safety & efficacy of low dose aspirin / ivermectin combination therapy for treatment of covid-19 patients

Conditions: Covid19

Summary: covid-19, caused by the novel severe acute respiratory syndrome corona virus 2 (sarscov-2), has become a global pandemic. fortunately, most of the covid-19 cases confirmed are categorized as mild for whom home- based symptomatic management with monitoring of clinical deterioration is recommended. despite providing symptomatic management, a therapeutic drug that would limit the course of infection is greatly needed to stop covid-19 disease progression. considering the current sars-cov-2 epidemiology and the legitimate rash towards appropriate therapies, our study seeks to evaluate the safety and efficacy of low dose aspirin and ivermectin combination therapy in covid-19 patients.

micro clotting is to date reported as a major cause of death among covid-19 patients. sars-cov-2 associated micro clotting results into acute respiratory distress syndrome (ards) and death. this micro-clotting cascade supports the potential role of anticoagulants like aspirin, heparin in the clinical management of covid-19 patients. other areas that could be considered for potential treatment of covid-19 include drugs and analogues of drugs that have demonstrated potential in-vitro and or in-vivo activity against sars-cov-2 like hydroxychloroquine, azithromycin, lopinavir/ritonavir and remdesivir and ivermectin. ivermectin has demonstrated broad-spectrum anti-viral activity and inhibition of the causative virus (sars-cov-2) with ability to cause a 5000-fold reduction in viral rna within 48hrs. although aspirin and ivermectin do not exhibit any synergistic or potentiation at cellular level, a clinical additive effect resulting from combination therapy with low dose aspirin and ivermectin is plausible. there is no documented drug-drug interactions or other biological basis that contra-indicate co-administration of low dose aspirin and ivermectin. we therefore propose, to explore the clinical use of combination anticoagulant: lower dose aspirin and the fda-approved anti-parasitic drug: ivermectin, in treatment of covid-19 patients in an exploratory randomized trial.

Eligibility criteria:
inclusion criteria: * provision of signed and dated informed consent form * willingness to comply with all study procedures and availability over the study duration \*patients aged above 18years to 64 years * pcr positive for sars-cov-2 (covid-19) from any of the moh covid-19 accredited testing laboratories * moderately ill covid-19 patients score 3(hospitalized with no oxygen therapy) to 4 (hospitalized with oxygen by mask or nasal prongs) according to the who ordinal scale for clinical improvement which translates to moderate to severe covid-19 patients according to the ministry of health uganda covid-19 disease category. exclusion criteria: * participants with known hypersensitivity to ivermectin * clinical diagnosis of severe renal and hepatic impairment. * pregnancy or breast feeding. * co-treatment with either strong cytochrome p-450 inducers including: rifampicin, carbamazepine and barbiturates or inhibitors: isoniazid, clofazimine that might potentially affected ivermectin disposition and clinical outcomes * co-morbidities including asthma * loa loa as assessed by travel history to angola, cameroon, chad, central african republic, congo, dr congo, equatorial guinea, ethiopia, gabon, nigeria and sudan in the last 4 years * persons clinically diagnosed with and receiving treatment for any diathesis and pud * active participation in another clinical trial

Keywords: covid-19 therapies