Ivermectin Prophylaxis Used for Covid-19 (Peer-Reviewed)

https://www.cureus.com/articles/82162-ivermectin-prophylaxis-used-for-covid-19-a-citywide-prospective-observational-study-of-223128-subjects-using-propensity-score-matching

by benpiper • 5 years ago

52 65 5 years ago

cureus.com

johng• 5 years ago

These seems like a pretty thorough study... is it OK for people to talk about Ivermectin now or are they still going to censor and ban accounts?

coding123• 5 years ago

Well, I don't think HN will ban accounts for that. They ban accounts for being mean or starting flamewars. Being republican is NOT a reason for bans here.

hunter2_• 5 years ago

Genuinely curious why alignment with this drug is so republican. Seems like the kind of thing that ought to be bipartisan if it's arguably progressive.

threeseed2• 5 years ago

Many of those that I saw banned were for those recommending taking ivermectin.

Nobody should take anything without discussing it with their doctor.

josephcsible2• 5 years ago

Does "anything" include the COVID vaccines?

noja• 5 years ago

Is this the "if the subject is suffering from worms, then treating the worms allows them to fight the virus" result? (So not relevant in the US)

JohnTHaller5• 5 years ago

Yes. It took place in a city in southern Brazil where worms are endemic. It's exactly what we already knew and not relevant in the US.

rootusrootus• 5 years ago

Makes sense in Brazil, but is it applicable to the US or other Western nations?

threeseed2• 5 years ago

Not when we have extremely safe, highly effective vaccines.

But in places where they aren't available it could be interesting especially if Omicron is the dominant variant and reducing transmission isn't of much use (which Ivermectin doesn't help with).

ncmncm13• 5 years ago

People in those places should be treating their parasite infections anyway. We already knew they would be the healthier for it. But they aren't, because they can't afford it.

JohnTHaller5• 5 years ago

Nope. Worms are not endemic here, so Ivermectin has no impact on Covid-19 outcomes. It has a slight effect in this area of Brazil where worms are endemic.

tinus_hn6• 5 years ago

Interesting. It’s not double blind and I’m not sure how practical this is but it does cast a lot of doubt on the conclusion that ivermectin doesn’t do anything unless the dose is lethal.

ncmncm13• 5 years ago

Ivermectin affects parasite load, and parasite load affects outcomes of acute respiratory infection.

The effect size is smaller than from wearing a good mask.

supperburg• 5 years ago

Parasites double your chances of getting severe Covid? Shouldn’t people be taking it anyway then, as well as wearing a mask?

tinus_hn6• 5 years ago

This is a completely nonsensical dismissal unless you want to claim the outcome for people who actually get ill is different for those who wore masks versus those who didn’t.

And be sure to keep in mind that the vast majority of infections occur at home where I sincerely doubt people are wearing masks.

lambdaba8• 5 years ago

Could you share a link to such a debunking? I could search, but you probably have one that you find most convincing.

ncmncm13• 5 years ago

In interpreting this result, one should keep in mind that an active parasite infection produces worse results for respiratory infections of all kinds. Taking ivermectin reduces parasite load.

The size and location of the study suggests that reporting of COVID-19 infections was by presentation, meaning asymptomatic or minimal infections were probably not counted.

tl;dr: These results will probably not translate well to places without pervasive parasite infestation. Wearing an N95 mask has a much larger protective effect than taking ivermectin, in any case, even there.

lambdaba8• 5 years ago

I've seen other similar results, and I don't share this skepticism. I can't find the exact study, but here's one on hospital staff in Argentina: https://www.cureus.com/articles/64807-prophylactic-role-of-i...

I just don't see how parasites would explain all these results. I do see how monetary incentives would play into maligning them though.

ncmncm13• 5 years ago

Scurrilous accusations violate posting rules.

gus_massa2• 5 years ago

Note that the original article and the article you posted are not randomized controlled trails. Does the people that accept to take Ivermectin more cautious than the people that don't? Does young people more likely to try? There are too many variables and it's just too hard to know without a RCT.

Also, the problem with these types of studies is that bad outcomes are sometimes not published. Nobody want to write an article with the title "We used Ivermectin and we killed an additional statistical significant number of coworkers" https://en.wikipedia.org/wiki/Reporting_bias For a RCT it's necessary more paperwork and authorizations and ideally preregistering. So that increase the chance of that they must write the final paper.

Also, as the PG noted the "peer review" of this site is not the traditional peer review of a normal journal. For example, the title says "Observational Study of 223,128 Subjects" but later it says "a total of 159,561 subjects were included in the analysis". The main part of the difference is that they report in the title the total number of inhabitants, but for the analysis they use only the ones that have more than 18 years old. It's not a smoking gun, but at least it's a small red flag.

whiskeyRanger• 5 years ago

SIQ™ is a predictive measure of scientific quality.
How can I improve my article's SIQ™?
Telling your friends, colleagues and advisors to review the article on Cureus
Cureus offers a social media promotional add-on, or boost, for eligible published articles at an additional cost.

So this site is like PubMed but with payola?

rsfern2• 5 years ago

For context, this journal uses crowd sourced open peer review, which is an interesting concept.

There’s one review, and it’s (IMO) not substantive. I would treat this as a preprint basically (not that you shouldn’t read peer reviewed studies critically either)

mullingitover• 5 years ago

not that you shouldn’t read peer reviewed studies critically either

Can't emphasize this enough. The MMR autism fraud paper that started the anti-vaccine industry was peer reviewed in the Lancet.

