https://www.researchgate.net/publication/344251319_COVID-19_IVERMECTIN_PROPHYLAXIS_IN_ADULT_CONTACTS_First_Report_on_Health_Personnel_and_Post-Exposure_ProphylaxisFIRST REPORT OF THE USE OF
PROPHYLAXIS WITH IVERMECTIN FOR COVID-19
The first study on the effect of Ivermectin on COVID-19 was carried out at Monash University in Melbourne, Australia18.
This study, in its preliminary or preprint versión, was made available April 3, 2020 on the website of the journal Antiviral Research. The study, carried out in vitro, found that with a single dose of 5 mM of Ivermectin given 2 hours after infection with SARS-CoV-2, viral RNA was reduced by 93% in 24 hours and by 99.8% in 48 hours. This is equivalent to
a 5,000-fold reduction in coronavirus RNA in 48 hours. At that time, there were concerns among doctors regarding mortality of healthcare personnel who had been in contact with people infected with COVID-19 as reported by European countries. Some local healthcare personnel in Lima, Peru then opted to use Hydroxychloroquine as prophylaxis against COVID-19. However in light of in vitro results seen with Ivermectin18,19, a decision was made to use Ivermectin instead of Hydroxychloroquine. This decision was also based on the fact that Ivermectin is safer to use than Hydroxychloroquine. On April 7, two doctors, 58 and 60 years old, living and working in Lima, Peru, received a prophylactic dose of 0.2 mg per kilogram of body weight of Ivermectin. Molecular and serological tests were performed which were negative. In the following days, both doctors were exposed to the virus by seeing patients and by walking through the crowded streets of Lima, considered where at that date as a city with community transmission of the virus.
As COVID-19 is a new disease, and the in vitro effectiveness of Ivermectin was discovered only on April 3, there was no existing guideline in terms of appropriate dosage and frequency of Ivermectin to be used against COVID-19. From the experience of its use against scabies and other ectoparasites by pediatricians, it was proposed to initially test a prophylaxis regimen with monthly doses of Ivermectin. In regards to the two doctors, the 58-year-old doctor has remained negative per laboratory tests and without symptoms until the closing of this report (July 21, 2020).
In May, she received a second single dose of Ivermectin prophylaxis, 31 days after the first dose (received on April 7). On June 10 she received a third dose, then on July 1 she received a fourth dose . Her final fifth dose of Ivermectin prophylaxis was given on July 15. Starting July 1, decision was made to change frequency of administration to every 15 days instead of every 30 days. This decision was based on the fact that prevalence of COVID-19 was steadily increasing at that time and that several symptomatic cases had occurred at their workplace affecting mosto f the staff, significantly increasing exposure and the probability of becoming infected. As for the 60-year-old doctor, she began to exhibit symptoms of COVID-19: Ivermectin Prophylaxis in Adult Contacts. Aguirre Chang, Gustavo y Trujillo Figueredo, Aurora 4
COVID-19, 19 days after taking Ivermectin. The symptoms were mild to moderate in
severity and lasted 1 week. The diagnosis of COVID-19 was confirmed by laboratory tests
for SARS CoV-2 infection. She recovered at home and did not require hospitalization. For
the case of the second doctor, we estimated the probable date of her infection by
subtracting 5 days from the date of onset of symptoms, since the average incubation time
is 5 days7. We concluded that the doctor had acquired the infection approximately 14 days
after taking the prophylactic dose of Ivermectin.
This analysis indicates that the Interval for
Ivermectin prophylaxis should not exceed 14 days for healthcare personnel and other
people who go to places of high risk of exposure, such as hospitals and esblishments
where patients with COVID-19 are treated. It is also important to note that prophylaxis with Ivermectin is a complementary preventive
measure, and does not replace other measures already established such as social
distancing and wearing of a mask.
After laboratory confirmation of COVID-19 for the 60-year-old doctor, contact tracing was
carried out to identify all those who had been in contact with her. Those contacts were then
subsequently provided with Ivermectin prophylaxis themselves. The total number of those
contacts totaled 37, this adding the domiciliary and work contacts, with which the realization
of a study of Prophylaxis in Contacts was proposed.
MATERIALS AND METHODS:
This Post-Exposure Prophylaxis (PEP) study for