Ivermectin and the odds of hospitalization due to COVID-19: evidence from a quasi-experimental analysis based on a public intervention in Mexico City

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Case study: Policy intervention in Mexico City

Increase in COVID-19 cases and with critical levels of hospital saturation during December 2020

Mexico City Government decided to expand population-based health
Interventions

Implementation of a prehospital home-care program

Combining early detection with antigen tests

230 kiosks

Phone-based follow up for positive patients

Since 28 December, 2020, medical ivermectin kits have been provided to positive mild to moderate symptomatic patients

Dyspnea, chest pain or cyanosis, referred to a hospital

Ivermectin, four 6mg tablets, two pills for two days

After one month, 83,000 medical kits delivered

Detailed data was collected on the evolution of patient illnesses

Quasi-experimental evaluation of the effects of the medical kits on
hospitalization

Kit receivers and non-kit receivers

Matched observations, adjusting by age, sex, COVID severity, and comorbidities

Controls, N = 156,468 patients with COVID-19 infection before implementing the ivermectin program

Experimental group, n = 77,381 after the implementation

Outcome variable: whether or not the person was hospitalized

Results

Negative and significant effect of the ivermectin-based medical kit on
the probability of hospitalization

Effect ranges from 50% to 76%

Difference in hospitalization odds between treated and untreated patients, statistically significant in all cases

As expected, the effect of the medical kits is higher and stronger among males, in older patients, and in cases without severe symptoms

Discussion and limitations

we found that the medical kit given en masse to patients who’d tested positive in Mexico City had a negative, significant, and robust effect on their odds of being hospitalized.

Independently of the medical telephone follow, level of hospital occupancy, specific period of time

Similar trend, Perú (Chamie-Quintero Et Al, 2021).

Principal mechanisms, reduction of viral load, in the patients that take ivermectin in early stages of the disease

Chamie-Quintero Et Al, 2021, Peru

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25 states of Peru

Grouped by extent of IVM distributions

Maximal, medium, minimal

Reductions in excess deaths (30 days after peak deaths)

maximal, 74%
medium, 53%
minimal, 25%

Reduction of excess deaths is correlated with extent of IVM distribution by state p less than 0.002

This strongly suggests that IVM treatments can likewise effectively complement immunizations to help eradicate COVID-19.

The indicated biological mechanism of IVM,

competitive binding with SARS-CoV-2 spike protein,

is likely non-epitope specific,

possibly yielding full efficacy against emerging viral mutant strains.

Uttar Pradesh

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Uttar Pradesh government, first to have introduced a large-scale “prophylactic and therapeutic” use of Ivermectin

Helped the state to maintain a lower fatality and positivity rate as compared to other states

Health Department introduced Ivermectin as prophylaxis for close contacts of Covid patients, August 6, 2020

Agra, Dr Anshul Pareek and State Surveillance Officer Vikssendu Agrawal

Administered Ivermectin to all RRT team members in Agra

None of them developed Covid-19

Despite being in daily contact

Despite being the state with the largest population base and a high population density, we have maintained a relatively low positivity rate and cases per million of population

Lower positivity and fatality rates may be attributed to the large-scale use of Ivermectin use UP

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