Federal University of Bahia, Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Pesquisa em Infectologia (LAPI), Bahia, BA, Brazil.
Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Institute of Virology, Berlin, Germany.
Braz J Infect Dis. 2021 Jul-Aug;25(4):101603. doi: 10.1016/j.bjid.2021.101603. Epub 2021 Aug 12.
Over-the-counter use of ivermectin amongst other drugs as SARS-CoV-2 treatment has been increasingly common, despite the lack of evidence on its clinical efficacy.
To evaluate the effect of ivermectin use on production of antibodies against SARS-CoV-2 in health care workers (HCW) diagnosed with COVID-19 and of Th1/Th2 cytokines by stimulated peripheral blood mononuclear cells of the same cohort (PBMCs).
This cross-sectional study evaluated seroconversion and neutralizing antibodies production in HCW at Complexo Hospitalar Universitário Professor Edgard Santos (Salvador, Brazil), diagnosed with COVID-19 from May to July, 2020, as well as in vitro production of antibody against SARS-CoV-2 and Th1/Th2 cytokines. Analyses were performed between December 2020 and February 2021. Participants were stratified according to the use of ivermectin (≤ 1 dose vs. multiple doses) for treatment of COVID-19.
45 HCW were included (62% women). Mean age was 39 years, and disease severity was similar across groups. Neutralizing antibodies were detected less frequently in multiple doses (70%) vs. ≤ 1 dose (97%) groups, p = 0.02). PBMCs of patients in multiple doses group also were less likely to produce antibodies against SARS-CoV-2 following in vitro stimulation with purified spike protein in comparison with patients in ≤ 1 dose group (p < 0.001). PBMC´s production of Th1/Th2 cytokines levels was similar across groups. Abdominal pain (15% vs 46%, p = 0.04), diarrhea (21% vs. 55%, p = 0.05) and taste perversion (0% vs. 18%, p = 0.05) were more frequently reported by participants that used multiple doses of ivermectin.
Although there was no evidence for differential disease severity upon ivermectin use for treatment of COVID-19 it was associated with more gastro-intestinal side-effects and impairment of anti-SARS-CoV2 antibodies production, in a dose dependent manner. This potentially impacts the effectiveness of immune response and the risk of reinfection and warrants additional studies for clarifying the mechanisms and consequences of such immunomodulatory effects.
尽管没有关于伊维菌素临床疗效的证据，但在治疗 SARS-CoV-2 方面，伊维菌素和其他药物的非处方使用越来越普遍。
评估伊维菌素的使用对 COVID-19 确诊的医护人员（HCW）产生针对 SARS-CoV-2 的抗体以及同一队列的外周血单个核细胞（PBMCs）产生 Th1/Th2 细胞因子的影响。
这项横断面研究评估了 2020 年 5 月至 7 月期间在巴西南里奥格兰德州萨尔瓦多 Complexo Hospitalar Universitário Professor Edgard Santos 医院 COVID-19 确诊的 HCW 的血清转化和中和抗体产生情况，以及针对 SARS-CoV-2 和 Th1/Th2 细胞因子的体外抗体产生情况。分析于 2020 年 12 月至 2021 年 2 月进行。参与者根据伊维菌素（≤1 剂与多剂）治疗 COVID-19 的使用情况进行分层。
纳入 45 名 HCW（62%为女性）。平均年龄为 39 岁，各组疾病严重程度相似。与≤1 剂组（97%）相比，多剂组（70%）中较少检测到中和抗体，p=0.02）。与≤1 剂组相比，多剂组患者的 PBMCs 在用纯化的刺突蛋白体外刺激后产生针对 SARS-CoV-2 的抗体的可能性也较小（p<0.001）。各组 PBMC 产生的 Th1/Th2 细胞因子水平相似。与使用伊维菌素多剂的参与者相比，使用伊维菌素一剂的参与者更常报告腹痛（15%比 46%，p=0.04）、腹泻（21%比 55%，p=0.05）和味觉障碍（0%比 18%，p=0.05）。
尽管没有证据表明伊维菌素治疗 COVID-19 时疾病严重程度存在差异，但它与更多的胃肠道副作用和抗 SARS-CoV2 抗体产生受损有关，且呈剂量依赖性。这可能会影响免疫反应的有效性和再次感染的风险，需要进一步的研究来阐明这种免疫调节作用的机制和后果。
