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Wednesday, September 23, 2020

SCIENTIFIC EVIDENCE FOR IVERMECTIN IN THE TREATMENT Of COVID-19

 

Background:

In vitro, ivermectin, an antiparasitic drug used to treat parasitic infestations, suppresses viral multiplication. The molecular mechanism of ivermectin's antiviral activity implies an inhibitory impact on SARS-CoV-2 replication in the early stages of infection, according to the molecular hypothesis. Evidence on the effectiveness and safety of ivermectin for SARS-CoV-2 infection prevention and COVID-19 therapy is currently contradictory.

Goal;-

The goal of this study was to evaluate the effectiveness and safety of ivermectin to no therapy, standard of care, placebo, or any other proven intervention for persons with COVID-19 who were being treated as inpatients or outpatients, as well as to avoid infection with SARS-CoV-2 (postexposure prophylaxis).

Method of findings:-

Up to May 26, 2021, we searched the Cochrane COVID-19 Study Register, Web of Science (Emerging Citation Index and Science Citation Index), medRxiv, and Research Square for completed and ongoing studies without language restrictions.

RCTs comparing ivermectin to no treatment, standard of care, placebo, or another proven intervention for the treatment of people with confirmed COVID-19 diagnosis, regardless of disease severity, treated in inpatient or outpatient settings, and for the prevention of SARS-CoV-2 infection were included. Both research arms required to use the identical co-interventions. We didn't include trials that compared ivermectin to other untested pharmaceutical treatments.

Data collection and analysis:

We used the Cochrane risk of bias 2 tool to analyze RCTs for bias. Studies having a high probability of bias were removed from the primary analysis. For the following outcomes, we used GRADE to assess the degree of certainty in the evidence.

1. Mortality, clinical deterioration or improvement, adverse events, quality of life, length of hospitalization, and viral clearance in inpatients with moderate-to-severe COVID-19;

2. Mild COVID-19 outpatient treatment: mortality, clinical deterioration or improvement, hospital admission, adverse events, quality of life, and viral clearance

3. To avoid SARS-CoV-2 infection: SARS-CoV-2 infection, COVID-19 symptom development, adverse events, death, hospitalization, and quality of life.

Main findings:

We discovered 14 trials including 1678 people that compared ivermectin to no therapy, placebo, or standard of care. There was no study that compared ivermectin to a known effective intervention. Nine studies treated intermediate COVID-19 patients in inpatient settings while four trials treated mild COVID-19 cases in outpatient settings. Ivermectin was studied for its ability to prevent SARS-CoV-2 infection in one research. Eight of the trials were open-label, with the other six being double-blind and placebo-controlled. About a third of the 41 research findings supplied by included studies had a high risk of bias. The dosages of ivermectin and the length of therapy differed amongst the trials.

 We found 31 research in progress and 18 studies awaiting categorization until findings were published or discrepancies were resolved. For inpatient COVID-19 therapy, ivermectin was compared to placebo or standard of care.

 We don't know whether ivermectin reduces or increases mortality (risk ratio (RR) 0.60, 95 percent confidence interval (CI) 0.14 to 2.51; 2 studies, 185 participants; very low-certainty evidence) or clinical worsening up to day 28 assessed as the need for invasive mechanical ventilation (IMV) (RR 0.55, 95 percent confidence interval (CI) 0.11 to 2.59; 2 studies, 185 participants; very low-certainty evidence).

1 study, 45 participants; very low-certainty evidence), adverse events within 28 days (RR 1.21, 95 percent CI 0.50 to 2.97; 1 study, 152 participants; very low-certainty evidence), and viral clearance on day seven (RR 1.21, 95 percent CI 0.50 to 2.97; 1 study, 152 participants; very low-certainty evidence) (RR 1.82, 95 percent CI 0.51 to 6.48; 2 studies, 159 participants; very low-certainty evidence). Ivermectin may have little or no effect on clinical improvement up to 28 days (RR 1.03, 95 percent CI 0.78 to 1.35; 1 study; 73 participants; low-certainty evidence) and hospitalization duration (mean difference (MD) -0.10 days, 95 percent CI -2.43 to 2.23; 1 study; 45 participants; low-certainty evidence) when compared to placebo or standard of care.