It's unfortunate that the critical thinking skills needed to know good research from bad aren't drilled into us as part of the core curriculum for every high school student.

cosmotic2• 5 years ago

This may look and smell like a peer reviewed study, but I cannot find any reliability rankings for the journal 'Cureus'. Wikipedia article on Cureus is brief and it appears they allow anyone to publish. I would take this article with a few large grains of salt.

sdeframond• 5 years ago

Could you explain what kind of reliability ranking you are referring to ? Is there a "standard" or something ? How does it work ?

cosmotic2• 5 years ago

There are a a few: https://en.wikipedia.org/wiki/Journal_ranking

rajangdavis• 5 years ago

Why did this get flagged? It's pretty measured in it's findings:

These results indicate that medical-based optional prescription and citywide covered ivermectin can have a positive impact on the healthcare system. However, the present results do not provide sufficient support for the hypothesis that ivermectin could be an alternative to COVID-19 vaccines

anagram6662• 5 years ago

This is an observational study, not strong enough to make any conclusions; The determination if a patient had taken ivermectin was self-reporting. There is no control of the dosage and how much time the patients took ivermectin before getting covid.

This is at best an indication of the need for better studies about the subject, but considering that Brazil's president is rabid pro-ivermectin and this was made in a medium city in a region favorable at the president, take this with a grain of salt.

JohnTHaller5• 5 years ago

Additionally, it was done in southern Brazil where worms are endemic. Being infected with worms is a known comorbidity of Covid-19. Treating the worms with Ivermectin has been shown to have a small improvement in chance of death from Covid-19. This doesn't apply to the US, of course.

ipspam• 5 years ago

We are two years into a pandemic. There isn't coming an answer to ivermectin. There should have been an answer 18 months ago, but the sycophantic vaccine pushers have done everything they can not to discredit ivermectin, but to simply say there isn't enough evidence to prove its effectiveness. Also, the only way to do this is to claim massive widescale multi-country research fraud.

I don't have a position on ivermectin, but it's pretty clear that any actual pre-treatmwent repurposing of drugs for any future pandemic should be the tip of the spear, but will be oppressed, underfunded, attacked, false-flagged, strawmanned, degraded, and doctor prescribers attacked.

This is totally, totally backwards. Even at $100,000,000 a clinical trial, funding 100 drugs with repurpose potential should have been step 1.

rsfern2• 5 years ago

Ivermectin and hydroxychloroquine were met with cautious optimism by the research community after the first preliminary hits in screening experiments for drug repurposing, exactly as you’re advocating [0]. The tides turned when things didn’t pan out in subsequent clinical studies. Actually, for ivermectin the tide started turning after people realized what an unrealistically massive dose was needed in the first in vitro study [0 again]

There were a few cases of fraud (most notably one of the biggest ivermectin studies last summer) but it’s not necessary to resort to allegations of ubiquitous fraud to conclude that the research doesn’t really support use of these drugs as effective Covid therapeutics

0: https://www.science.org/content/blog-post/what-s-ivermectin

anagram6662• 5 years ago

Sorry to say, but the vaccine is a better option to prevent covid, even considering this study. You can take ivermectin if you use the normal dosage, it is not harmful and may be helpful. But a lot of people is promoting ivermectin instead of the vaccine or using a higher dosage and this is causing a lot of preventable deaths.

b0sk• 5 years ago

The supposed “hackers” keep pushing these pseudo scientific garbage in Hacker News for some reason

JohnTHaller5• 5 years ago

Parasites are a comorbidity of Covid-19. Ivermectin is an anti-parasitic. You'll slightly improve your chances against Covid-19 by treating the parasites with Ivermectin so your body doesn't have to fight those, too. Parasites are endemic in Brazil in the South where Itajaí is located and Ivermectin is in heavy usage pre-pandemic as a result.

We already knew this. This doesn't apply outside areas with endemic parasites. It doesn't apply here in the US.

Grismar• 5 years ago

Science on this is great. However, don't parrot this to your friends until you see it replicated somewhere else (preferably somewhere not governed by ivermectin-peddling populists) and confirmed in a double-blind random-controlled trial (which this doesn't even get close to). After all, no reason to hold this stuff to a lower standard than the anyone want to hold the vaccines to (regardless of whether they realise these standards were already met there).

josephcsible2• 5 years ago

no reason to hold this stuff to a lower standard than the anyone want to hold the vaccines to

There absolutely is such a reason: the standard for things that people are required to take should be way, way higher than the standard for things that people are merely allowed to take.

SteveEM2• 5 years ago

These are the issues that limit ability to draw conclusions in this study: No pre-registration, No randomization, No blinding, No allocation concealment, No idea who did/did not fill prescriptions, Prescription writing was based on "judgement"?!, No uniform follow up, No idea who was followed up or lost to follow up

SteveEM2• 5 years ago

These authors have had one article retracted by the Journal of Intensive Care Medicine and another refuted by American Journal of Therapeutics. https://journals.lww.com/americantherapeutics/Fulltext/2022/...

LearnerHerzog• 5 years ago

I heard those researchers drank horse refresher (water). Can we really trust people putting horse refresher in their bodies?

Ivermectin Prophylaxis Used for Covid-19 (Peer-Reviewed)

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