A Comparative Study on Ivermectin and Hydroxychloroquine on the COVID19 Patients in Bangladesh
Condition: Ivermectin; Hydroxychloroquine; COVID19
MeSH terms: COVID-19
Study type: Observational [Patient Registry]

Summary: 
      COVID19 is a worldwide pandemic. Hence SARS-CoV-2 is a novel virus; there is no specific
      medication against it. Like other countries of the world, Bangladesh is also struggling in
      the case of treatment of this disease. Besides antiviral drugs other existing drugs like
      Hydroxychloroquine, Chloroquine, and recently Ivermectin has been used for the treatment of
      mild to moderate cases of COVID19 disease. Till now Hydroxychloroquine has shown a good
      effect. Recently anti-parasitic drug Ivermectin was found highly effective in an in-vitro
      study against SARS-CoV-2. This study is aimed to evaluate the efficacy of Ivermectin and
      Hydroxychloroquine as a combination therapy with antibiotics (Doxycyclin and Azithromycin)
      and compare the recovery period of these two drugs applied as core monotherapy.
    

Detailed description: 
      This study was done from May 2nd to June 5th, 2020. The investigators included 181 patients
      who were tested positive for SARS-CoV-2 infection by RT PCR presented and the sample
      collected at Chokoria Upazila Health Complex, Cox's Bazar; Bangladesh. The PCR analysis of
      the collected sample was done at Cox's Bazar Medical College. Each of the participants was
      examined carefully to find out the details of the disease symptoms, history, comorbid
      condition, and associated complaints. Patients with severe comorbid conditions like severe
      Bronchial asthma, COPD exacerbation, severe ischemic heart disease, uncontrolled diabetes
      mellitus, advanced renal and hepatic disease, carcinoma, hospitalized and Immuno-compromised
      patients were not included in this study. 42 patients had comorbid conditions (some required
      hospitalization) that might affect the recovery time; 14 patients were unwilling to
      participate in the study and 9 participants did not show-up (3 from group A and 6 from group
      B) for follow up sample collection so these were excluded. Following exclusion 116 patients
      were included with mild to moderate degree of illness with normal or near-normal chest
      radiograph and Oxygen Saturation more than 95% were included in this study. All the patients
      enrolled in the study were treated as an outpatient protocol.

      For the study Perouse the participants were divided into two groups as follows:

      Group A (n=60): Ivermectin 200µgm/kg single dose + Doxycycline 100mg BID for 10days.

      Group B (n=56): Hydroxychloroquine 400mg first day then 200mg BID for 9days + Azithromycin
      500mg daily for 5Days.

      Besides the above, symptomatic treatment for fever, headache, cough, myalgia, and other
      complaints were given accordingly. Participants were advised for self-isolation, proper
      nutrition, hydration, and a sanitary environment. Treatment outcomes were evaluated on every
      2days starting from the 5th day (Asymptomatic patients) or the 2nd non-symptomatic day from
      the first day of the drug intake by PCR study of nasopharyngeal and throat swab in each
      group. Regular contacts were maintained to find out the adverse or side effects of the
      therapy. Informed consent was obtained in every case.
    

Intervention name(s): Ivermectin + Doxycycline; Hydroxychloroquine + Azithromycin
Intervention type(s): Drug; Drug
Intervention description(s): SARS-CoV-2 infection was confirmed by RT PCR in every case. For group A, Ivermectin 200mcg/kg single dose and Doxycycline 100mg BID for 10 days were given. For group B, Hydroxychloroquine 200mg BID for 10 days and Azithromycin 500mg single daily dose for 5days was given. Before advising the contraindications and possible adverse effect and drug interactions were kept in consideration. Incase of asymptomatic patients, repeat sample collection (nasopharyngeal and throat swab) for PCR was done on 5th day. For the symptomatic patients, this duration was on the 3rd nonsymptomatic day from the first day of drug intake. In the case of positive PCR, the test was repeated after 2days and onward.; SARS-CoV-2 infection was confirmed by RT PCR in every case. For group B, Hydroxychloroquine 400mg first day then 200mg BID + Azithromycin 500mg BID for 5 days were given. For group B, Hydroxychloroquine 200mg BID for 10 days and Azithromycin 500mg single daily dose for 5days was given. Before advising the contraindications and possible adverse effect and drug interactions were kept in consideration. Incase of asymptomatic patients, repeat sample collection (nasopharyngeal and throat swab) for PCR was done on 5th day. For the symptomatic patients, this duration was on the 2nd nonsymptomatic day from the first day of drug intake. In the case of positive PCR, the test was repeated after 2days and onward.
Intervention MeSH terms: Azithromycin; Doxycycline; Hydroxychloroquine; Ivermectin
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The total number of patients was 116; male 84 and female 26, age 16 to 80years, mean age
        33.94years.

        Group A (Ivermectin + Doxycyclin): male 43 (71.67%), female 17 (28.33%), age 35.72 ± 15.1
        years. Male 37and, female 32.88 years.

        Group B (Hydroxychloroquine + Azithromycin): male 47 (83.93%), female 9(16.07%), age
        31.91years. Male 31.35, and female 34.5 years.
      
Keywords: Ivermectin; Hydroxychloroquine; COVID19; Bangladesh; SARS-CoV-2