Ivermectin, the anti-parasitic drug that’s used to treat roundworm infection in humans and to de-worm animals, is risky, and there is no conclusive evidence that it is beneficial in preventing or treating COVID-19, Dayton area doctors say.
Readers continue to ask questions about the coronavirus pandemic, including about ivermectin, a drug some have prematurely touted as a miracle cure for COVID-19. So the Dayton Daily News assembled a panel of trusted local experts, including doctors and pharmacists, to answer your questions on a regular basis. Here are answers to some of the questions we’ve received from readers in recent weeks.
Local experts quoted in this article are:
- Dr. Roberto Colón, chief medical officer at Premier Health’s Miami Valley Hospital.
- Dr. Jeffrey Weinstein, patient safety officer at Kettering Health.
Why are hospitals and doctors not offering safe doses of ivermectin to patients with COVID-19 who want it?
Weinstein: There are potential harms that can occur from the use of any medications, so standard practice is to only use treatments that are proven to be effective. While there is some evidence that, in the test tube, ivermectin can inhibit the SARS-CoV-2 virus, we cannot achieve that same high level of the drug in humans. Neither of the two U.S. treatment guidelines recommend using ivermectin outside of a clinical trial. They both have independently reviewed all of the studies, and determined that they were not properly performed and are too small to allow any definitive conclusions.
Colón: There is no such thing as a “safe dose of ivermectin for COVID-19,” as this is in fact not an effectively identified treatment. Medication doses studied for diseases are established to determine the best balance between risk and benefit. In the case of ivermectin, this has not been proven to be effective and no “standard or effective dose” has therefore been established. It should not be used in the management of COVID-19 patients unless it is as part of a research study.
I read online that ivermectin can help prevent or treat COVID-19. What does the research say?
The consensus among experts is that studies on whether ivermectin is beneficial in treating COVID-19 have not been conclusive. According to clinicaltrials.gov, there are more than 77 active studies testing the use of ivermectin to treat or prevent COVID-19.
Some readers asked specifically about a report on ivermectin and the prevention and treatment of COVID-19 published in the American Journal of Therapeutics. The report found that reductions in COVID-19 deaths are possible using ivermectin. But other studies have found no evidence that ivermectin provides any benefits in combating COVID-19.
Weinstein: This study is what is called a meta-analysis, which combines lots of small studies to see if, when combined, there is evidence of a benefit of any treatment. The problem is that combining multiple poorly designed studies leads to a poorly designed meta-analysis. It is only when what are called randomized double-blind studies of sufficient size are completed we will have a true picture of whether or not ivermectin has any effectiveness in treating COVID-19.
Colón: Unfortunately, numerous meta-analyses in favor of ivermectin are utilizing data from studies that have been retracted due to falsification of data and inconsistencies in the methodology that adversely impact the validity of results. Metanalyses are also subject to the limitation of the initial studies they include and some have been used to derive conclusions that were not part of the intended original studies’ aims. To date, no study has demonstrated a significant benefit for the use of ivermectin for either the prevention or the treatment of COVID-19. Claims that this “risk-free” treatment should be used more widely are dangerous as ivermectin does in fact carry risks, including liver toxicity and death without any valid evidence of significant effectiveness against COVID-19.
Are hospitals rewarded monetarily for each COVID-19 patient, thus diagnosing patients with COVID-19 just to get the money?
Weinstein: COVID-19 has been a burden on our community as well as our hospitals. Across the industry, the cost of care has increased in areas like staffing and often exceeds reimbursements for the care we provide. Simply put: We do not make a profit from caring for those with COVID-19.
Colón: There is zero additional monetary incentive for anyone in health care, hospitals or clinicians, to diagnose patients with COVID-19. The only reason to make this diagnosis is to establish a cause of a patient’s symptoms and help protect others from exposure. In fact, most patients are not diagnosed with COVID-19 in hospitals but rather in other laboratories or testing facilities, many of which are run independently of health care systems. From a financial perspective, COVID-19 has had the opposite effect in most hospitals across the country as it has necessitated additional resources be obtained. Some of these additional expenditures include purchasing much larger quantities of PPE than ever before; many have needed to acquire additional ventilators for management of COVID-19 patients; and others have had to bring on additional staff to help manage the growing numbers of patients that require complex care in the hospital.
Have questions about COVID-19, face masks, vaccines, testing, quarantining or anything else pandemic-related? Send them to firstname.lastname@example.org. Answers will be published regularly in print and online.