Ivermectin vs Hydroxychloroquine vs Quercetin: What are the Differences?
The number of options for the treatment of COVID-19 has increased drastically in recent months, thus making it complicated when it comes to choosing the right combination. In general, there are 3 broad categories of medical interventions:
- Prevention or Prophylaxis e.g. vaccine
- Early out-patient treatment
- Hospital treatment
|Image credit: Cleveland Clinic|
All these treatments come with various technologies and jargons, thus could be overwhelming and confusing for you as a consumer.
Generally, multiple treatments and strategies are used in combination to achieve the best possible outcome.
In this article, we would like to cover 3 popular treatments i.e. Ivermectin, Hydroxychloroquine and Quercetin.
Ivermectin and COVID-19
Ivermectin is an anti-parasitic medication widely used in low- and middle-income countries to treat parasitic worm infections in adults and children. It’s been used for decades for this purpose by over 3.7 billion people, and is considered safe and effective. It has an increasing list of indications due to its antiviral and anti-inflammatory properties, and is included on the WHO’s Model List of Essential Medicines.
Ivermectin and COVID-19 Updates:
“When the effectiveness of ivermectin for the COVID-19 pandemic is confirmed with the cooperation of researchers around the world and its clinical use is achieved on a global scale, it could prove to be of great benefit to humanity. It may even turn out to be comparable to the benefits achieved from the discovery of penicillin—said to be one of the greatest discoveries of the twentieth century.”—From Global trends in clinical studies of ivermectin in COVID-19, published in the Japanese Journal of Antibiotics, March, 2021.
This international collaboration — comprised of physicians, like lead author Peter McCullough, MD, courageously treating patients despite the prevalence of “therapeutic nihilism” among government agencies like the NIH and FDA — outlines the urgency of, “prompt early initiation of sequenced multidrug therapy (SMDT) … to stem the tide of hospitalizations and death.”
The authors wrote:
The early stage of viral replication provides a therapeutic window of tremendous opportunity to potentially reduce the risk of more severe sequelae in high risk patients. Precious time is squandered with a ‘wait and see’ approach … resulting in unnecessary hospitalization, morbidity, and death. … In newly diagnosed, high-risk, symptomatic patients with COVID-19, SMDT has a reasonable chance of therapeutic gain with an acceptable benefit-to-risk profile.
Related Ivermectin and COVID-19 Publications:
- Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19 by Kory et al., published on American Journal of Therapeutics.
- Dr. Satoshi Ōmura, co-author of the newly published paper, “Global trends in clinical studies of ivermectin in COVID-19” was one of the four researchers from Kitasato University in Tokyo, Japan who received the Nobel Prize in Physiology or Medicine in 2015 for their discovery of ivermectin. Global trends in clinical studies of ivermectin in COVID-19, published in the Japanese Journal of Antibiotics, March, 2021.
- A multi-centre randomised controlled study in Egypt (Elgazzar, Research Square) reported that the death rate was significantly lower in Ivermectin treated patients group (severe patients) vs non-Ivermectin group (2% vs 20%). 1,300 patients were included in this randomized controlled trial.
- This randomized controlled trial out of Iran (Hashim, pre-print) used Ivermectin and Doxycycline in mild, moderate, and severe hospitalized COVID-19 patients. No patients in the mild and moderate COVID-19 category died and 18% of the severe patients perished taking this medication combo. In the control group, no mild-moderate patients died, but 27% of the severe COVID patients died. The patients who also got Ivermectin had a shorter recovery.
- A randomized, double-blind, placebo-controlled, multicenter, phase 2 clinical trial at five hospitals (Iran) and 180 patients with mild to severe disease (Niaee, ResearchSquare, Nov 2020). Ivermectin as an adjunct reduced the rate of mortality, the duration of low oxygen saturation, and the duration of hospitalization.
- The ICON study in US, published in Chest, Oct 2020 reported that Ivermectin treatment was associated with lower death rate vs Control (13.3% vs 24.5%) during treatment of COVID-19, especially in patients with severe pulmonary involvement.
- A double-blinded randomised controlled study in Bangladesh (Mahmud et al) reported that the death rate was 0% (0/183) in the Ivermectin arm vs 1.67% (3/180) in the control arm in mild to moderate COVID-19 patients.
- The IDEA (Ivermectin, Dexamethasone, Enoxaparin and Aspirin) study from Argentina reported 1 death out of 167 patients studied. The patient that died was a severe COVID-19 patient that required ventilator support.
- The pre-AndroCoV trial from Brazil reported that early detection of COVID-19 followed by a pharmaceutical approach with different drug combinations (Azithromycin, Hydroxychloroquine, Nitazonide, Ivermectin) yielded irrefutable differences compared to non-treated controls in terms of clinical outcomes, ethically disallowing placebo-control randomized clinical trials in the early stage of COVID-19 due to the marked improvements.
- A retrospective study out of Bangladesh (Khan, Archivos de Bronconeumologia 2020). This retrospective study enrolled a total of 325 from April to June 2020. 248 adult COVID-19 patients were looked at in two groups, 115 received ivermectin plus standard care (SC), while 133 received only standard care (SC). This study showed that Ivermectin was efficient at rapidly clearing SARS-CoV-2 from nasal swabs (median 4 days). This was much shorter than in the COVID-19 patients receiving only SC (15 days) or receiving a combination of three antiviral drugs (7–12 days). In addition, fewer Ivermectin patients developed respiratory distress leading to ICU admission. In fact, with Ivermectin, there was a quick hospital discharge (median 9 days) in 114 out of 115 patients; the one remaining patient had been admitted with advanced disease.
