The COVID-19 pandemic has become a global public health problem causing crises in various fields of human life. The lack of a proper medical solution that would eliminate not only the symptoms but the cause of the disease urges the scholarly and healthcare communities to find effective ways of treatment of COVID-19 and the prevention of the virus from further spreading. The topic under investigation in this research paper is highly relevant in the context of the modern global healthcare systems since the burden of COVID-19 has been experienced at a large scale, causing significant health and economic problems to humanity. One of the drugs that have been researched and tested for their effect on the COVID-19 disease is Ivermectin, which proves to be an effective solution to the infections caused by SARS-CoV-2. Nonetheless, due to the recent discovery of the potential benefits of the drug when used as COVID-19 treatment, the evidence on the consequences, including possible side effects and complications for the human body, is limited.
Therefore, the purpose of the study is to identify and evaluate the available evidence and scholarly research findings pertaining to the effectiveness and possible risk factors associated with using Ivermectin as a medicine for the prevention and treatment of COVID-19. This research paper will present a research proposal for the study, validating its relevance and necessity for the healthcare community struggling with the burdens of the pandemic. Furthermore, an in-depth literature review of recent scholarly publications on the effects of Ivermectin will be presented with the following critical discussion of the findings. Finally, the findings will be summarized, and the applicability of the proposed drug for the treatment of COVID-19 will be validated. This research study is based on the literature review approach; recent publications have been retrieved from such databases as Science Direct, PubMed, and Google Books.
Regardless of the multiple attempts of researchers to find and research effective treatment for COVID-19, there is no sufficient evidence that would provide the healthcare systems with a reliable and safe evidence-based treatment. Moreover, Ivermectin demonstrated potentially beneficial outcomes for individuals with COVID-19, is characterized by ambiguous research findings, which implies that the use of Ivermectin might cause unpredictable outcomes for human health in both short- and long-term perspectives. Therefore, due to the limited research on Ivermectin’s effect on the human organism and the overall urgent necessity to provide the medical community with a solution to the pandemic, a research study should be launched to bridge this gap in scholarly literature and supply medical practice with an effective treatment tool.
The concern about the potentially harmful effect of Ivermectin as the aftermath of treatment is validated by the prior utilization of the drug. Indeed, according to the World Health Organization (WHO) (2020), it was initially used as a means of eliminating parasites, usually in combination with other medicines to ensure the proper effect. It has been proven that one dose of Ivermectin is capable of suppressing Mansonella streptocerca and Mansonella ozzardi (Bennett et al., 2019). However, the dosage that would be applicable to the treatment of COVID-19 is not supported by any scientific evidence and requires an in-depth investigation.
Another important aspect associated with Ivermectin that contributes to the grounds for this research study is the increase of interferon as one of the effects of the drug. Since interferon is an essential element in the immune reaction mechanisms, the use of Ivermectin is supposedly an effective immune system booster, which amplifies its benefits alongside its antiviral and antiparasite effects (Landrito, 2020; Mukhopadhyay et al., 2020). Multiple research studies have been initiated to investigate Ivermectin as applied to SARS-CoV-2 (Bryant et al., 2021; Cabot, 2020; Mansour et al., 2021). However, due to the lack of unity in findings, it is necessary to investigate Ivermectin’s long-term effects on the human body, proper dosage, effect on pregnant women’s health, and fetus development. Thus, given the high prevalence and mortality rates of COVID-19, it is imperative to launch in-depth research on the effectiveness and safety of using Ivermectin as SARS-CoV-2 treatment.
The outbreak of COVID-19 and its devastating health-related consequences manifested through high levels of comorbidities and mortality have prompted the advancement in medical research in the search for effective treatment methods. Indeed, at present, COVID-19 is considered “a major public health challenge, affecting over 175 million people globally and causing more than 3 million deaths” (Mohan et al., 2021, para. 5). While statistics suggest that the majority of patients experience mild and moderate forms of the infection, there is a significant population that is exposed to complications, the most dangerous of such are those of inflammatory nature (Burgan, 2021; Zein et al., 2021). Given such a wide range of health concerns and global threats due to the lack of effective treatment, availability necessitates the urgent finding of a cure.
