Inclusion Criteria:  adult men and women age 18-80 years non-pregnant or breast-feeding women had mild to moderate symptoms as defined by the World Health Organization (WHO) severity score for COVID-19 Mild disease was defined as cough , runny nose,anosmia, fever, diarrhea without dyspnea or tachypnea.  Moderate disease was defined as pneumonia but with oxygen saturation more than 90 percent  Exclusion Criteria:  were allergic to ivermectin have the potential for a drug-drug interaction with ivermectin such as tamoxifen or warfarin previously treated with ivermectin in the last 7 days had received any herbal medicine had severe chronic illness (severe congestive heart failure, chronic kidney disease stage 4-5, chronic liver disease, terminal cancer diseases) had concurrent bacterial infection or unwilling to participate in the trial Patients with severe symptoms, likely due to cytokine release syndrome uncontrolled co-morbidities and immunocompromised states