الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
COVID-19 is caused by SARS-CoV-2, a new corona virus that quickly spreads throughout the entire world.
By 24th May 2021, there were more than 167 million individuals that have been diagnosed and more than 3 million have died as a result of the worldwide illnesses.
To effectively minimize the spread of COVID-19 and especially the associated deaths, a highly effective treatment option is needed.
The aim of this study is to assess the effectiveness of ivermectin and colchicine as treatment options for COVID-19.
The current study was a three-arm randomized controlled clinical trial conducted in Triage Clinic of Family Medicine Department at Ain Shams University Hospitals over a period of 18 months from July 2021 till November 2022 on 120 COVID-19 patients with moderate severity.
Patients were selected from Triage/COVID-19 Outpatient Clinic and every patient was subjected to the following:
1. Full history was obtained from each patient asking about socio-demographic data such as age, gender, residence, marital status, habits as smoking, history of present illness (onset, course, duration), family history, past history, and presence of Co-morbidities.
2. Full general examination included: temperature, heart rate, blood pressure, respiratory rate, and oxygen saturation.
Suspected patients according to CDC criteria were subjected to laboratory and radiological confirmation with (PCR-COVID-19, Complete Blood Count, CRP, Ferritin and D-Dimer) and High-Resolution CT chest.
After confirmation of the diagnosis and patients were confirmed to be moderate severity with laboratory and radiological findings then allocation to study groups was done.
Participants were randomized into three groups by giving every patient who met the inclusion criteria sealed envelopes containing code (A, B, C) for intervention or control. Thus, the treatment to be given was randomly determined. The first group received ivermectin as add on standard care. The second group received colchicine as add on standard care while the third group received the standard care only. Then all groups received instructions of home isolation and informed that they would be followed by phone twice weekly for one month. They were called by phone to ask about their symptoms e.g., they were asked about symptoms relief, cough, fever (temperature measurement by thermometer if possible), oxygen saturation (pulse oximeter if possible) and emphasis on taking medications regularly.
Two weeks later, patients were followed up in the clinic. They were asked to repeat the primary investigations (CBC, CRP, Ferritin and D-dimer).
After one month of symptoms onset, patients were followed up in the clinic and the previous investigations (CBC, CRP, Ferritin and D-dimer) were re-tested.
The collected data were introduced and statistically analyzed by utilizing the Statistical Package for Social Sciences (SPSS) version 20 for windows.
After Analyzing the data, the results of the study showed that the mean age of the study participants was around 40 years old. Most of the participants in each of the three groups were female. There wasn’t a statistically significant difference in between the intervention and control groups in the present study regarding age, sex and disease severity indicating matched groups.
Regarding clinical data, respiratory symptoms (cough, dysnea rhinorrhea and nasal congestion) were the most presenting symptoms in our participants followed by fever while GIT symptoms were the least presenting symptoms. The mean duration of fever in the present study was 7 days while the mean duration of symptoms was 10 days with no significant difference between the three groups.
Regarding laboratory data, a statistically significant difference in all the parameters over the three points in time, except for the lymphocytes in all groups with a non-significant difference in between them. Over the course of the monitoring periods, the CBC significantly changed (the mean level of Hb decreased then increased, TLC and neutrophils increased, while the mean monocyte level decreased).
Regarding inflammatory markers, CRP was the most frequently elevated inflammatory marker followed by D-dimer and S. ferritin in the three treatment groups with no difference in between them. There was a statistically significant reduction in their levels when patients’ clinical conditions improved over time.
Regarding COVID-19 outcomes, in the present study, most of symptoms recovered after 10 days of infection while about 30% of research participants experienced symptoms that lasted for more than ten days in each of the three intervention and control groups.
There wasn’t a statistically significant difference between the intervention and control groups regarding duration of fever, duration of symptoms, presenting symptoms, clinical outcomes, or laboratory data, indicating that adding ivermectin or colchicine to standard care didn’t show any additional benefit.
Future multicentre randomized controlled trial with larger sample size could be conducted to confirm these results.
LIMITATIONS
Lack of data about RT-PCR, so the effect of colchicine and ivermectin on viral load can’t be assessed.
Not all the inflammatory markers were measured in the current study, so full data about the effect of ivermectin and colchicine on the rest of inflammatory markers can’t be obtained.
The sample size was not large so further studies with larger sample size can be conducted to allow generalization of data.
CONCLUSION
Adding ivermectin or colchicine to the standard care didn’t show any additional benefit in treatment plan of COVID-19 patients.
RECOMMENDATIONS
Using ivermectin and colchicine in COVID-19 should be limited on clinical trials until scientific evidence for their usage would be found.
Future multicentre randomized controlled trial with larger sample size could be conducted to confirm these results.