Antimalarials for COVID-19 Treatment: Rapid Reversal of Oxygen Status Decline with the Nobel Prize-Honored Macrocyclic Lactone Ivermectin

19 Pages Posted: 15 Jun 2020

Date Written: June 3, 2020


The worldwide spread of the COVID-19 pandemic has prompted intense interest among researchers, physicians and patients in viable treatment options. Among the first antimalarial drugs repurposed for treatment of this pandemic was hydroxychloroquine (HCQ), as pioneered at Marseille’s main COVID-19 treatment hospital. HCQ’s unusual pharmacology has limited its effectiveness in advanced stages of the disease, but 3,300 mixed stage COVID-19 patients treated in Marseille with HCQ and azithromycin (AZ) had a mortality rate 16% of the world average. Optimal tissue levels of HCQ require several days to accrue, and some advanced stage COVID-19 patients may have cardiac complications that require screening for HCQ use. The Marseille research team found more generally that other antimalarial drugs were active in vitro against the SARS-CoV-2 virus.

One such antimalarial drug of Nobel Prize-winning distinction is ivermectin (IVM). As determined by a US research team from a database spanning 169 hospitals in three continents, 704 COVID-19 patients treated with a single, low dose of IVM (150 µg/kg) had a mortality rate that was one-sixth (1.4% vs. 8.5%) of that of untreated, case-matched controls. Treatments of 71 COVID-19 patients with IVM at 200 µg/kg plus HCQ, AZ and Zinc by a clinical team in Florida yielded a statistically significant reduction in mortality, with reversals in 1-2 days of rapidly deteriorating oxygen status. The pharmacology and toxicology of IVM is briefly reviewed, indicating the potential for an even sharper response at increased, safe doses. The central role of the CD147 transmembrane receptor in the binding of SARS-CoV-2 is considered. A catch and clump scenario for impedance of capillary flow through viral bindings to blood cells via CD147 is proposed as a possible explanation for the observed rapid clinical response to IVM and for other puzzling aspects of COVID-19.

Note: Funding: This research received no external funding.

Conflict of Interest: The author declares no conflict of interest.

Keywords: SARS-CoV-2, COVID-19, ivermectin, hydroxychloroquine, chloroquine, azithromycin, doxycycline, QTc prolongation, red blood cell, RBC, erythrocyte, spike glycoprotein, RNA helicase, ACE2, CD147, basigin, BSG, EMMPRIN

Suggested Citation

Scheim, David, Antimalarials for COVID-19 Treatment: Rapid Reversal of Oxygen Status Decline with the Nobel Prize-Honored Macrocyclic Lactone Ivermectin (June 3, 2020). Available at SSRN: or

David Scheim (Contact Author)

US Public Health Service ( email )

Bethesda, MD 20892
United States

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