Multiple scholarly sources have addressed the issue of the scarcity of evidence-based methods of COVID-19 treatment due to its rapid evolvement and insufficiently researched nature. According to Hassanien (2021), the level of technological development in contemporary medicine promotes and boosts the improvements in effective disease treatment. Moreover, Bennett et al. (2019) state that despite the developed methods of successful elimination of infectious diseases by means of advanced scientifically supported cures, humanity continues to face health threats in the form of viruses. The methods that have worked with the infections that have originated in the past might be ineffective in addressing newly emerging viruses since they mutate and have a tendency to adapt.
For that reason, it is essential to continue researching new ways of tackling the problem; one of the most accessible, time-efficient, and resource-efficient approaches to doing so is by reapplying existing substances for new infections. Indeed, as researchers indicate, “most medications that are touted for COVID-19 failed to demonstrate benefit in randomized controlled trials,” which is why “there is a mounting interest in repurposing the available antiviral and antiparasitic medications to treat COVID-19” (Zein et al., 2021, p. 1). One of such drugs is Ivermectin, which has demonstrated some positive outcomes in minimizing morbidity and mortality associated with COVID-19, as well as raised a scholarly discussion of its implied risks.
The implicit danger of Ivermectin is validated by its initial usage as a veterinary drug. On the one hand, the principle of its mechanism provides a promising basis for applying it as a treatment for human beings. The drug induces the release of gamma-aminobutyric acid (GABA) that causes the arthropod muscles’ post-synaptic stimulation blocking, thus destructing the virus (Plumb, 2018). Successful results of using one dose of Ivermectin for treatment of such infections as Mansonella streptocerca and Mansonella ozzardi justify the anticipated effectiveness in suppressing COVID-19 (Bennet et al., 2019). On the other hand, there is a significant degree of a potential threat to human health due to under-discovered side effects, long-term outcomes, and possible toxicity impact (WHO, 2020). Indeed, when a human body resists the infectious organisms, it actively uses the immune cells, in the working mechanism of which interferon plays an essential role.
Importantly, specific findings in the reviewed scholarly literature demonstrate that Ivermectin increases the production of interferon and thus, helps the immune system fight the virus (Landrito, 2020). Antiparasitic and antiviral effects of the drug as applied to the improvement of the immune system’s functioning might be helpful in both treatment and prevention of the COVID-19 infection (Mukhopadhyay et al., 2020). Moreover, immune-based treatment has been addressed as an effective way of treating Coronaviruses, which is why Ivermectin might be a relevant solution to the problem (Rezaei, 2021). In such manner, research suggests significant potentially beneficial outcomes of using the proposed drug as an agent against SARS-CoV-2, which is why it is necessary to overview the evidence concerning risks.
Multiple laboratory testings, meta-analyses, and other types of experimental research studies have been initiated to clarify the applicability of Ivermectin as a safe drug for COVID-19 treatment. In particular, laboratory trials have proven the capacity of Ivermectin to inhibit viruses, including SARS-CoV-2, which is particularly promising under the circumstances of the ongoing pandemic (Cabot, 2020). Furthermore, potentially harmful effects of Ivermectin on human health have been researched by Zaheer et al. (2021). The researchers drew their assumption about the danger of the drug for people from the evidence concerning neurotoxicity and hepatoxicity that might occur as a result of the wrong dosage of the medicine (Zaheer et al., 2021). The researchers found positive effects of Ivermectin as a strong agent in fighting against COVID-19 but urged in-depth research related to accurate dosage to avoid toxicity.
As a counterargument against the claims for Ivermectin’s toxicity, one might refer to Plumb (2018), who stated that Ivermectin does not “readily penetrate into the CSF, thereby minimizing its toxicity” (p. 896). Moreover, the effectiveness of Ivermectin in reducing mortality associated with COVID-19 has been repeatedly supported by the evidence presented by several studies. Indeed, as stated by Bryant et al. (2021), “meta-analysis of 15 trials found that Ivermectin reduced risk of death compared with no ivermectin” (p. 434). This finding goes in accord with the evidence that the use of Ivermectin in the treatment of COVID-19 patients leads to a decreased rate of mortality (Zein et al., 2021). However, the findings presented by Zein et al. (2021) require the following investigation to ensure a more reliable and definite verdict.
Similar findings that justify the safety and effectiveness of using Ivermectin for the treatment and prevention of COVID-19 were presented by Campos et al. (2021). The researchers studied the effects of oral usage of Ivermectin in patients at the onset stage of COVID-19 and found that “there seems to be sufficient evidence about the safety of oral Ivermectin, as well as the efficacy of the drug in the early treatment and the prophylaxis of COVID-19” (p. 1). However, again, these findings require clarification of dosage since, due to the effectiveness in the early stages of the disease, small doses might work, while they might be ineffective for more severe cases.
