Comparison of Artesunate and Ivermectin on the Treatment of Mild COVID -19 Infection in Kaduna State, Nigeria

Abstract

Background: At the outbreak, there was no specific therapeutic agent for the management of the novel Corona Virus Disease 2019 (COVID-19). Several agents have been tried in different countries with varying outcomes. Ivermectin an anti-parasitic agent was found to be effective in the management of mild COVID-19 infections. Artesunate, being a semisynthetic derivative of artemisinin, an antimalarial drug is suggested to be effective in the treatment of COVID-19. The study was carried out to compare the effect of Artesunate and Ivermectin in the treatment of mild COVID-19 cases in Kaduna state. Methodology: It was a comparative cross-sectional study conducted among 40 mild COVID-19 cases enrolled for the study in the 3 isolation centers between 15/09/2020 to 14/12/2020. The outcome variables viral clearance and resolution of symptoms from the onset at the commencement of the treatment regimens. Data were collected from patients' folders using a questionnaire and were analyzed using SPSS 26 and level of significance at P < 0.05. Results: A total of 40 patients were enrolled in this study. 16 patients managed on Artesunate with a mean age of 40.37±3.79 (95%CI= 32.79-47.95) while 24 on Ivermectin 33.58±2.39 (95%CI= 28.8-38.36. There were 7 males (43.8) and 9 females (56.2) on Artesunate. There were statistically significant differences between respondents' ethnicity, religion and occupation and the type of regimen. Fifteen (93.8%) on Artesunate have symptoms comparable to twenty-two (91.7%) on Ivermectin and there was no significant statistical difference. Symptoms ranged from fever, anosmia, and cough. At Day 7 of the commencement of therapy, 14 (87.5%) patients on Artesunate tested negative to COVID-19 PCR compared to 20 (83.3%) of the Ivermectin group. Bivariate analysis revealed no significant difference in symptom resolution and viral clearance between the two groups. However, patients on Artesunate reported side effects on the first and second day of treatment, ranging from dizziness and nausea while none among the Ivermectin group. Conclusion: Artesunate plus standard care in the management of COVID-19 was not found to have any difference from the use of Ivermectin plus standard care. It was however noticed to present more side effects.