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Background <p>Ivermectin, an antiparasitic agent with reported antiviral properties, has been investigated for repurposing in the treatment of COVID-19. This study aimed to assess the efficacy of a single weight-adjusted oral dose of ivermectin in reducing viral load and improving clinical outcomes in asymptomatic individuals infected with SARS-CoV-2.</p> Methods <p>A randomized controlled trial was conducted with 126 asymptomatic SARS-CoV-2-positive participants. Subjects were assigned to receive either standard care (zinc and vitamin C supplementation) or standard care plus a single dose of ivermectin. Reverse transcription-PCR was used to assess changes in cycle threshold (Ct) values after 96&#xa0;h. Clinical symptom development and hospitalization rates were also monitored.</p> Results <p>Baseline Ct values were similar between groups. After 96&#xa0;h, participants in the ivermectin group showed a greater increase in Ct values (from 15.97 ± 2.823 to 24.35 ± 3.086) compared with controls (from 16.65 ± 3.593 to 19.84 ± 3.743; <i>p</i> &lt; 0.001), the mean increase in Ct was 8.38 (95% CI, 7.56–9.20) in the ivermectin group versus 3.19 (95% CI, 2.36–4.02) in the control group (mean difference 5.19 (95% CI, 3.72 to 6.66); <i>p</i> &lt; 0.001), suggesting a potential for more rapid reduction in viral load. Participants receiving ivermectin also reported fewer symptoms (e.g., anosmia, fatigue, myalgia) and had a lower hospitalization rate, though these clinical trends should be interpreted cautiously.</p> Conclusion <p>A single oral dose of ivermectin may accelerate viral clearance and reduce symptom progression in asymptomatic SARS-CoV-2-positive individuals. Further large-scale, multi-center randomized trials are warranted to confirm these findings and evaluate ivermectin’s potential role in early COVID-19 management.</p> Trial registration <p>This randomized controlled trial was conducted between November and December 2021 and was registered in the World Health Organization Clinical Trial Registry (ChiCTR2000033627; Date of Registration: 2020-06-07).</p> Graphical Abstract <p></p>

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Ivermectin therapy is associated with changes in SARS-CoV-2 RNA load in asymptomatic patients: a randomized controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月1日

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  • Hussein Mouawia,
  • Hamid Bou Saab,
  • Hassan Ayoub,
  • Abbas Mourad,
  • Najwa Yaghi,
  • Ahmad Al Saabi,
  • Mohamed El-Seblani,
  • Houssam Raad

摘要

Background

Ivermectin, an antiparasitic agent with reported antiviral properties, has been investigated for repurposing in the treatment of COVID-19. This study aimed to assess the efficacy of a single weight-adjusted oral dose of ivermectin in reducing viral load and improving clinical outcomes in asymptomatic individuals infected with SARS-CoV-2.

Methods

A randomized controlled trial was conducted with 126 asymptomatic SARS-CoV-2-positive participants. Subjects were assigned to receive either standard care (zinc and vitamin C supplementation) or standard care plus a single dose of ivermectin. Reverse transcription-PCR was used to assess changes in cycle threshold (Ct) values after 96 h. Clinical symptom development and hospitalization rates were also monitored.

Results

Baseline Ct values were similar between groups. After 96 h, participants in the ivermectin group showed a greater increase in Ct values (from 15.97 ± 2.823 to 24.35 ± 3.086) compared with controls (from 16.65 ± 3.593 to 19.84 ± 3.743; p < 0.001), the mean increase in Ct was 8.38 (95% CI, 7.56–9.20) in the ivermectin group versus 3.19 (95% CI, 2.36–4.02) in the control group (mean difference 5.19 (95% CI, 3.72 to 6.66); p < 0.001), suggesting a potential for more rapid reduction in viral load. Participants receiving ivermectin also reported fewer symptoms (e.g., anosmia, fatigue, myalgia) and had a lower hospitalization rate, though these clinical trends should be interpreted cautiously.

Conclusion

A single oral dose of ivermectin may accelerate viral clearance and reduce symptom progression in asymptomatic SARS-CoV-2-positive individuals. Further large-scale, multi-center randomized trials are warranted to confirm these findings and evaluate ivermectin’s potential role in early COVID-19 management.

Trial registration

This randomized controlled trial was conducted between November and December 2021 and was registered in the World Health Organization Clinical Trial Registry (ChiCTR2000033627; Date of Registration: 2020-06-07).

Graphical Abstract