Introduction:

The lack of drugs against COVID-19 and the health crisis prompted to evaluate ivermectin plus anticoagulation (ANCO) versus ANCO in non-ventilated critically ill patients with COVID-19, and the effect on clinical outcome, complications and survival.

Objectives:

To evaluate ivermectin vs anticoagulation in non-ventilated critical patients with COVID-19, and its effect on the patient's clinical condition, laboratory parameters, evolution and complications in 2nd and 3rd level hospitals (Hospital Sud and Hospital Obrero No. 2 of the Caja Nacional de Salud-CNS).

Material and methods:

Randomized clinical trial, from July 2020 to January 2021, ivermectin (0.2 mg/k) + ANCO arm and ANCO arm; with two variable groups and three assessments. Results: 44 patients enrolled, 27 at Hospital Sud and 17 CNS; 64% to the ivermectin+ANCO group, 57% male. Average age 57.3 years; of hospitalization 13 days; obesity 40%; possibility of recovery with ivermectin 10 days and ANCO> 20 days. The mean initial oxygen saturation (SatO2) 79% (PaO2/FiO2=60) in the group with ivermectin + ANCO and 75% (55) in the ANCO group; in a final measurement 86% (138) and 83% (120) respectively. The first evaluation showed Rho Spearman=-0.7 between SatO2 and respiratory rate (FR) and a Rho=-0.7 between pH and FiO2 in the third evaluation. 26-day survival, RR = 0.98, 95% CI (0.49-1.98), with no differences in both arms (p = 0.94); 27% intubated with ivermectin + ANCO and 21% ANCO; >60% were admitted to intensive care; probability of needing intubation, with RR of 0.76, 95% CI (0.42-1.40), (p = 0.4).

Conclusions:

Ivermectin does not reduce mortality or possibility of intubation. Evolution depends on severity, whether patients are polymedicated, days of progression and use of oxygen. It is necessary to standardise combinations, doses, large and homogeneous samples; for the moment we cannot recommend the use of ivermectin.

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