Indeed, a significant benefit reported in the scholarly literature related to the application of Ivermectin to COVID-19 treatment is the ease of its administration. Since the substance is “well distributed to most tissues,” which guarantees the ease of administration orally (Plumb, 2018, p. 896). However, since the studies to which Plumb (2018) primarily refers were conducted with animals and not humans, it requires thorough investigation to validate the same effect on humans. Another form of drug administration and its dosage was tested by Mansour et al. (2021), who investigated the use of inhaled Ivermectin, in particular. The study validated the safety of using the drug since “ivermectin-HP-β-CD formulation administered in doses of 0.05 and 0.1 mg/kg revealed safety profiles” (Mansour et al., 2021, p. 1). Additionally, several studies have proven the safety of using Ivermectin during pregnancy, claiming its safety for the reproductive system. Plumb (2018) states that research in the sphere of reproductive and nursing safety of Ivermectin shows that the drug “is considered safe to use in pregnancy” based on the reproductive studies conducted with cattle, dogs, swine, and horses (p. 897). Thus, the usage of Ivermectin in the treatment of COVID 19 has more supported benefits than evidentially proved risk factors, given the proper dosage of the medicine.
The presented literature review allows for identifying some of the key issues associated with the advantages and disadvantages of using Ivermectin as a drug against the COVID-19 disease. The relevance of the study is validated by the pandemic’s scope of negative effects on public health. The outbreak of the disease is numbered in millions of contamination and lethal cases. Although the infection is commonly manifested through sneezing and coughing, there are high chances of complications, which often result in pneumonia and other respiratory, cardiovascular, and neurological comorbidities that hinder the longevity and wellbeing of patients (Burgan, 2021). Since the disease is caused by a new type of virus, SARS-CoV-2, there is no specifically designed effective drug that would ensure the cure (Campos et al., 2021). On the one hand, the use of available drugs for stopping the pandemic provides a resource-efficient approach. However, the evidence is insufficient to guarantee the long-term benefits of the treatment for human organisms. Despite the ambiguity behind the research findings of the studies that have recently been conducted, the results of the carried out literature review provide their important insights.
The strengths of the findings are based on the comprehensive synthesis of the versatile findings from a variety of publications, both laboratory studies, systematic reviews, monographs, and reports. Indeed, the literature review provided a multifaceted overview of the findings that equally represent the side that promotes the use of Ivermectin and the side that urges to use it cautiously. Therefore, the objectivity and unbiased analysis of the information allows for making informed conclusions. Another significant advantage of the study is that it approached the issue from a variety of angles, addressing the mechanisms of Ivermectin’s action when inhibiting viruses and parasites, its administration forms, origins, tested results, and usage for different patient groups. It has been found that the results of using Ivermectin for different subgroups were not the same due to the distinction in the anticipated outcomes; however, they were consistently positive. For example, patients with severe forms of COVID-19 and complications experienced reduced severity of symptoms while individuals with first signs of the disease were capable of preventing it.
As with any other study, the current literature review might be characterized by several limitations associated with the overall approach and the types of data. In particular, since the literature review was conducted on the basis of secondary data, the findings are bound to the evidence presented in the past studies without providing much novelty to the scholarly discussion of the topic. Another disadvantage of the conducted study might be found in the scope of research which includes multiple aspects of the drug’s effects, which might be a limitation to an in-depth understanding of the causes of some risk factors. However, the quality and quantity of data retrieved and synthesized in this study are validated by its purposes and design. It is recommended that in-depth investigation of the particularities are addressed in laboratory trials since they would yield the most reliable results.
Despite the use of secondary data as the basis for this research, it has generated novelty and contributed to the scope of literature on the topic. Firstly, the study has raised awareness about the unresolved issues of COVID-19 treatment and the options for effective drug use. Secondly, the study has introduced a solid validation of the necessity for the scientific medical community to concentrate on the research efforts directed at the investigation of dosages. Thirdly, the study has generated a set of most essential concerns and evidence-based benefits of using Ivermectin, which might serve as a basis for practitioners when validating their treatment options. Indeed, the study found that low dosages of the drug are safe for patients, including pregnant women. It has significant positive results for patients with mild forms of the COVID-19 disease and as a preventative treatment at the early stages of illness.