Ivermectin for COVID-19: Real-time meta analysis of 52 studies
- 98% of the 52 studies to date report positive effects (25 statistically significant in isolation). Random effects meta-analysis for early treatment and pooled effects shows an 81% reduction, RR 0.19 [0.09-0.39], and prophylactic use shows 85% improvement, RR 0.15 [0.09-0.25]. Mortality results show 76% lower mortality, RR 0.24 [0.14-0.42] for all treatment delays, and 84% lower, RR 0.16 [0.04-0.63] for early treatment.
- 96% of the 27 Randomized Controlled Trials (RCTs) report positive effects, with an estimated 64% improvement, RR 0.36 [0.24-0.52].
- The probability that an ineffective treatment generated results as positive as the 52 studies to date is estimated to be 1 in 85 trillion (p = 0.000000000000012).
- Heterogeneity arises from many factors including treatment delay, patient population, the effect measured, distribution of SARS-CoV-2 variants, ivermectin dosage, and other treatment details. There is high heterogeneity across all studies, however for ivermectin the consistency of positive results is remarkable. Heterogeneity is low when looking at specific cases, for example early treatment mortality.
Source: ivmmeta.com (constantly updated)
Hydroxychloroquine and COVID-19
- HCQ is effective for COVID-19. The probability that an ineffective treatment generated results as positive as the 231 studies to date is estimated to be 1 in 3 quadrillion (p = 0.0000000000000003).
- Early treatment is most successful, with 100% of 28 studies reporting a positive effect (12 statistically significant in isolation) and an estimated reduction of 64% in the effect measured (death, hospitalization, etc.) using a random effects meta-analysis, RR 0.36 [0.25-0.51].
- 92% of Randomized Controlled Trials (RCTs) for early, PrEP, or PEP treatment report positive effects, the probability of this happening for an ineffective treatment is 0.0032.
- There is evidence of bias towards publishing negative results. 88% of prospective studies report positive effects, and only 73% of retrospective studies do.
- Studies from North America are 3.9 times more likely to report negative results than studies from the rest of the world combined, p = 0.0000000013.
Hydroxychloroquine and COVID-19 Updates:
Quercetin and COVID-19
There is evidence that vitamin C and quercetin co-administration exerts a synergistic antiviral action due to overlapping antiviral and immuno-modulatory properties and the capacity of ascorbate to recycle quercetin, increasing its efficacy.
- Vitamin D3: 1000–3000 IU/day. Note RDA (Recommended Daily Allowance) is 800–1000 IU/day. The safe upper-dose daily limit is likely < 4000 IU/day. Vitamin D deficiency has been associated with an increased risk of acquiring COVID-19 and from dying from the disease. Vitamin D supplementation may therefore prove to be an effective and cheap intervention to lessen the impact of this disease, particularly in vulnerable populations, i.e. the elderly and obese. (Amazon)
- Vitamin C: 500 - 1,000 mg BID (twice daily)
- Quercetin: 250 mg daily. It is likely that vitamin C and quercetin have synergistic prophylactic benefit. Quercetin should be used with caution in patients with hypothyroidism and TSH levels should be monitored. (Amazon)
- Melatonin: 6 mg before bedtime (causes drowsiness). (Amazon)
- Zinc: 30 - 40 mg/day (elemental zinc). Zinc lozenges are preferred. (Amazon)
- Ivermectin for
- prevention in high-risk individuals (> 60 years with co-morbidities, morbid obesity, long term care facilities, etc): 0.2 mg/kg per dose (take with or after meals) — one dose today, repeat after 48 hours, then one dose weekly. (also see ClinTrials.gov NCT04425850).
- Post COVID-19 exposure prevention: 0.2 mg/kg per dose (take with or after meals) — one dose today, repeat after 48 hours.
- Vitamin D3 — 4000 IU/day. (Amazon)
- Vitamin C: 500 - 1,000 mg BID (twice daily) (Amazon)
- Quercetin: 250 mg twice a day. (Amazon)
- Melatonin: 10 mg before bedtime (causes drowsiness). (Amazon)
- Zinc: 100 mg/day. Zinc lozenges are preferred. (Amazon)
- Ivermectin: 0.2–0.4 mg/kg per dose (take with or after meals) — one dose daily, take for 5 days or until recovered. (Find a Doctor)
- Fluvoxamine: 50 mg twice daily for 10–14 days. Add to ivermectin if: 1) minimal response after 2 days of ivermectin; 2) in regions with more aggressive variants; 3) treatment started on or after day 5 of symptoms or in pulmonary phase; or 4) numerous co-morbidities/risk factors. Avoid if patient is already on an SSRI (selective serotonin reuptake inhibitor).
- Nasopharyngeal Sanitation: Steamed essential oil inhalation 3 times a day (i.e. vapo-rub) and/or chlorhexidine/benzydamine mouthwash gargles and Betadine nasal spray 2–3 times a day.
- Aspirin: 325 m/day unless contraindicated.
- Pulse Oximeter: FLCCC also recommend monitoring your oxygen saturation with a pulse oximeter and to go to the hospital if you get below 94%.
Ivermectin vs Hydroxychloroquine vs Quercetin
The important key takeaway is that you should never attempt to self medicate without the guidance of a licensed medical provider. If you are not a medical doctor, you are likely to find the above information overwhelming. The aim of this article is to empower you with a better understanding of the options available and to discuss the options with your medical doctor.