Ivermectin treatment for Strongyloides infection in patients with COVID-19

Elizabeth Leung; Sumit Raybardhan; Christopher Graham; Caroline Nott; Bradley J Langford; Nisha Andany; William Ciccotelli; Sumon Chakrabarti; Isaac I Bogoch; Wayne L Gold; Menaka Pai; Andrew M Morris; Anne McCarthy

doi:10.14745/ccdr.v47i78a04

Canada Communicable Disease Report (Jul 2021)

Ivermectin treatment for Strongyloides infection in patients with COVID-19

Elizabeth Leung,
Sumit Raybardhan,
Christopher Graham,
Caroline Nott,
Bradley J Langford,
Nisha Andany,
William Ciccotelli,
Sumon Chakrabarti,
Isaac I Bogoch,
Wayne L Gold,
Menaka Pai,
Andrew M Morris,
Anne McCarthy

Affiliations

Elizabeth Leung: Department of Pharmacy, St. Michael’s Hospital/Unity Health Toronto, Toronto, ON; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON; Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group
Sumit Raybardhan: Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group; Department of Pharmacy, North York General Hospital, Toronto, ON
Christopher Graham: Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group; Trillium Health Partners, Mississauga, ON
Caroline Nott: Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group; Department of Medicine, University of Ottawa, Ottawa, ON
Bradley J Langford: Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group; Public Health Ontario, Toronto, ON
Nisha Andany: Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group; Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, ON; Department of Medicine, University of Toronto, Toronto, ON
William Ciccotelli: Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group; Grand River Hospital, Kitchener, ON; St. Mary’s General Hospital, Kitchener, ON
Sumon Chakrabarti: Trillium Health Partners, Mississauga, ON
Isaac I Bogoch: Department of Medicine, University of Toronto, Toronto, ON
Wayne L Gold: Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group; Department of Medicine, University of Toronto, Toronto, ON; Department of Medicine, University Health Network, Toronto, ON
Menaka Pai: Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group; McMaster University, Hamilton, ON; Hamilton Health Sciences and Hamilton Regional Laboratory Medicine Program, Hamilton, ON; Ontario COVID-19 Science Advisory Table
Andrew M Morris: Ontario COVID-19 Science Advisory Table Drugs and Biologics Clinical Practice Guidelines Working Group; Department of Medicine, University of Toronto, Toronto, ON; Ontario COVID-19 Science Advisory Table; Department of Medicine, Sinai Health and University Health Network, Toronto, ON
Anne McCarthy: Division of Infectious Diseases, The Ottawa Hospital, Ottawa, ON

DOI: https://doi.org/10.14745/ccdr.v47i78a04
Journal volume & issue: Vol. 47, no. 78
pp. 316 – 321

Abstract

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Ivermectin, an antiparasitic agent, is not recommended for prophylaxis or treatment of coronavirus disease 2019 (COVID-19). Inappropriate use of ivermectin for treatment of COVID-19 may make it less available for patients with serious parasitic infections who could benefit from its use and worsen the current shortage of ivermectin in Canada. However, patients with COVID-19 who are candidates to receive immunomodulatory therapies (e.g. corticosteroids and interleukin-6 inhibitors) may be at risk of hyperinfection syndrome and disseminated disease from Strongyloides stercoralis. These complications can be severe and even fatal. It is important to recognize and screen patients who may be at risk of strongyloidiasis, as these patients may require treatment with ivermectin to avoid the potential for a hyperinfection syndrome and disseminated disease, which is frequently deadly. Clinicians should follow evidence-based recommendations to screen and treat for Strongyloides infection in patients with COVID-19 who are under consideration to receive specific COVID-19 therapies that alter immune response and may lead to hyperinfection syndrome or disseminated disease.

Published in Canada Communicable Disease Report

ISSN: 1719-3109 (Print); 1481-8531 (Online)
Publisher: Public Health Agency of Canada
Country of publisher: Canada
LCC subjects: Medicine: Internal medicine: Infectious and parasitic diseases
Website: https://www.canada.ca/en/public-health/services/reports-publications/canada-communicable-disease-report-ccdr.html

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