Effectiveness of a multidrug therapy consisting of Ivermectin, Azithromycin, Montelukast, and Acetylsalicylic acid to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico
René Lima-Morales, Pablo Méndez-Hernández, Yvonne N Flores, Patricia Osorno-Romero, Christian Ronal Sancho-Hernández, Elizabeth Cuecuecha-Rugerio, Adrián Nava-Zamora, Diego Rolando Hernández-Galdamez, Daniela Karola Romo-Dueñas, Jorge Salmerón
International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.02.014
There is an urgent need for effective treatments to prevent or attenuate lung and systemic inflammation, endotheliitis, and thrombosis related to COVID-19. This study aimed to assess the effectiveness of a multidrug-therapy consisting of Ivermectin, Azithromycin, Montelukast, and Acetylsalicylic acid ("TNR4" therapy) to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico. Design and methods: A comparative effectiveness study was performed among 768 confirmed SARS-CoV-2 cases aged 18-80 years, who received ambulatory care at the Ministry of Health of Tlaxcala. A total of 481 cases received the TNR4 therapy, while 287 received another treatment (comparison group). All participants received home visits and/or phone calls for clinical evaluation during the 14 days after enrollment. Results: Nearly 85% of cases who received the TNR4 recovered within 14 days compared to 59% in the comparison group. The likelihood of recovery within 14 days was 3.4 times greater among the TNR4 group than in the comparison group. Patients treated with TNR4 had a 75% and 81% lower risk of being hospitalized or death, respectively, than the comparison group. Conclusions: TNR4 therapy improved recovery and prevented the risk of hospitalization and death among ambulatory COVID-19 cases.
Differences between means were estimated from linear regression, and differences between proportions were evaluated using the chi2 test. A p-value 0.05 was considered to be significant. Proportions and means were adjusted by age, sex, comorbidities, and occupation. A p-value 0Á05 was considered significant. a Comparison group: participants who did not accept the TNR4 treatment because they were asymptomatic, were already taking another treatment, or they had self-medicated for cold and flu. However, they agreed to take part in the follow-up portion of the study.
Conflict of interest The authors declare no conflict of interest in this article.
Ethical approval Approval for this study was granted by the Ministry of Health of the Tlaxcala state, Mexico (#CEI02092020).
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