Ivermectin

30 January 2021 – The Efficacy of Ivermectin Against COVID‑19 – FLCCC – 27 JANUARY 2021 …. more news and articles on ivermectin, also about Slovakia….

A study by All India Institutes of Medical Sciences (AIIMS)-Bhubaneswar in the Indian state of Odisha found that two doses of potential drug ivermectin prophylaxis resulted in a 73% reduction in Covid-19 infection.    Between 20 September and 19 October, 12 physicians of AIIMS-Bhubaneshwar conducted the study on healthcare workers (HCWs) at risk of virus exposure.   Ivermectin is one among several potential drugs currently in trials for its therapeutic and preventive role in Covid-19 infection.

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CM Hasan and Pauline Francisca Gomes

Dr CM Hasan is Interventional Cardiologist and Associate Clinical Professor of Medicine and Cardiology, Mount Sinai Hospital, New York. Dr Pauline Francisca Gomes is Research Fellow, Shomman Foundation, Dhaka.

Ivermectin, a drug that has been highly acclaimed in the past few months for treatment of Covid-19 has once again come under the lime-light, but this time as a tool of prevention of the novel virus. A research on the preventive effect of Ivermectin on the SARS-COV-2 was published in the European Journal of Medical and Health Sciences on December 15, 2020, conducted by a research team in Bangladesh Medical College and Shomman Foundation under the guidance of chief investigator Dr Tarek Alam, professor and Head of Medicine Department in Bangladesh Medical College, and co-investigator Dr Rubaiul Murshed, Chairperson of Shomman.

Study on Ivermectin as pre-exposure prophylaxis of Covid-19 has also been acknowledged across the globe by many doctors and researchers. Recently, Dr Pierre Kory, a well-known pulmonologist in USA and the President of Frontline Covid-19 Critical Care (FLCCC) Alliance emphasised on the preventive effect of the drug on his recent review article where he compiled all data of Ivermectin prophylaxis studies, being conducted across the world. In Dr Kory’s manuscript, along with many studies from Argentina, India, France and Egypt, Dr Alam’s research on the preventive effect of Ivermectin gained acknowledgement as a commendable achievement from Bangladesh. Also, Dr Thomas Borody, renowned Australian Gastroenterologist and discoverer of the triple therapy for peptic ulcer, addressed the anti-viral effect of Ivermectin on Covid-19 in his study.

Recently, news from India stated that over 20,000 kalpwasis who are likely to camp on the Magh Mela will receive prophylactic dose of Ivermectin along with the frontline workers assigned duties on the Mela campus. Internationally acclaimed trials have shown positive cure rates of Covid-19 with Ivermectin in the past few months and now with its preventive capabilities, the drug has taken over the podium yet again. Based on the mountains of data on Ivermectin, many hospitals have already included the “wonder drug” in their treatment protocol to fight this disease.

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FLCCC ALLIANCE

A Review of the Evidence Base Demonstrating the Efficacy of Ivermectin in the Prevention and Treatment of COVID-19

https://covid19criticalcare.com/media/flccc-lecture-for-ypo-gold-on-ivermectin/

FLCCC Alliance Issues Public Response to New NIH Recommendation on the Use of Ivermectin: did an episode of Beyond The Roundup, where we discussed how the NIH, AFTER having met with the FLCCC and Dr. Andrew Hill, put out an interim update, that softened their stance on Ivermectin, for the use of Covid-19. The new recommendation from the NIH, changed their stance from against the use of Ivermectin for Covid-19, with the exception of clinical trials, to neither for, nor against the use of the drug against the virus.

https://www.youtube.com/watch?v=Ir6ylvwf09Q

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TUCSON, Ariz.Dec. 9, 2020 /PRNewswire/ — At a Dec 8 hearing, the U.S. Senate Homeland Security and Government Affairs Committee heard testimony about currently available, safe, and affordable treatments for both prophylaxis and treatment for COVID-19, reports Physicians for Civil Defense. The primary focus was on the anti-parasitic drug ivermectin.

Nearly 4 billion doses of ivermectin have been used worldwide, said critical care specialist Jean-Jacques Rajter of Fort Lauderdale, Fla., mostly to control serious parasitic diseases in Africa. It was serendipitously found to benefit nursing home patients exposed to COVID, who were being treated for scabies.

A meta-analysis of 21 studies has shown ivermectin to be beneficial in early disease, late disease, and both pre-exposure and post-exposure prophylaxis.