Up to 28 days, no study reported on quality of life. For outpatient COVID-19 therapy, ivermectin was compared to placebo or standard of care. We don't know whether ivermectin reduces or increases mortality up to 28 days (RR 0.33, 95 percent CI 0.01 to 8.05; 2 studies, 422 participants; very low-certainty evidence) or clinical worsening up to 14 days assessed as need for IMV (RR 2.97, 95 percent CI 0.12 to 72.47; 1 study, 398 participants; very low-certainty evidence) or non-IMV or high flow compared to placebo or standard of (0 participants required non-IMV or high flow; 1 study, 398 participants; very low-certainty evidence).

We don’t know if ivermectin decreases or improves viral clearance at seven days when compared to placebo (RR 3.00, 95 percent CI 0.13 to 67.06; 1 study, 24 participants; low-certainty evidence). Ivermectin may have little or no effect on the number of individuals with symptoms relieved after 14 days (RR 1.04, 95 percent CI 0.89 to 1.21; 1 trial, 398 participants; low-certainty evidence) and adverse events within 28 days when compared to placebo or standard of treatment (RR 0.95, 95 percent CI 0.86 to 1.05; 2 studies, 422 participants; low-certainty evidence).

The primary analysis included studies that reported the duration of symptoms. Up to 14 days, no research recorded hospital admission or quality of life. Ivermectin was found to be more effective than no therapy in preventing SARS-CoV-2 infection. One research was discovered. The only outcome suitable for primary analysis was mortality up to 28 days. When compared to no treatment, we don't know if ivermectin reduces or increases mortality (0 participants died; 1 study, 304 participants; very low-certainty evidence).

Because of the significant potential of bias, the study's data for the development of COVID-19 symptoms and adverse events up to 14 days were included in a secondary analysis. There was no study that looked at SARS-CoV-2 infection, hospitalization, or quality of life for more than 14 days.

CONCLUSION: We are unsure about the effectiveness and safety of ivermectin in treating or preventing COVID-19 based on the present extremely low-to-low-certainty data. The number of completed studies is minimal, and just a handful are of good quality. Several research are now being conducted that may provide clearer answers in future review updates. Outside of well-designed randomized studies, the credible data does not support the use of ivermectin for the treatment or prevention of COVID-19.

Click here to view our Ivermectin prices

 

Why SMS?

You can reach 20 million economically active consumers via SMS.

Everyone these days has a cell phone. And there are currently only two real ways to get a messageto a person's phone who isn't already an existing customer of yours: SMS or phone call. SMS is betterbecause most people prefer to communicate this way these days, finding phone calls quite invasive.

Cold calling is soul destroying and boring for the caller and often irritating for the prospectivecustomer. It's far better to have the potential customer respond to your SMS in a proactive mannerand request a call, than for them to be reacting to an unexpected phone call. Using SMS as amarketing tool is therefore more effective, and more enjoyable, than sitting down with a list ofprospects to cold call.

SMS is also far less expensive and more targeted than handing out flyers at the traffic lights, orplastering your advert on a billboard or street pole ad. While those marketing activities all have theirplace when it comes to creating brand affinity or generating awareness, SMS can be used as the finalnudge that turns a non-customer into a customer.  
What is SMS good for?

1. Driving foot traffic

Getting your audience to actually come to your shop or place of business means that you'll probablyneed to offer them some kind of incentive for their effort (unless your product is so unique andcannot be found anywhere else). The trick is to then provide a premium level of service when theydo visit, so you can turn them into a repeat customer.

Incentive examples:"Come visit my health bar and show this message to get a free smoothie with any breakfast""Hey #Firstname# did you know that my carwash has just opened up in your neighbourhoodat 10 Olico Road? Show this message to get 50% off your 1st visit""Spaza shop Umhlanga super specials Margarine R11.99 10Kg, Potatoes R25.99, Milk R10.99until end of Feb"

2. Driving web traffic

Companies use SMSes to drive traffic to their websites, whether it’s so the recipient can read moreinformation than can be supplied in that SMS, or whether it’s about generating leads/sales. The bestway to get the customer to your website is to insert a shortened URL into your message, whichLeadify will do for you.

