Abstract

Abstract Background: Up-to-date, there is no recognized effective treatment or vaccine for the treatment of COVID-19 that emphasize urgency around distinctive effective therapies. This study aims to evaluate the anti-parasitic medication efficacy "Ivermectin" plus standard care (azithromycin, vitamin C, Zinc, Lactoferrin & Acetylcystein & prophylactic or therapeutic anticoagulation if D-dimer > 1000) in the treatment of mild/moderate and severely ill cases with COVID 19 infection, as well as prophylaxis of health care and/ or household contacts in comparison to the Hydroxychloroquine plus standard treatment. Subject and methods: 600 subjects; 400 symptomatic confirmed COVID-19 patients and 200 health care and household contacts distributed over 6 groups; Group I: 100 patients with Mild/Moderate COVID-19 infection received a 4-days course of Ivermectin plus standard of care; Group II: 100 patients with mild/moderate COVID-19 infection received hydroxyxholorquine plus standard of care; Group III: 100 patients with severe COVID-19 infection received Ivermectin plus standard of care; Group IV: 100 patients with Severe COVID-19 infection received hydroxyxholorquine plus standard of care. Routine laboratory investigations and RT-PCR were reported before and after initiation of treatment. Group V stick to personal protective equipment (PPE) plus Ivermectin 400mcg / kg to be repeated after one week, and Group VI stick to PPE only and both groups V&VI were followed for two weeks. Results: Patients received ivermectin reported substantial recovery of laboratory investigations; and significant reduction in RT-PCR conversion days. A substantial improvement and reduction in mortality rate in Ivermectin treated groups; group I (mild/moderate cases), (99%, and 0.0%, respectively) and group III (severe cases), (94%, and 2.0%, respectively) versus hydroxychloroquine plus standard care treated groups; group II (mild/moderate cases), (74% and 4%, respectively) and group IV (severe cases) (50% and 20%, respectively). Ivermectin had significantly reduced the incidence of infection in health care and household contacts up to 2% compared to 10% in non ivermectin group Conclusion: Addition of Ivermectin to standard care is very effective drug for treatment of COVID-19 patients with significant reduction in mortality compared to Hydroxychloroquine plus standard treatment only. Early use of Ivermectin is very useful for controlling COVID 19 infections, prophylaxis and improving cytokines storm