Dr. Rajter said that as yet no major large-scale randomized controlled trials have been completed, because it has been extremely difficult to obtain funding. Dr. Pierre Kory of St Luke’s Aurora Medical Center stated: “Seemingly the only research and treatment focus that we have observed on a national scale is with novel or high-cost pharmaceutically engineered products such as remdesivir, monoclonal antibodies, tocilizumab, with all such therapies costing thousands of dollars.”

Dr. Kory noted that the National Institutes of Health (NIH) has not updated its Aug 27 guideline that recommends against using ivermectin in COVID-19 outside a clinical trial—despite consistent, large benefits. Meanwhile, “people are dying at unacceptable and untold rates.”

Dr. Kory noted that it is difficult to disseminate information to the American public. All his attempts have been censored on social media. Graphical data and 88 references were supplied to the Committee and are publicly available with his written testimony. Dr. Kory also presented at a press conference in Houston.

Democrats boycotted the hearing except for an opening statement by ranking member Sen. Gary Peters (D-Mich.), who accused witnesses of “attacking science” before any said a word, and then left.     The federal response to this deadly disease, which she described as “therapeutic nihilism,” is “shocking and unprecedented,” stated Physicians for Civil Defense president Jane M. Orient, M.D.

https://www.prnewswire.com/news-releases/early-home-treatment-for-covid-19-needed-now-states-physicians-for-civil-defense-301189803.html

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AIIMS Director and corresponding author of the study Gitanjali Batmanabane said: “Earlier, at least 20 to 25 HCWs were getting infected with the virus daily. After the workers started taking ivermectin, the number of infection has come down to one or two per day.” 

ICMR guidelines advised HCWs of AIIMS Bhubaneswar to use hydroxychloroquine (HCQ) prophylaxis from 11 April along with the appropriate Personal Protective Equipment (PPE) depending on their place of posting.

Performed on two sets of HCWs, the study evaluated the association between the drug and development of Covid-19 infection, The New Indian Express reported.   In the two-cohort study, one set of HCWs received two-dose ivermectin prophylaxis at a dose of 300 μg / kg with a gap of 72 hours while workers in the other group received other prophylaxis.

With around 4,600 employees, over 625 employees of the institute tested positive for Covid-19.   The month-long study took place using 372 participants, including doctors, nurses, paramedics and sanitisation workers.  Based on WHO risk assessment guidelines, the contact tracing team of the institute made the list depending on subjects’ exposure to the disease.

https://www.pharmaceutical-technology.com/news/aiims-study-covid-19/

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Clinical data for human use.   Dr Coetzee of SOUTH AFRICA

The South African Medical Association says the lifting of the prohibition on the use of Ivermectin to treat COVID-19 patients is a step in the right direction.

https://www.youtube.com/watch?v=5nyisUFn08Y

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SLOVAKIA

Slovakia Becomes the First EU Nation to Formally Approve Ivermectin for Both Prophylaxis and Treatment for COVID-19 Patients: The Slovakia Republic’s Minister of Health has formerly registered Ivermectin as an approved prophylaxis and treatment for SARS-CoV-2, the virus behind COVID-19.

In breaking news, the authorization occurred as doctors received the news that they could proceed with formally authorized prescriptions both in hospitals and outpatient. On January 26, Health Minister Marek Krajci granted a permit for the unregistered drug as the drug has already been in use on a compassionate basis over the past half year. TrialSite interviewed Ondrej Halgas, a researcher from University of Toronto and originally from Slovakia. Halgas has been actively involved with a network organizing and lobbying for the drug’s approval during the pandemic.

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The Slovakia Republic’s Minister of Health has formerly registered Ivermectin as an approved prophylaxis and treatment for SARS-CoV-2, the virus behind COVID-19. In breaking news, the authorization occurred yesterday as doctors received the news that they could proceed with formally authorized prescriptions both in hospitals and outpatient. On January 26, Health Minister Marek Krajci granted a permit for the unregistered drug as the drug has already been in use on a compassionate basis over the past half year. TrialSite interviewed Ondrej Halgas, a researcher from University of Toronto and originally from Slovakia. Halgas has been actively involved with a network organizing and lobbying for the drug’s approval during the pandemic. This landlocked Eastern European nation of 5.4 million people, a member of the European Union since 2004, just made history. 

The antiparasitic drug was authorized by the Health Minister after a formal request from professor Ivan Schréter, CSc, the Chief Expert for Infectious Disease with the Ministry of Health of the Slovak Republic. A conditional authorization, TrialSite interprets that the registration is valid for a six (6) month period for hospitals and ambulatory care for the indication of prophylaxis and treatment of patients with COVID-19. The medicine will also be available at licensed prescription pharmacies.

