This is a discussion regarding an in-vitro study of how Ivermectin could potentially work for COVID-19. 
Give credit where credit is due. This paper was sent to me by @itskatiesway, @bug_drugs, @sanamoh92, @sy_doctornetwork, @paul.neil95, @nascarnora. Thank you all for sending data to me. Also, I am getting somewhere around 50-100 messages per day from the community. Much love to you all. I cannot answer every single question bc I wouldn’t be able to live my own life. Thanks for understanding.

Let’s get started. It bears repeating that I like simple and cheap stuff. Ivermectin, has been around since 1998 and many of us learned about it as a treatment for scabies. It’s about $5 a tab per UpToDate. This paper is quite different than what I am used to reading (since I mainly read clinical trial data which is written a particular way). This is far more science-y than what I am accustomed to understanding. Even this nerd has his limitations.

Limitation for this study of Ivermectin for COVID-19

Let’s start off with the first and glaringly obvious limitation to this study. It works in vitro. No data that it work in vivo. Made simple means we have absolutely zero data that it would work in a human body.

What they did to show an effect of Ivermectin in COVID-19

Basically they infected cells with SARS-CoV-2 and then added ivermectin. They followed up later to see if there was a reduction of viral RNA at different time points and there was! They noted that “a single dose was able to control viral replication within 24-48 hours” in their system. Don’t get too excited now. Again, this is in vitro. They provide some mechanisms which are way over my head.

They recommend trying multiple regimens on COVID-19 patients to assess for a clinical response. At least could postulate, perhaps erroneously, that we could see a change in 24-48 hours. I am not holding my breath but this seems like something that should be attempted early in the disease course, like plaquenil, and may not have too much benefit once the patient is in my hands in the ICU. I can’t wait for a good. The best thing is that the Australians discovered this and the know how to put together some great trials with their ANZICS group. A hat tip to the authors!
– EJ

Click here for a link to the first in-vivo study of Ivermectin in COVID-19.

Citation:

Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro [published online ahead of print, 2020 Apr 3]. Antiviral Res. 2020;178:104787. doi:10.1016/j.antiviral.2020.104787

Link to Article
Link to FULL PDF (this link may not work extremely well, go to the article and sort it out there)

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