Possible Role of Ivermectin Mucoadhesive Nanosuspension Nasal Spray in Recovery of Post-COVID-19 Anosmia

Figures & data

Figure 1 Flow chart showing difference between both group in different follow up durations.

Figure 2 Characteristics of the used ivermectin nanosuspension. (A) Particle size distribution. (B) Transmission electron micrograph of the prepared ivermectin nanosuspension.

Figure 3 In-vitro release profiles of ivermectin from mucoadhesive nanosuspension in SNF (simulated nasal fluid) pH 5.5 at 37 °C. Data expressed at mean ± SD (n=3).

Abbreviation: NS, Nanosuspension.

Table 1 Demographic and Clinical Data of the Study Groups

Variables		Ivermectin Group (n= 49)	Placebo Group (n=47)	P value
Age (years, mean±SD)		30.9 ± 14	29.1± 9.6	0.5
Sex (No.,%)	Males	33(67.3%)	39(83%)	0.07
	Females	16(32.7%)	8(17%)
Co-morbidities (No.,%)	No	41(83.7%)	39(83%)	0.8
	Diabetes mellitus	4(8.2%)	4(8.6%)
	Hypertension	2(4.1%)	2(4.3%)
	Diabetes mellitus and hypertension	2(4.1%)	2(4.3%)
COVID-19 severity (No.,%)	Mild	29(59.2%)	30(63.8%)	0.9
	Moderate	11(22.4%(	9(19.1%)
	Severe	9(18.4%)	8(17%)
Anosmia duration before starting therapy(days, mean±SD)		19.5±5.8	19.1±5.9	0.7

Abbreviations: SD, standard deviation; COVID-19, Coronavirus disease 2019.

Table 2 Comparison Between the Study Groups Regarding to Anosmia Recovery at Different Follow Up Durations

Follow Up (No.,%)		Ivermectin Group (n= 49)	Placebo Group (n=47)	P value
1 week	Recovered	29(59.2%)	13(27.7%)	0.001*
	Partially or not recovered	20(40.8%)	34(72.3%)
1 month	Recovered	11(55%)	16(47.1%)	0.6
	Not recovered	9(45%)	18(52.9%)
2 months	Recovered	4(44.4%)	8(44.4%)	0.99
	Not recovered	5(55.6%)	10(55.6%)
3 months	Recovered	3(60%)	5(50%)	0.7
	Not recovered	2(40%)	5(50%)
Cumulative recovered patients		47(95.9%)	42(89.4%)	0.2

Note: *Significant p value (p˂0.05).

Figure 4 Comparision between the study groups according to the percentage (%) of recovery of anosmia in different follow up durations (after one week, one month, two months and three months).

Table 3 Comparison Between the Total Duration of Anosmia Till Recovery in the Study Groups

Variable	Ivermectin Group (n= 49)	Placebo Group (n=47)	P value
Duration of anosmia till recovery [days, Median (Interquartile range)]	13 (3–105)	50 (6–115)	0.000*

Notes: Mann Whitney test was used. *Significant p value (p˂0.05).

Figure 5 The median duration of post-COVID-19 persistent anosmia recovery (days) in the study groups.