As COVID-19 continues to rapidly spread throughout the world, incidence varies greatly among different countries. These differences raise the question whether nations with lower incidence share any medical commonalities that could be used to not only explain that lower incidence, but that could also provide guidance for potential treatments elsewhere. Such treatment would be particularly valuable if it could be used as a prophylactic against COVID-19 transmission, thereby effectively slowing spread of the disease while we await the wide availability of safe and effective vaccines. Here, we show that countries with routine mass drug administration of prophylactic chemotherapy including Ivermectin have significantly lower incidences of COVID-19. Prophylactic use of Ivermectin against parasitic infections is most common in Africa and we hence show that the reported correlation is highly significant both when compared among African nations as well as in a worldwide context. We surmise that this may be connected to Ivermectin’s ability to inhibit SARS-CoV-2 replication which likely leads to lower infection rates. However, other pathways must exist to explain persistence of such inhibitory effect after serum levels of Ivermectin have declined. It is suggested that Ivermectin be evaluated for potential off-label prophylactic use in certain cases to help bridge the time until a safe and effective vaccine becomes available.
Copyright © 2020. Published by Elsevier Ltd.

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