Manejo de ivermectina en el tratamiento de pacientes adultos mayores con covid-19

Abstract

Introduction: The SARS-CoV-2 virus (COVID-19), an infectious disease that was discovered in the city of Wuhan-China in December 2019, the outbreak of this disease was presented as a relative increase of respiratory cases, causing the death of several individuals worldwide due to the absence of treatment or vaccine to date, this has led to the search for effective treatment; Among the therapeutic options used is ivermectin, which is proposed as a possible prophylactic option that should be administered in exact doses under medical supervision and prescription, although from the point of view of World Level Scientific Institutions, including the FDA, this drug for veterinary use should not be administered in humans since it can present short and long term adverse effects. Objectives: To evaluate detailed and updated information on the use of ivermectin in elderly patients infected by COVID-19 in order to identify information on treatment, and to categorize information on adverse effects to be presented in individuals treated with the drug and also to estimate its efficacy. Material and methods: it is a documentary research of retrospective descriptive study type, a search of documentary sources was carried out, articles published in indexed journals during the years 2019-2020, a systematic review of diverse virtual bases was carried out such as Google Academico, Pub Med, Scielo, Proquest, Scopus, Sciencedirect, infoMED. Results: Fifty scientific articles related to the subject were identified and located in the aforementioned databases. Divergent criteria were found, among which the most important elements were a reduction in symptoms, a decrease in the occupancy rate of mechanical ventilation, and a shortening of the time of hospitalization as long as it is administered between 48 and 72 hours after the patient has been admitted, which is supported by evidence of 70% of patients using this drug; contrary to this position, the data that do not recommend the use of this drug are based on criteria such as the presence of mild adverse effects (nausea, blurred vision, epigastralgia, constipation, diarrhoea, etc.) as well as others without a determined association to the use of ivermectin such as insomnia and drowsiness. In addition, the particular and strict therapeutic margin of the drug should be considered in order to avoid adverse effects and even death. Conclusions: There is evidence that supports the use of ivermectin within the first hours of patient admission to the health centre, achieving a shortening of the hospitalization time, a decrease in the symptoms and a decrease in the need for mechanical ventilation, among others. It is necessary to compare the current information in order to establish conclusive non-divergent criteria that guarantee the unanimous use of this medicine. Ivermectin was used as a treatment in the early identification of disease symptoms; although it has been approved by the FDA as an antiparasitic and in dermatological problems, its use remains uncertain due to adverse effects