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.
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.
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
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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