Rapid Recovery of Peripheral Oxygen Saturation in Hypoxic COVID-19 Patients With Ivermectin/Doxycycline/Zinc Multidrug Therapy

Abstract

Several combination therapies for the early outpatient treatment of COVID-19 were proposed by independent research groups at the onset of the pandemic during 2020 and 2021. In this observational study, we report on the outcomes of an off-label triple combination therapy, consisting of ivermectin, doxycycline, and zinc, with adjunct vitamin C and D3 supplementation, which was used on high-risk COVID-19 patients. These patients refused an initial recommendation to seek inpatient care, despite a high-risk presentation compounded with one or more comorbidities and/or severe hypoxia. Telemedicine was used to administer personalized treatment to patients at home, who did not have access to supplemental oxygen. Descriptive statistics was used to describe patient characteristics and outcomes. Of 26 consecutive patients, 25 presented with baseline SpO₂ ≤ 90% on room air. All 24 of 26 patients accepting the 10-day treatment survived without hospitalization. Within 24 hours on combination therapy, a rapid response of SpO₂ levels on room air was observed with a statistically significant median +6% (IQR 5-7%) increase between baseline (day 1) and day 2, with 18 patients stabilized at SpO₂ > 90% by day 2, and with full recovery of SpO₂ levels on room air within 10 days for all 24 patients who completed the 10-day treatment. Faster recovery rates of room air SpO₂ levels were observed in patients receiving an additional 36 mg ivermectin stat dose. All other symptoms were resolved within less than 20 days for 23 of 24 patients accepting treatment. All 24 patients fully recovered within 33 days. The results are assessed in the context of previous case series with similar treatments, historical controls suggesting longer recovery time-scales with non-ivermectin treatments, and previous randomized controlled trials.