The effect of adding ivermectin to the standard COVID-19 treatment in intubated patients

Introduction: Effective antiviral medications with minimal side effects has received scholarly attention since the start of the COVID-19 pandemic. Ivermectin, a long-time anti-parasitic drug, has been proven through laboratory tests to have anti-COVID-19 effects. Objectives: This study investigated the effects of inclusion of ivermectin to the standard treatment of mechanically ventilated patients. Patients and Methods: This study is a double-blinded, randomized, placebo-controlled clinical trial that was conducted on COVID-19 patients, in Ahvaz, Iran, from March 2020 to September 2021. Intubated COVID-19 patients who met the inclusion criteria were randomly allocated into two groups, placebo (n = 29) and the ivermectin-treated (n = 31). The primary outcome was the mortality, and the secondary outcomes were pulmonary compliance and vital signs. Results: Two groups were similar regarding demographic characteristics such as age, gender, the length of time since the onset of symptoms before intubation, the level of lactate dehydrogenase (LDH) in the blood. Moreover, the difference in erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), D-dimer, and interleukin 6 (IL-6) was not significant between the two groups. Regarding mortality rate, no significant difference between the two groups was detected. Furthermore, O2 saturation on day 5 was significantly higher in the ivermectin group as opposed to the control group (P=0.008). No statistically significant difference was found between the two groups regarding respiratory rate, heart rate, systolic and diastolic blood pressure, and lung compliance (dynamic and static). Conclusion: Regarding the importance of blood oxygen saturation in COVID-19 patients, our results showed no significant effect of ivermectin in the treatment of ventilated COVID-19 patients, suggesting that its addition to the standard COVID-19 treatment either is ineffective or has no synergistic effect. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (Identifier: IRCT20190417043295N2; https://www.irct.ir/trial/57603, ethical code#IR.AJUMS. REC.1400.234).