A scientist from University of Toronto, Ondrej Halgas, expressed pride that his home country was able to become the very first nation in Europe to formally approve this drug as a complement to vaccines and other treatments. In an interview with TrialSite’s Daniel O’Connor, Halgas shared he has been collaborating with physicians such as Dr. Pierre Kory and Paul E. Marik as well as others. In Germany, apparently Ivermectin use has grown, reports Halgas. He was in touch with a physician group there that treated the elderly at a nursing home.

The mortality rate in nursing homes in that European country (Germany) is about 25% to 30%. After treating about 100 residents with Ivermectin, that rate in one case series apparently went down to about 5%—a huge difference. Of course, this isn’t the result of a formal study but nonetheless represents more real world data points.

This latest edict by the Health Minister now allows for the importation.  Doctors and hospitals have been importing the drug from Austria and even as far away as India, and it’s not clear how the country’s predominantly national health system will work to efficiently and effectively import the drug. Presently, the country has three payers, including one national payer and two private sector groups.

Slovakia Becomes the First EU Nation to Formally Approve Ivermectin for Both Prophylaxis and Treatment for COVID-19 Patients

https://www.visegradgroup.eu/news/health-ministry-okays

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INDIA – JULY 2020

A group of senior doctors with vast experience in the management of COVID-19 got together on 19th July’20 under the leadership of Prof Dr V. K. Arora, Prof. Dr D. Behera, Prof. Dr Surya Kant Tripathy, Dr. MohanKumar Thekkinkattil, Dr. Agam Vora, Dr. Vasant Nagvekar, Lt Gen (Rtd) Dr. B.N.B.M Prasad, Dr. K.S. Satish, Dr. V.K.Singh, Dr. Mangesh Tiwaskar, Dr. Parthiv Mehta, Dr. P. Sarat Singh, Dr. Narayana Pradeep, Dr. Rahul Mayekar and Dr. Bhupesh Dewan, under the auspices of Academy of Advanced Medical Education. Many of the attending doctors shared their personal experience of using Ivermectin successfully with very good results in their patients. The group, at the end of the discussion, proposed the following consensus statement:

“Ivermectin in the dose of 12 mg BD alone or in combination with other therapy for 5 to 7 days may be considered as safe therapeutic option for mild moderate or severe cases of Covid-19 infection. It is cost effective especially when the other drugs are very costly & not easily available”.

Ivermectin is a well-known anthelmintic agent from the late-1970s. In recent times, the antiviral function of ivermectin has been discovered. Already its effectiveness against certain flavivirus (dengue fever, Japanese encephalitis and tick-borne encephalitis virus) and chikungunya virus has been demonstrated in vitro. Since then the same activity has been assessed in numerous other viral infections. Off lately its potency has been recognized in eliminating coronavirus in vitro.    It reduces the SARS-CoV-2 viral load by a factor of 5000 in 48 hours.

Current clinical trials have used Ivermectin in a dose ranging from 200 to 1200 mcg/kg body weight, for a duration of 3–7 days, showing promising results both in terms of symptomatology as well as viral load reduction.

Sequestration of the SARS-CoV-2 viral nucleocapsid protein (NCP) into the host nucleus through the nuclear-pore-complex is a vital step in viral pathogenesis and defense against host immune response.

Ivermectin selectively inhibits host importin α/β transporter protein which decreases translocation (shuttling) of SARS CoV nucleocapsid protein (NCP) from the cytoplasm to the nucleus, altered NCP distribution disrupts viral propagation & survival.

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It has been proposed that COVID-19 infection in the lungs encompasses three main phases: an initial phase involving viral replication and relatively mild symptoms (early infection phase); a second phase characterized by adaptive immunity stimulation and predominance of respiratory symptoms (pulmonary phase); and, in some cases, a third and last phase with progress to a hyper inflammatory condition (hyper inflammation phase). According to phase of infection, clinical features ranges from mild symptoms (fever, cough, myalgia or fatigue, sore throat, headache) to acute respiratory distress syndrome (hypoxemia, shortness of breath) to ARDS, shock, multi-organ failure respectively.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434458/

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SARS coronavirus 2: from genome to infectome

The major co-morbid conditions leading to the severity of COVID-19 include 10.5% for cardiovascular disease (CVD), 37.3% for diabetes, 8.3% for chronic obstructive pulmonary diseases (COPD), and 55.4% for hypertension, and 8.1% for cancer patients.

The COVID-19 clinical presentations are similar to that of SARS-CoV1 and MERS, which are mild and self-limiting in 80% of the cases. Only 20% of the cases aggravate to secondary complications of ARDS or multiple organ failure.   The virus affects people differently depending upon the genetic pre-disposition, immune status and diseases associated with respiratory system.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314621/

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