Here's an example of an SMS that was sent in late November 2018 and had huge success for acustomer that owns gyms across the Gauteng region. There was no option to call or receive acallback, the only option was to visit the signup page and signup.

For example: "Start your Jan Fitness & Weight loss prep now and only pay from Jan'19Unlimited BoxFit Classes for R549pm for more info #CLICK__TRACKING__URL#"

Note: #CLICK__TRACKING__URL# is actually replaced with a unique link per user that willlook like e.g. https://ldfy.de/SFsda4. This link allows us to track and report on individualswho actually clicked through to your site.

3. Creating a lead

When a lead is created, it's because the customer has responded YES or with some other phrase toyour message. You'll receive the lead by email (or for advanced users we have an API integrationprocess) and from there it's up to you, the merchant, to call up the interested prospect and close thedeal. 

For example: "Want to sell your home fast? Lead home sells homes within an average of 35days. Pay only one flat fee, R39,995 +VAT. Reply YES for more info or STOP to opt out" 
Who should I be sending my message to?

What do your ideal customers look like?

You should be sending your messages to the people who you believe are most likely to beinterested in your product or service, in order to get the best result for your spend (or Return onInvestment – ROI).

Demographic targeting

Every good marketer knows their target market. A health bar in Umhlanga for example will be ableto tell you who their typical customers are, from their gender to their age, and even the time of daythey generally visit.

Target on a range of variables from simple demographic information (likeage, gender, race etc.) through to economic variables (like income, credit profile, employment etc)and then on to product ownership information (like home owners, car owners, loan users etc). 

Regional GEO targeting

This feature allows targeting by region, area and postal code or even street. This search tool featureis most valuable if your business is locality specific. When used in conjunction with other searchcriteria options, you'll be able to drill down into the data and extract a list of your ideal customers.For example: A carwash has opened up and wants to let car owners know about an opening special.The most important criteria to use in that search would be:1. location2. vehicle owners

Another example of locality being important would be residential security companies. To build thismarketing list the most important criteria would be:1. location2. homeownersThis is because a security company would want to reach out to residents in areas they already cover,or in areas they want to expand into.  


Accessible from any web browser

Send bulksms using your iPhone using the iOS app

Open rates - 98% of all SMS messages are opened and read by the recipient, and on average within five seconds.

Speed and Flexibility - campaigns can be conceived of and delivered to their target audience in a matter of minutes. This can be used to drive footfall on a slow day or clear old stock ahead of new deliveries.

Low Cost and High ROI – cheaper than other types and high reach.

Highly Targeted – permission based, created a relationship by giving you their number

Personalisation – based on previous activity

SMS is reliable - SMS is a dependable platform for sending important information out, it’s the ideal tool for businesses to communicate critical and time sensitive information.

SMS is ubiquitous : Unlike most other instant messaging apps and social chat platforms, SMS is not an app and does not need to be downloaded or updated.

SMS’s cost money : Because SMS messages are paid for, they tend to provide valuable content which is relevant to the recipient.
Spam : Email is free which means that it is more prone to spam. In fact, according to The Radicati Research Group, Inc., 49.7% of emails received are spam.

Replacing the middleman - Afghanistan: find out how much your goat is worth
Traffic updates - [Bangalore] 
Missed call notification - [mcn]

Customer Service - Singapore Airlines Club allows members to contact a customer service representative via SMS. The service, called PPS Connect, allows members to SMS their membership number to the club, and receive a phone call within 30 minutes.

Is this halal - Islamic Development Department of Malaysia now offers an SMS service to help consumers confirm whether what they’re buying conforms to Muslim dietary laws. All they need to do is text the word “halal” along with the bar code on the product packaging to find out.

Slow customer service – automated reply 

Missed Delivery Or Appointment Windows - send out multiple delivery or appointment reminders via dispatch text messages that clients and customers are likely to check.