Introduction

From working from home to hybrid learning in schools, COVID-19 has greatly affected our everyday lives. Over a year later since the lockdowns, things are finally looking up. As cases continue to fall in a lot of areas, some governments such as Texas's and Florida's have completely opened up and dropped their mask mandates. That said, governments like Canada's continued to enforce strict lockdown rules.

The road to recovery has not been a smooth ride as politicization reared its ugly head at every turn. For instance, when Texas Governor Greg Abbott lifted the mask mandate, a lot of Democrats criticized it as an "anti-science" measure. However, it turned out a month later, the state's cases dropped significantly. Most recently, the April jobs report fell severely short of economists' expectations because small businesses could not find new workers. Republicans want to end the enhanced unemployment benefits whereas Democrats want to maintain them.

Lastly, there's the ongoing debate surrounding Pfizer, Moderna, Johnson & Johnson, and AstraZeneca's vaccines. While some are convinced of the vaccines' efficacy, others are very skeptical. It also doesn't help that some female recipients suffered from blood clots. I remember posting about my 2nd dose of the Pfizer vaccine and it rubbed some people the wrong way.

In my opinion, you can't force people to take the vaccines if they don't want to. That said, if there is a certain percentage of the population who does not want to take any of the COVID-19 vaccines, what's the solution?

Well, Kory et al. (2021) recently published a peer reviewed paper on ivermectin's effectiveness against COVID-19 in the American Journal of Therapeutics. The paper looks at several clinical studies on how effective ivermectin is at preventing and treating COVID-19 symptoms. When I read the abstract, the results look quite positive. Apparently, the study grabbed The Weather Channel's attention that it published its own article on the matter.

What is Ivermectin?

Ivermectin is an anti-paraistic drug. The discovery of ivermectin happened by accident in 1975 by Professor Satoshi Omura at the Kitsato Institute. He "isolated an unusual Streptomyces bacteria from the soil near a golf course along the south east coast of Honshu, Japan". Omura and William Campbell "found that the bacterial culture could cure mice infected with the roundworm Heligmosomoides polygyrus". Campbell isolated the active compounds that stopped the parasite and named them "avermectins". Ivermectin is a derivative of the avermectins Omura and Campbell discovered.

Ivermectin proved to be a very revolutionary drug. Not only is it used by veterinarians, but it played a huge role in treating Onchocerciasis (river blindness) caused by another parasite, Onchocerca volvulus, when it was introduced in 1988.

But you may wonder how can a drug designed to target parasites possibly help us fight against COVID-19, a coronavirus?

Ivermectin's Inhibitory Properties

On Page 5 of the pre-print, the paper discussed about the drug's ability to inhibit the virus's replication activities. The paper reviewed four studies that identified ivermectin as having the highest binding affinity to the virus's S1 spike protein. In addition, the binding mechanism is similar to that of viral antibodies generated by the Pfizer and Moderna vaccines. The studies the paper references suggest that the drug can limit COVID-19's binding to the ACE-2 receptor or sialic acid receptors, which will respectively prevent cellular entry or hemagglutination.

COVID-19's cellular entry mechanism involving the ACE-2 receptor.

The paper also states that ivermectin can bind to or interfere with the essential structural and non-structural proteins that COVID-19 needs in order to replicate. On top of that, the drug can bind to RNA polymerase to stop the replication process.

By binding to the viral polymerase, ivermectin can slow down the replication of the COVID-19 virus.

Ivermectin's Prophylactic (Preventative) Properties

In Page 6-9, Kory et al. (2021) investigated multiple clinical trials that tested the drug's effectiveness at reducing transmission rates. Elgazzar et al. (2020) held a randomized controlled trial at Benha University of Egypt with 200 patients. 100 patients served as the control group, i.e. no ivermectin, while the other 100 patients received two doses of ivermectin on Day 1 and 7. Both groups wore PPE throughout the duration of the trial. Results showed that the experimental group had a significantly lower infection rate than the control group (2% vs. 10%, p<0.05).

Chamie (2020) studied the effects of the "ivermectin distribution" campaigns in Peru, Paraguay, and Brazil. In Brazil, cities that distributed the anti-parasitic drug exhibited much higher drops in cases and death rates than their adjacent counterparts. The same pattern was observed in Peru:

Ivermectin's Treatment Potential

Later in the study at Page 11, Kory et al. (2021) investigated the ivermectin's efficacy at treating already-infected patients. They once again referenced Elgazzar et al. (2020) who held a randomized controlled trial across 400 COVID-19 infected patients. The patients were divided into four equal groups. Groups 1 and 2 had mild to moderate illness. The former received ivermectin with standard of care (SOC) while the latter received hydroxychloroquine (HCQ) plus SOC. Groups 3 and 4 had exclusively severely ill patients. Group 3 received ivermectin plus SOC while Group 4 received HCQ plus SOC.

Elgazzar et al. (2020) observed a significant difference between Groups 1 and 2. Group 1 had a progression rate of 1% with no deaths whereas Group 2 had a progression rate of 22% with 4 deaths (p<0.001). Among the severely ill groups, the differences were even more pronounced. Group 3 had a 4% progression rate and a 2% mortality rate. In contrast, Group 4 had a 30% progression rate and a 20% mortality rate (p<0.001).

Many other studies that Kory et al. (2021) referenced have found similar results.

Closing Thoughts

After reading through the paper, I think ivermectin can be a huge game changer in combating COVID-19. There is a strong case that the drug is effective at inhibiting the virus's replication mechanism, reducing transmission, and treating already-ill patients. Even better, this drug has been around for more than three decades, so it's not like this is a recently rolled-out experimental drug. For the people who are skeptical of the COVID-19 vaccines, ivermectin may be a viable preventative measure.

Of course, this is just person's opinion. If you want to verify the study's findings for yourself, you can read it on OSF. I did skip a lot of stuff mainly because the paper is dozens of pages long and if I tried to cover it all, this post would go on forever.