Effect of combined use of ivermectin and colchicine in COVID-19 patients

Abstract

Background Despite the great results of the SARS-CoV-2 vaccine, there is an increasing need for effective therapeutics. Increasing viral loads are associated with systemic inflammatory response, more disease progression, and increased mortality, while exaggerated immune responses result in immune overreaction and cytokine storm (CS)-induced acute lung injury. We hypothesize that ivermectin by reducing viral load and colchicine by reducing inflammation when used in combination might improve the outcomes of COVID-19 while offering cheap and safe options.Methods A total of 135 COVID-19 patients were divided into three groups, with 45 patients in each group (colchicine/colchicine and ivermectin/neither of them). Group (A): ivermectin + colchicine + standard care, Group (B): colchicine + standard care, and Group (C): (control group) standard care.Results We found that colchicine was associated with clinically significant decrease in days of oxygen need, length of ICU stay, less need for mechanical ventilation, and less mortality, while ivermectin failed to add any beneficial effect.Conclusion Adding ivermectin to the treatment of moderate cases of COVID-19 is not of clinical value, while we support the use of colchicine in such cases.Trial registration The trial was registered in February 2022 in ClinicalTrials.gov (NCT05246072).

Keywords

• Colchicine
• COVID-19
• ivermectin
• NLRP3 inflammasome
• viral load
• cytokine storm