Moreover, the literature review found that the administration of Ivermectin significantly reduces the mortality rate associated with COVID-19, as well as minimizes the risk of complications. Finally, it has been found that while oral and inhaled forms of Ivermectin administration are the safest and most effective, precise dosage needs to be further investigated to ensure the balance between the risk of toxicity and the necessary healing effect.
Thus, the conducted study outlines some prospects for improvement in COVID-19 treatment. It presents a scientifically validated basis for the effective use of Ivermectin as an antiviral drug helping to boost the immune system. Technologies should be applied to diversify the approaches, scope, and accuracy of testing results to validate the exact dosage of Ivermectin as a COVID-19 treatment (Hassanien, 2021). Since it has separated the most tentative concerns, such as dosage and toxicity, as the most threatening to human health, the study might be used as a basis for researchers’ concentration on the validation of the drug’s effectiveness.
Given the scope of the presented implications of the study, its impact on public health is difficult to overestimate. Under the conditions of the ongoing COVID-19 pandemic, the emergence of new types of the virus, and the continuous morbidity and mortality induced by the disease, the implementation of the findings of this research to practice might have a significant positive effect on the improvement of the pandemic situation. In particular, due to the availability of the drug and a relatively high level of researched effects of it, the use of Ivermectin might avert the crisis in the healthcare system. The proven preventative application of the drug as a mechanism of protection against the COVID-19 virus will help reduce the number of cases and save human lives on a global level.
The study has summarized the findings of the studies and scientific publications related to COVID-19 treatment and prevention using Ivermectin. However, since multiple gaps in research and evidence have been identified, it is suggested that extensive in-depth future research is initiated. Firstly, laboratory tests and trials expanding the findings based on the comparison of Ivermectin and placebo groups should be launched. They should concentrate on the differences in dosage of both oral and inhaled drugs in order to identify the change in antiviral effectiveness and threats to human health. Secondly, although it might be time-consuming, long-term outcomes of using Ivermectin should be tested using advanced technologies that might yield reliable results. Thirdly, research should be initiated to identify possible risks for the fetus if a pregnant woman is treated using Ivermectin since limited evidence is available on the response of the fetus to such treatment. Finally, alternative forms of drug administration and their combination with other treatments should be investigated to eliminate the risk of over toxicity due to drug incompatibility. Overall, the studies of various scopes and with a variety of patient groups should be initiated to obtain diverse findings illustrating the capability of the drug to address the needs of the contemporary medical sphere in the conditions of the COVID-19 pandemic.
To summarize, the presented research study based on the recent scholarly literature review showed that Ivermectin is an effective antiviral drug that has demonstrated significant positive results in inhibiting the COVID-19 virus. The literature review was conducted on the basis of scientific articles, monographs, and reports published within the past four years. The studies were overviewed, and their findings were synthesized to obtain an objective set of data pertaining to both positive and negative consequences of using Ivermectin. The main concern that informed this study was the lack of evidential basis for the dosage of Ivermectin and the under-investigation of its unpredictable consequences due to its origin as a veterinary drug used against parasites. The study showed that the majority of reviewed literature sources proved the positive antiviral effect of the drug, as well as directly validated the inhibiting impact of Ivermectin of SARS-CoV-2. As for the negative outcomes and threats, the only reported concern was the risk of toxicity associated with potentially high dosages for human organisms.
However, the literature review found that the majority of studies justified Ivermectin’s effectiveness. Firstly, it was effective in inhibiting viruses and infections in humans; secondly, it was successful in decreasing mortality rates in patients with severe forms of COVID-19 disease. Thirdly, the patients who were administered the drug at the early stages of the disease were less prone to experience complications and severe symptoms. Fourthly, Ivermectin use demonstrated positive preventative results in withstanding the virus due to its strong immune system-boosting effect. Moreover, both oral and inhaled forms of the drug were proven to be safe and effective. Thus, when weighing the findings that justify the positive and negative effects of Ivermectin, one might state that there is a prevalent amount of evidence suggesting that Ivermectin is a safe and potentially revolutionary treatment of COVID-19. Thus, further research on dosage and possible long-term outcomes of the drug on the human body should be initiated to ensure the safety of its use when fighting the pandemic.
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