Ivermectin confers benefits in the treatment of COVID-19, with a recent study showing that its use helps reduce the risk of death especially in patients with severe pulmonary involvement.

The study included 280 patients (mean age, 59.6 years; 45.4 percent female), 173 of whom received ivermectin and 107 did not. Most patients in both groups were also given hydroxychloroquine, azithromycin, or both.

Ivermectin dosing guidelines were provided, but treatment decisions were left to the treating physician. Most patients received a single dose, while 13 patients received a second dose for ongoing signs or symptoms on day 7 of treatment.

Univariate logistic regression analysis revealed a significant advantage with ivermectin (mortality rate, 15.0 percent vs 25.2 percent; odds ratio [OR] for death, 0.52, 95 percent CI, 0.29–0.96; p=0.03), which was more pronounced in the subgroup of patients with severe pulmonary involvement (mortality rate, 38.8 percent vs 80.7 percent; OR for death, 0.15, 95 percent CI, 0.05–0.47; p=0.001).

The favourable effect of ivermectin on mortality remained despite adjustments for confounders and mortality risks (OR, 0.27, 95 percent CI, 0.09–0.80; p=0.03).

There were no significant differences observed in extubation rates (36.1 percent vs 15.4 percent; OR, 3.11, 95 percent CI, 0.88–11.00; p=0.07) or length of hospital stay.

Results were consistent in a propensity score analysis involving 98 matched pairs. Ivermectin lowered mortality (13.3 percent vs 24.5 percent; OR, 0.47, 95 percent CI, 0.22–0.99; p<0.05), with an 11.2-percent absolute risk reduction and a number needed to treat of 8.9.

Chest 2020;doi:10.1016/j.chest.2020.10.009

First published 21 Nov 2020