Ivermectin in Long-Covid Patients: A retrospective study, 2021, Del Franco et al

Dolphin · Apr 8, 2021

https://www.researchgate.net/profil...LONG-COVID-PATIENTS-A-RETROSPECTIVE-STUDY.pdf

ORIGINAL ARTICLE February 2021
DOI: 10.13140/RG.2.2.14189.51683

AUTHORS: Del Franco, Aroldo 1; Carvallo, Hector 2; Hirsch, Roberto 3 1 Neumologist, Mercante Public Hospital 2 Professor of Internal Medicine, U.A.I. 3 Professor of Infectology, U.B.A. Buenos Aires, Argentina

ABSTRACT:

Long COVID convalescence has become a major issue in COVID infection.

The variety and magnitude of sequelae has, so far, baffled scientific community, and no measure has proved to be both useful and reliable in diminishing and/or shortening it.

We are summarising the outcomes in 856 patients previously admitted at a Public Hospital in the Province of Buenos Aires, due to moderate/severe COVID infection, who surmounted the infection and could be released later on. We selected those whose symptoms, and mainly, the duration of them- could be attributed to long convalescence (“long haulers”).

In them, a simple post-COVID treatment with ivermectin (IVM) was applied, thus provoking a faster reduction of manifestations.

KEY WORDS: long COVID long haulers ivermectin

Hutan · Apr 8, 2021

Interesting to see the recognition of one type of Long Covid equalling post viral fatigue syndrome/ CFS from these Argentinian authors:

Defining and measuring recovery from COVID-19 should be more sophisticated than checking for hospital discharge, or testing negative for active infection or positive for antibodies.
Once recovery is defined, we can differentiate COVID that quickly goes away from the prolonged form lasting several weeks and impairing a person’s usual function should not be called mild, neither should the subject be considered up to returning to usual activities so quickly. Restoring such a subject to his ordinary labour tasks is a potential risk for both himself and his fellow co-workers.
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The terms “COVID long haulers,” “long COVID,” and “Post COVID Syndrome,” have all been used interchangeably in recent months to describe individuals who have been infected with the SARS-CoV-2 and continue to experience symptoms after “recovery.”
However, these terms may be misleading, as they represent three different patient subsets with prolonged symptoms, usually defined as greater than one month after COVID-19 infection.

These subsets include:

a-Critically-ill patients, almost all who have been admitted to intensive care, who, are expected to have a lengthy recovery period (often months) and may have permanent organ damage, particularly in the lung.

b-An undetermined number of patients, following mild or severe infection, who have organ damage/dysfunction, such as myocarditis or an encephalopathy.
The long-range consequences are unclear.

c-Many patients, in some series estimated up to 10%, have prolonged, multisystem symptoms with no evidence of organ damage or dysfunction. These patients most often have severe exhaustion, headaches, myalgias, and mood and cognitive disturbances with normal physical and laboratory findings. This is the subset experiencing symptoms most similar to post-viral fatigue syndrome (PVFS), chronic fatigue syndrome (CFS) – also termed benign myalgic encephalomyelitis (BME) in the UK, fibromyalgia and other related, poorly understood disorders associated with chronic fatigue and pain. In these conditions, there has been no strong evidence for organ damage or persistent and significant immune/inflammatory abnormalities.

The confusion and controversy playing out online and among support groups for the third subset of patients mirrors the misunderstandings of CFS over the past 40 years in both the United States and the United Kingdom. The symptoms are similar to those reported in PVFS or CFS. However, dyspnea and loss of taste and smell appear to be much more common in Post COVID Syndrome patients.
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Hutan · Apr 8, 2021

The authors suggest that Long Covid may be related to the virus remaining in tissues other than blood.

They are fans of Ivermectin as a treatment of Covid-19.

Ivermectin (IVM) is an antiparasitic (endodecticide), with nematicidal and ectoparasiticidal properties.
Recently, its viricidal effects on flaviviruses, dengue, Zica, Chikungunya, among others, have been compiled.
Ivermectin is an inhibitor of the causative virus (SARS-CoV-2).
These results, as a whole, demonstrated that ivermectin possesses antiviral action against SARS-CoV-2 in vitro, with a single dose capable of controlling viral replication in 24-48 hours, and the possibility of repeating it periodically.
Our figures account for a 95.5 % reduction in the need of hospitalization, and a 95,6 % reduction in death rate, when IVM treatment was applied at the early stages of the disease, in consonance with existing data.
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856 patients discharged from a Buenos Aires hospital. 57 of these were still under the supervision of various specialists (4 of the 57 for fatigue). The remaining 799 (approximately even gender split) were given ivermectin for 8 weeks or until remaining symptoms ceased, whichever happened first.

Up until this point, it's looking quite interesting. I'm willing to believe there's a reasonable rationale as to why ivermectin might help and I want to know what they found.

But the pie chart below is the only report of the impact of the treatment - there are no figures given. It's quite extraordinary.

It looks as though the red and violet slices of the pie are representations of the mean number of days people treated with ivermectin had symptoms. Whereas the big blue slice is a representation of how many days people without ivermectin had symptoms - presumably an average from the various reports of Long Covid from other countries that the authors mention earlier in the paper. So, I'm just guessing, but perhaps they are saying that the ivermectin reduced the average time of Long Covid symptoms by something like 10 to 20 times?

I'm not sure what else to say, other than I wish the authors had had the benefit of good maths or science teachers somewhere along the way. Maybe they have identified a useful treatment, but this presentation is not helping anyone.

Hutan · Apr 8, 2021

If the authors are reading this, thank you for your understanding that much of Long Covid is probably ME/CFS, and that trying to return people with the condition back to work before they are well isn't going to be helpful. Thanks for your concern for these people.

Please reach out to colleagues familiar with study design and data presentation before doing more studies. There are people on the forum who would be pleased to review a study plan or draft report for you too.

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