García-Méndez Jorge O, Fernández-Garza Luis E, Vallejo-Oviedo Karen, Gómez-Curiel Diana I, Barrera-Barrera Silvia A, Ordaz-Cuellar Rosario, Sosa-García Jesús O, García-Torrentera Rogelio A, Cervera Eduardo, Barrera-Saldaña Hugo A
Internal Medicine, Instituto Nacional de Cancerología, Mexico City, MEX.
Internal Medicine, General Hospital of Zone No. 2, Mexican Institute of Social Security, Monterrey, MEX.
Cureus. 2024 Nov 26;16(11):e74513. doi: 10.7759/cureus.74513. eCollection 2024 Nov.
Background and objective The use of ivermectin and nitazoxanide in the treatment of coronavirus disease 2019 (COVID-19) has been a subject of controversy. In this study, we aimed to describe our clinical experience in treating COVID-19 patients with these drugs in Mexico. Material and methods The study involved out- and inpatient clinical assessments of COVID-19 patients conducted in Mexico City from September 2020 to November 2021. Outpatients were treated with either ivermectin, nitazoxanide, or both drugs, while all inpatients received both. Clinical and laboratory analyses were used to assess the results. Results Of the 228 subjects in the outpatient group, 26.8% received ivermectin, 25.4% nitazoxanide, and 47.8% both. The proportion of negative polymerase chain reaction (PCR) was highest in patients treated late with ivermectin (≥5 days after symptom onset; p=0.004), followed by those receiving late treatment with nitazoxanide, and those with the combination at any time. The inpatient group had 179 subjects. A significant increase was seen in neutrophil, lymphocyte, monocyte, ferritin, and D-dimer levels, while an opposite trend was observed for C-reactive protein (CRP) and fibrinogen levels. Mechanical ventilation requirement was 15.5%, and 5% died during hospitalization. Conclusions Despite the limitations of our study, based on its findings, ivermectin and nitazoxanide could be useful in reducing the viral load, the requirement for mechanical ventilation, proinflammatory and procoagulant parameters, and the fatality rate in COVID-19 patients. Controlled clinical trials evaluating this combination should be carried out to determine its true usefulness and safety profile.
背景与目的 伊维菌素和硝唑尼特用于治疗2019冠状病毒病（COVID-19）一直存在争议。在本研究中，我们旨在描述在墨西哥使用这些药物治疗COVID-19患者的临床经验。材料与方法 本研究对2020年9月至2021年11月在墨西哥城的COVID-19患者进行了门诊和住院临床评估。门诊患者接受伊维菌素、硝唑尼特或两种药物治疗，而所有住院患者均接受两种药物治疗。采用临床和实验室分析评估结果。结果 门诊组的228名受试者中，26.8%接受伊维菌素治疗，25.4%接受硝唑尼特治疗，47.8%接受两种药物治疗。伊维菌素治疗较晚（症状出现后≥5天）的患者中，聚合酶链反应（PCR）阴性比例最高（p=0.004），其次是接受硝唑尼特治疗较晚的患者，以及任何时间接受联合治疗的患者。住院组有179名受试者。中性粒细胞、淋巴细胞、单核细胞、铁蛋白和D-二聚体水平显著升高，而C反应蛋白（CRP）和纤维蛋白原水平则呈相反趋势。机械通气需求率为15.5%，住院期间死亡率为5%。结论 尽管本研究存在局限性，但基于研究结果，伊维菌素和硝唑尼特可能有助于降低COVID-19患者的病毒载量、机械通气需求、促炎和促凝血参数以及死亡率。应开展评估这种联合用药的对照临床试验，以确定其真正的有效性和安全性。
