Journal of Clinical Chemistry and
Laboratory Medicine
1
J Clin Chem Lab Med, Vol.5 Iss.5 No:1000222
OPEN ACCESS Freely available online
Research Article
Correspondence to: Femi Babalola, Department of Ophthalmic Surgery and Epidemiology, Bingham University, New Karu, FCT Nigeria, E-mail:
Bablo57@gmail.com
Received: 11-May-2022, Manuscript No. JCCLM-22-17450; Editor assigned: 16-May-2022, PreQC No. JCCLM-22-17450 (PQ); Reviewed: 30-May-2022,
QC No. JCCLM-22-17450; Revised: 06-Jun-2022, Manuscript No. JCCLM-22-17450 (R); Published: 13-Jun-2022, DOI:10.35248/JCCLM.22.5.222
Citation: Babalola F, Ajayi A , Yunusa T, Ndanusa YA, Ogedengbe J, Omede O (2022) Ivermectin is Associated with Increase in SPO
2
in Hypoxemic
SARS-CoV-2 Patients: Pharmacodynamic Profile and Correlates. J Clin Chem Lab Med. 5:222
Copyright: © 2022 Babalola F, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Ivermectin is Associated with Increase in SPO
2
in Hypoxemic SARS-CoV-2
Patients: Pharmacodynamic Profile and Correlates
Babalola OE
1*
, Ajayi AA
2
, Thairu Y
3
, Ndanusa YA
4
, Ogedengbe JO
5
, Omede O
6
1
Department of Ophthalmic Surgery and Epidemiology, Bingham University, New Karu, FCT Nigeria;
2
Department of Medicine, Baylor
college of Medicine, Texas, USA;
3
Department of Microbiology, University of Abuja, Gwagwalada, FCT, Nigeria;
4
Al Ummah Foundation,
Abuja, Nigeria;
5
Department of Physiology, University of Abuja, Gwagwalada, FCT, Nigeria;
6
Federal Ministry of Health, Abuja, Nigeria
ABSTRACT
Background and objectives: Hypoxemic respiratory failure is a common mode of demise in COVID-19 disease.
We aimed to describe the time course of SPO
2
changes in COVID-19 patients treated with and without ivermectin.
Methods: This was a parallel group, prospective comparative study of propensity matched COVID-19 patients (Cycle
threshold Ct<25, SPO
2
<94%). 21 of the patients received Ivermectin (IVM) inclusive regime at 12 mg daily for 5
days, while 26 others received Non-ivermectin Inclusive Regime (NIVM).
Results: The IVM group demonstrated earlier and greater increase in SPO
2
(p=0.000) which paralleled greater and
faster virological clearance (p=0.000) on Repeat measures Analysis of Variance RMANOVA. There was a significant
correlation between absolute SPO
2
and absolute Ct on day 5 (r=0.77) and day 7 (r=0.77) both p=0.000. Incremental
SPO
2
also correlated with incremental Ct. by day 5 (r=0.397, p=0.003) and day 7 (r=0.315, p=0.0002) relative to
baseline. Increase in platelet count correlated with increased SPO
2
(r=0.252, p=0.029) on IVM, but negatively with
NIVM (r=-0.28, p=0.17). Inflammatory markers such as ESR, CRP or D-dimer showed no significant correlation
with SPO
2
. Increase in SPO
2
on IVM was magnified in males.
Conclusion: IVM regime appears to be associated with faster and greater increase in SPO
2
paralleling faster viral
clearance in COVID-19 patients.
Keywords: Ivermectin; Arterial oxygen saturation; COVID-19; Viral load
INTRODUCTION
The COVID-19 pandemic caused by SARS-CoV-2 has caused
global disruptions in all spheres of life, as well as morbidity and
mortality in excess of 6 million as of April 2022 [1].
A central feature of this disease, which is commonly the mode
of demise, is the variable degree of hypoxemia/respiratory failure
(Acute Respiratory Disease Syndrome) [2,3]. This is thought to
arise from Immunothrombosis of small pulmonary micro vessels,
caused by inflammation, hypercytokinenemia (raised IL-1 beta,
IL-6, TNF-alpha) [4,5] and coagulation/microthrombosis, with
platelet consumption and fibrinolysis [6,7].
There is also Ventilation/Perfusion (V/Q) mismatch, with
perfusion of non-ventilated alveolar spaces in severe COVID-19,
and this may contribute to the artetial hypoxemia and consequent
reduction in blood oxygen saturation [8]. The SPO
2
% (arterial
oxygen saturation) measured by digital arterial pulse oximeter, is
further employed in the classification of the severity of COVID-19
patients into mild outpatient, mild in patient, moderate, severe
or critical status [9]. Thus, the SPO
2
% is both a diagnostic and
prognostic parameter in COVID-19 disease and is adopted by the
World Health Organization [10] to classify COVID-19 severity.
In addition to vaccines, several novel and repurposed medications
have been used to treat or prevent COVID-19 disease [11,12].
Ivermectin has been used both in chemo-prophylaxis, and as a
repurposed active treatment of COVID-19, especially in Low and
Middle Income Countries [13]. A critical goal of anti COVID-19
therapeutic regime is the reversal of pathophysiological basis of the
disease, especially the systemic and pulmonary microthrombosis
and cytokine-induced-inflammation, as adumbrated above [11-14].
In this regard, we have previously reported the beneficial effect
of Ivermectin on SPO
2
% in a placebo-controlled double blind