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. 2021 Apr:105:598-605.
doi: 10.1016/j.ijid.2021.02.014. Epub 2021 Feb 10.

Effectiveness of a multidrug therapy consisting of Ivermectin, Azithromycin, Montelukast, and Acetylsalicylic acid to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico

René Lima-Morales  1 , Pablo Méndez-Hernández  2 , Yvonne N Flores  3 , Patricia Osorno-Romero  4 , Christian Ronal Sancho-Hernández  5 , Elizabeth Cuecuecha-Rugerio  6 , Adrián Nava-Zamora  7 , Diego Rolando Hernández-Galdamez  8 , Daniela Karola Romo-Dueñas  9 , Jorge Salmerón  10
Affiliations

Effectiveness of a multidrug therapy consisting of Ivermectin, Azithromycin, Montelukast, and Acetylsalicylic acid to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico

René Lima-Morales et al. Int J Infect Dis. 2021 Apr.

Abstract

Objective: There is an urgent need for effective treatments to prevent or attenuate lung and systemic inflammation, endotheliitis, and thrombosis related to COVID-19. This study aimed to assess the effectiveness of a multidrug-therapy consisting of Ivermectin, Azithromycin, Montelukast, and Acetylsalicylic acid ("TNR4" therapy) to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico.

Design and methods: A comparative effectiveness study was performed among 768 confirmed SARS-CoV-2 cases aged 18-80 years, who received ambulatory care at the Ministry of Health of Tlaxcala. A total of 481 cases received the TNR4 therapy, while 287 received another treatment (comparison group). All participants received home visits and/or phone calls for clinical evaluation during the 14 days after enrollment.

Results: Nearly 85% of cases who received the TNR4 recovered within 14 days compared to 59% in the comparison group. The likelihood of recovery within 14 days was 3.4 times greater among the TNR4 group than in the comparison group. Patients treated with TNR4 had a 75% and 81% lower risk of being hospitalized or death, respectively, than the comparison group.

Conclusions: TNR4 therapy improved recovery and prevented the risk of hospitalization and death among ambulatory COVID-19 cases.

Keywords: Acetylsalicylic acid; Azithromycin; COVID-19; Ivermectin; Mexico; Montelukast; SARS-CoV-2.

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Figures

Figure 1
Figure 1
The study population of laboratory-confirmed cases of COVID-19 who received ambulatory treatment at the Tlaxcala Ministry of Health, Mexico.
See this image and copyright information in PMC

References

    1. Abd El-Aziz T.M., Stockand J.D. Recent progress and challenges in drug development against COVID-19 coronavirus (SARS-CoV-2) — An update on the status. Infect Genet Evol. 2020;83(September):104327. [Internet] 2020/04/19, Available from: https://pubmed.ncbi.nlm.nih.gov/32320825. - PMC - PubMed
    1. Almerie M.Q., Kerrigan D.D. The association between obesity and poor outcome after COVID-19 indicates a potential therapeutic role for montelukast. Med Hypotheses. 2020;143(October):109883. - PMC - PubMed
    1. Anderson T.J., Meredith I.T., Yeung A.C., Frei B., Selwyn A.P., Ganz P. The effect of cholesterol-lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med. 1995;332(February (8)):488–493. - PubMed
    1. Arshad S., Kilgore P., Chaudhry Z.S., Jacobsen G., Wang D.D., Huitsing K. Treatment with Hydroxychloroquine, Azithromycin, and combination in patients hospitalized with COVID-19. Int J Infect Dis. 2020;97(August):396–403. - PMC - PubMed
    1. Awortwe C., Cascorbi I. Meta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactions. Pharmacol Res. 2020 - PMC - PubMed

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