepted date: November 16, 2020;
It's a very short review period. Perhaps it's common in the area, but in many areas the reviewers take like a month or more. I'm not sure if it's a good or bad journal. It's very difficult to know that if you are not in the area.
There’s one review, and it’s (IMO) not substantive. I would treat this as a preprint basically (not that you shouldn’t read peer reviewed studies critically either)
Can't emphasize this enough. The MMR autism fraud paper that started the anti-vaccine industry was peer reviewed in the Lancet.
It's unfortunate that the critical thinking skills needed to know good research from bad aren't drilled into us as part of the core curriculum for every high school student.
We already knew this. This doesn't apply outside areas with endemic parasites. It doesn't apply here in the US.
> How can I improve my article's SIQ™?
> Telling your friends, colleagues and advisors to review the article on Cureus
> Cureus offers a social media promotional add-on, or boost, for eligible published articles at an additional cost.
So this site is like PubMed but with payola?
But in places where they aren't available it could be interesting especially if Omicron is the dominant variant and reducing transmission isn't of much use (which Ivermectin doesn't help with).
The effect size is smaller than from wearing a good mask.
And be sure to keep in mind that the vast majority of infections occur at home where I sincerely doubt people are wearing masks.
If you want not to die from COVID-19, getting fully vaccinated is the way. If you want not to catch and spread it (vaccinated or no) wear a mask when you might be exposed or expose others. If you can't get vaccinated, anyway do things to be healthy -- treat any parasite infections, eat well, sleep well, eat well, exercise.
People aren’t going to wear masks forever and aren’t going to take boosters forever so we need more solutions. And before you say, they aren’t going to take ivermectin forever either but that doesn’t mean it’s not useful to know if, why and how it works.
There absolutely is such a reason: the standard for things that people are required to take should be way, way higher than the standard for things that people are merely allowed to take.
These results indicate that medical-based optional prescription and citywide covered ivermectin can have a positive impact on the healthcare system. However, the present results do not provide sufficient support for the hypothesis that ivermectin could be an alternative to COVID-19 vaccines
Nobody should take anything without discussing it with their doctor.