A Comparative Study on Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin Therapy on COVID-19 Patients

Abstract

Background The worldwide COVID-19 pandemic was caused by a newly discovered Coronavirus. The treatment methods for COVID-19 are emerging and rapidly evolving. Existing drugs, including Ivermectin and Hydroxychloroquine, offer the hope of effective treatment in early disease. In this study, we investigated and compared outcomes of Ivermectin-Doxycycline vs. Hydroxychloroquine-Azithromycin combination therapy COVID19 patients with mild to moderate disease.Methods Patients with mild to moderate COVID-19 disease, tested positive by RT PCR for SARS-CoV-2 infection at Chakoria Upazilla Health Complex, Cox's Bazar, Bangladesh, were included in this study.Patients were divided randomly into two groups: Ivermectin 200µgm/kg single dose + Doxycycline 100 mg BID for 10days in group A, and Hydroxychloroquine 400 mg 1st day, then200mg BID for 9days + Azithromycin 500 mg daily for 5 days in group B. PCR for SARS-CoV-2 was repeated in all symptomatic patients on the second day onward without symptoms, or, for those who were asymptomatic (throughout the process), on the 5th day after taking medication and repeated every two days onward if the result is positive. Time to negative PCR and time to full symptomatic recovery was measured for each group.Results All subjects in the Ivermectin-Doxycycline group (group A) reached a negative PCR for SARS-CoV-2, at a mean of 8.93days, and all reached symptomatic recovery, at a mean of 5.93days, with 55.10% symptom-free by the 5th day. In the Hydroxychloroquine-Azithromcyin group (group B), 96.36% reached a negative PCR at a mean of 6.99days and were symptoms-free at 9.33days. Group A patients had symptoms that could have been caused by the medication in 31.67% of patients, including lethargy in 14(23.3%), nausea in 11(18.3%), and occasional vertigo in 7(11.66%) of patients. In Group B, 46.43% had symptoms that could have been caused by the medication, including 13(23.21%) mild blurring of vision and headache; 22(39.2%) increased lethargy and dizziness, 10(17.85%) occasional palpitation, and 9(16.07%) nausea and vomiting. ConclusionThe Ivermectin-Doxycycline combination showed a trend toward superiority to the Hydroxychloroquine-Azithromycin combination therapy in the case of patients with mild to moderate COVID19 disease, though the difference in time to becoming symptom-free and the difference in time to negative PCR was not statistically signi cant. Background:Coronavirus disease 2019 (COVID19) is a WHO declared a global pandemic. Over eight million people have already been infected by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), and billions have been affected by the socioeconomic squeal. As SARS-CoV-2 is a novel virus, there are not yet proven treatment options. Early treatment, before the disease becomes severe, would be optimal.Current considerations for treatment include Lopinavir/ritonavir, favipiravir, and remdesivir, which are all currently in wide use in the case of moderate to severe COVID19 patients. Treatments for patients earlier in disease with mild to mode...

An Updated Systematic Review and Meta-Analysis of Mortality, Need for ICU admission, Use of Mechanical Ventilation, Adverse effects and other Clinical Outcomes of Ivermectin Treatment in COVID-19 Patients

“…IRB approval was exempted because data was extracted from publicly available studies. We also analyzed raw data files or supplemental files of studies by Cadegiani 42 and Lima-Morales et al 43 for outcomes of cases receiving Ivermectin, Niaee et al 44 for clinical severity based mortality data and duration of hospital stay, Choudhary et al 35 for time for viral clearance, Mahmud et al 45 for need for hospitalization, Ghooi et al 46 for mortality in Ivermectin receiving patients, Samaha et al 47 for viral clearance. In Cadegiani et al’s study 42 , we considered ‘CG1’ as control group because only this sample was demographically comparable to the treatment group.…”

“…An Australian study demonstrated the effectiveness of Ivermectin in inhibiting SARS-COV2 in-vitro 31 . Subsequently, several Ivermectin-based clinical trials and observational studies conducted globally showed mostly positive results 32-35 . Some countries have incorporated this therapy in their COVID-19 guidelines 36-39 .…”

Canary Science in the Mineshaft of the Anthropocene

“…It's the exact opposite of what normally happens, where doctors are telling the patients" (Sy 2021). Just as graduate students may be more familiar with contemporary scholarship than their overworked advisors, bed-bound patients may oft en be more versed in PubMed research or new clinicals than harried clinicians about the potential off -label prescription of ivermectin to treat COVID-19 (Chowdhury 2020).…”

Doxycycline Inhibition of a Pseudotyped Virus Transduction Does Not Translate to Inhibition of SARS-CoV-2 Infectivity

“…With their pleiotropic features, including anti-inflammatory and antioxidant properties, and their ability to chelate zinc compounds on matrix metalloproteinases [ 4 ], tetracyclines have been proposed, alone or combined with other compounds, as potential therapeutic candidates against COVID-19 [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. Second-generation tetracyclines, such as minocycline and doxycycline, exerted a direct antiviral effect and can inhibit the replication of different viruses, including the human immunodeficiency virus (HIV), West Nile virus, Japanese encephalitis virus, and influenza virus [ 12 ].…”

“…Tetracyclines, alone or together with colchicine, have therefore been given to COVID-19 patients in a non-hospital setting and have been reported to improve symptoms and hasten recovery in case reports [ 18 ] and observational clinical studies [ 19 , 20 ]. Doxycycline combined with Ivermectin has recently resulted in better symptomatic relief, shortened recovery duration, fewer adverse effects, and superior patient compliance compared to the Hydroxychloroquine-Azithromycin combination in patients with mild to moderate COVID-19 [ 11 ].…”