Ivermectin: a multifaceted drug of Nobel prize-honoured distinction with indicated efficacy against a new global scourge, COVID-19

Abstract

In 2015, the Nobel Committee for Physiology or Medicine, in its only award for treatments of infectious diseases since six decades prior, honoured the discovery of ivermectin (IVM), a multifaceted drug deployed against some of the world's most devastating tropical diseases. Since March 2020, when IVM was first used against a new global scourge, COVID-19, more than 20 randomized clinical trials (RCTs) have tracked such inpatient and outpatient treatments. Six of seven meta-analyses of IVM treatment RCTs reporting in 2021 found notable reductions in COVID-19 fatalities, with a mean 31% relative risk of mortality vs. controls. During mass IVM treatments in Peru, excess deaths fell by a mean of 74% over 30 days in its ten states with the most extensive treatments. Reductions in deaths correlated with the extent of IVM distributions in all 25 states with p < 0.002. Sharp reductions in morbidity using IVM were also observed in two animal models, of SARS-CoV-2 and a related betacoronavirus. The indicated biological mechanism of IVM, competitive binding with SARS-CoV-2 spike protein, is likely non-epitope specific, possibly yielding full efficacy against emerging viral mutant strains.

Keywords: COVID-19; H. pylori; SARS-CoV-2; ivermectin; spike protein.

Fig. 1

A) Excess all-cause deaths (all ages), the national population of Peru. These decreased 14-fold from 1st August through 1st December 2020; then, after IVM use was restricted, increased 13-fold through 1st February. For A and B, y values are 7-day moving averages; for B and C, ages ≥60. Data are from Peru’s National Death Information System (SINADEF). (B) Drops in excess deaths for all states of operation MOT, an army-led program of mass IVM distributions, but Pasco, which had them on three dates. • MOT start date; ▴ peak deaths; ▪ day of peak deaths +30 days. Junin distributed IVM through local channels 13 days before MOT start. (C) Reductions in excess deaths at +30 days after peak deaths for the 25 states by extent of IVM distributions: maximal-MOT (), mean -74%; moderate-local distributions (), mean -53%; and minimal-Lima (), -25%. The absolute value of these reductions by state correlated with extent of IVM distributions with Kendall τ_b = 0.524, p < 0.002 (Spearman rho = 0.619, p < 0.001). All these data are from publicly accessible Peruvian national databases, with associated frozen datasets available from the Dryad data repository [42].