Early nitazoxanide therapy significantly reduces viral load in Covid-19: Study
Brazil: Early nitazoxanide therapy is safe and helps in a significant reduction of viral load in patients with mild Covid-19, suggests a recent study in medRxiv. However, it did not help in symptom resolution compared to placebo after 5 days of therapy.
The antiparasitic drug nitazoxanide is available widely and exerts broad-spectrum antiviral activity in vitro. However, there is no evidence of its impact on SARS-CoV-2 infection. The multicenter, randomized, double-blind, placebo-controlled trial by Patricia R. M. Rocco, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, and colleagues enrolled adult patients who presented up to 3 days after onset of Covid-19 symptoms (dry cough, fever, and/or fatigue)
Patients were randomized in the ratio 1:1 to receive either nitazoxanide (500 mg) or placebo, TID, for 5 days.
The primary outcome was complete resolution of symptoms. Secondary outcomes were viral load, general laboratory tests, serum biomarkers of inflammation, and hospitalization rate. Adverse events were also assessed. From June 8 to August 20, 2020, 1,575 patients were screened. Of these, 392 (198 placebo, 194 nitazoxanide) were analyzed.
Key findings of the study include:
- Median time from symptom onset to first dose of study drug was 5 (4-5) days.
- At the 5-day study visit, symptom resolution did not differ between the nitazoxanide and placebo arms.
- At the 1-week follow-up, 78% in the nitazoxanide arm and 57% in the placebo arm reported complete resolution of symptoms.
- Swabs collected were negative for SARS-CoV-2 in 29.9% of patients in the nitazoxanide arm versus 18.2% in the placebo arm.
- Viral load was also reduced after nitazoxanide compared to placebo.
- No serious adverse events were observed.
"In patients with mild Covid-19, symptom resolution did not differ between the nitazoxanide and placebo groups after 5 days of therapy. However, early nitazoxanide therapy was safe and reduced viral load significantly," concluded the authors.
"Early use of nitazoxanide in mild Covid-19 disease: randomized, placebo-controlled trial," is published in medRxiv.