Ivermectin for COVID: How Do We Know What to Believe?

F. Perry Wilson

This Video transcript has been edited for clarity.

Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I’m Dr F. Perry Wilson of the Yale School of Medicine.

This week, it’s time we talk about ivermectin.https://722a37a0de816a9ae8595b23858d398c.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

Since the first days of the COVID-19 pandemic, various existing drugs have been touted as near miracle cures for the disease. Often, the discussion of agents like hydroxychloroquine, lopinavir, and their ilk veered into the conspiratorial, squelching reasonable scientific discussion. Boosters would accuse detractors of hiding the truth of a safe and effective treatment at the behest of big pharma or the deep state. Detractors would accuse boosters of bad data analysis and wishful thinking.

Enter ivermectin and this meta-analysis of randomized trials by Andrew Hill and his colleagues in Open Forum Infectious Diseases that seems to show that the drug has pretty remarkable efficacy against COVID-19.

But before we dig in, let’s put the mechanistic cards on the table.

Ivermectin is an antiparasitic agent that has been used to treat scabiesriver blindness, and filariasis, among others. You may give it to your dog to prevent heartworm. Discovered in 1975, the drug has been in worldwide use for nearly five decades and appears on the WHO list of essential medicines.

Ivermectin binds to certain chloride channels on nerve and muscle cells, paralyzing the creature exposed to it. These channels are present in worm and insect nervous systems, which is why the drug works.

Humans have the channels too, but only in our brains and spinal columns. Since ivermectin can’t cross the blood-brain barrier, we are spared from its effects.

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