COVID-19 Prophylaxis: AIIMS Study Of Healthcare Workers In India Using Ivermectin As A Prophylaxis Shows Reduced COVID-19 Infection

COVID-19 Prophylaxis: A recent study by All India Institutes of Medical Sciences (AIIMS)-Bhubaneswar in the Indian state of Odisha found that two doses of the drug ivermectin served as a prophylaxis that resulted in a 73% reduction in COVID-19 infection.


 
In the study that was also propelled by Thailand Medical News research initiatives, ivermectin prophylaxis was taken by 77 controls and 38 cases. A two-dose ivermectin prophylaxis (0.27, 95% CI, 0.15-0.51) was associated with 73% reduction of COVID-19 infection among healthcare workers for the following one month involving those who were involved in physical activity at the hospitals(3.06 95% CI, 1.18-7.93) for more than an hour/day as these were were most  likely to contract COVID-19 infection.
 
The study found that a two-dose ivermectin prophylaxis at a dose of 300 μg/kg with a gap of 72 hours was associated 73% reduction of COVID-19 infection among healthcare workers for the following one-month.
 
The study findings were published on a preprint server but are currently being peer-reviewed for publication in medical journal. https://www.medrxiv.org/content/10.1101/2020.10.29.20222661v1
 
Thailand Medical News would like to highlight that ivermectin has been explored in numerous studies around the world and has been found to show efficacy in numerous studies to date but there has been a concerted effort by certain big pharmaceutical companies in collaboration with certain Western governments to downplay or restrict its usage by using unethical Western researchers who have been bought to try to discredit ivermectin studies through claims of toxicity or on dosing requirements without first understanding the pharmokinetics of the drug. Meanwhile America and many of the European countries are the worse places that badly affected and are having their citizens infected and dying while they are peddling drug and therapeutic scams like overpriced remdesivir, tocilizumab, monoclonal antibodies etc which studies are showing does not work and is not saving their citizens as the daily infected and death figures can attest. Furthermore there are lots of case reports emerging on the toxicity of drugs like remdesivir that the U.S. NIH, U.S. FDA, the Trump administration and Dr Anthony Fauci have been trying to peddle.
 
In this study conducted between 20 September and 19 October, 12 physicians of AIIMS-Bhubaneshwar performed the study on healthcare workers (HCWs) at risk of SARS-CoV-2 coronavirus exposure.
 
The ivermectin was  selected one among several potential drugs currently in trials for its therapeutic and preventive role in COVID-19 infection.
 
The study evaluated the association between the drug and development of COVID-19 infection performed on two sets of HCWs.
 
For 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.
 
The detailed month-long study took place using 372 participants, including doctors, nurses, paramedics and sanitization workers.
 
Conforming to WHO risk assessment guidelines, the contact tracing tea m of the institute made the list depending on subjects’ exposure to the disease. (With around 4,600 employees, over 625 employees of the institute tested positive for COVID-19.)
 
Corresponding author of the study Dr Gitanjali Batmanabane who is also  AIIMS Director told Thailand Medical News, “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.”
 
The study results are similar to the randomized trial conducted by Dr Waheed Shouman from the Zagazig University of Egypt in which out of the 203 HCWs in the intervention arm, only 7.4% developed symptoms versus the 58.5% of the 101 HCWs in the control arm after 14 days of enrolment. The study also reported no mortality or serious adverse events due to ivermectin in the intervention arm. https://clinicaltrials.gov/ProvidedDocs/61/NCT04422561/Prot_SAP_000.pdf
 
Mostly, ivermectin prophylaxis will benefit the HCWs who are vulnerable to the infection because of their profession. This new Indian study findings throw light in the same direction that ivermectin may play a vital role in the prevention strategy of COVID-19 infection.
 
It should be noted that another study conducted by Peruvian researchers from the National University of San Marcos showed the effectives of ivermectin as a prophylaxis against COVID-19 by healthcare workers  (HCW) as well. https://www.researchgate.net/publication/343683169_INCLUSION_OF_IVERMECTIN_IN_THE_FIRST_LINE_OF_THERAPEUTIC_ACTION_FOR_COVID-19_A_very_significant_decrease_in_the_Mortality_Rate_is_reported_with_its_use
 
Another study in Florida also showed the effectiveness of the drug in reducing mortality rates of hospitalized COVID-19 patients. 
https://www.medrxiv.org/content/10.1101/2020.06.06.20124461v2

Interestingly ICMR (Indian Council of Medical Research) 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. However, on account of known side-effect, the uptake was not encouraging.
 
Furthermore this study also found that single-dose of hydroxychloroquine (HCQ) had no association with the reduction of infection in COVID-19 patients.
 
The strengths of this study are the adequate sample size, completeness of the data collection and verification from subjects. All the HCWs received ivermectin procured from a single manufacturer and belonged to the same batch for each strength. The study team adjusted for confounders by matching and multivariate analysis. Though recall bias is inherent in case-control studies, the data regarding the drug intake within the last one month is less likely to be forgotten by HCWs. Due to its observational nature, the study’s findings need further confirmation using longitudinal studies or interventional studies to strengthen the evidence before its large-scale use among HCWs and the implementation of public health programs.
 
The study team concludes that two-dose ivermectin prophylaxis at a dose of 300 μg/kg body weight with a gap of 72 hours was associated with a 73% reduction of COVID-19 infection among HCWs in the following one month.
 
This is an intervention worth replicating at other medical centres and hospitals around the world until a decent and truly effective third or fourth generation vaccine is available that does not cause ADE (antibody-dependent enhancement) or other issues considering the dynamics of the current COVID-19 pandemic with the emergence of so many new mutations and variants and even antibody resistant strains coupled with newer projected trends of reinfections, co-infections etc.
 
For more on COVID-19 Prophylaxis, keep on logging to Thailand Medical News.
 
Thailand Medical News will shortly be publishing a detailed report of a variety of new studies that have demonstrated the actual mechanisms of how ivermectin actually works to inhibit the SARS-CoV-2 coronavirus unlike overpriced ineffective drugs that are being peddled by American (remdesivir)or Chinese entities.(favipiravir)
 
Thailand Medical News also desperately needs the support of generous donors as we in the midst of a herb based project that is near completion and we need additional funds to refine our research and to initiate randomized clinical trials in various countries. We are desperately still short of US$96,000 and are appealing for help in whatever amounts generous donors can help.

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