Editorial Team

A recent peer-reviewed journal paper published in Nature Scientific Reports (https://www.nature.com/articles/s41598-022-10370-1.) has shown the excellent efficacy of Indomethacin, a non-steroidal anti-inflammatory drug, as an antiviral agent in the treatment of mild and moderate COVID-19 patients.

The study conducted at Panimalar Medical College and Research Institute was led by Dr Rajan Ravichandran, an Adjunct Faculty at IIT Madras and Director Nephrology at MIOT hospitals. The study was conceptualised and coordinated by Prof. R. Krishna Kumar, Institute professor, IIT Madras.

Indomethacin, with more than 20 lakh prescriptions per year in the US alone is an established drug widely used since the 1960s to treat various types of inflammation-related.

The Indian researchers are the first to show the efficacy of indomethacin through a randomised clinical trial though the scientific basis has been researched by Italian and US scientists.

The entire study was funded by Mr. Kris Gopalakrishnan an alumnus of IIT Madras and Chairman Axilor Ventures.

Dr. Rajan Ravichandran an Adjunct Faculty at IIT Madras and Director Nephrology at MIOT hospitals, said, “Knowing that one of the deadly effects of the COVID infection is inflammation and the cytokine storm, we decided to study the non‐steroidal anti‐inflammatory drug, Indomethacin. The scientific evidence strongly shows the anti-viral action against Coronavirus. Indomethacin is a safe and well-understood drug. I have been using it in my profession for the past thirty years.”

Highlighting the Research findings, Prof. R. Krishna Kumar, Institute professor, IIT Madras, said, “Out of a total of 210 admitted patients 107 were randomly allocated to a control group, treated with paracetamol and standard care of treatment. 103 patients were administered indomethacin along with standard care of treatment. The patients were monitored every day for symptoms such as cough, cold, fever and muscle pain along with oxygen saturation.”

None of the 103 patients who received indomethacin developed oxygen desaturation. On the other hand, 20 of the 109 patients from the control group were desaturated with oxygen saturation levels below 93%. Indomethacin group patients recovered from all symptoms in three to four days. It took double the time for the control group. Liver and kidney function tests showed no adverse reaction.

The fourteenth‐day follow‐up showed that nearly half of the control group patients had several discomforts while a few indomethacin patients complained only of tiredness”.

Commenting on this work, Prof. V. Kamakoti, Director, IIT Madras, said, “I congratulate Dr. Rajan Ravichandran, Prof. R. Krishna Kumar and team for the successful publication of the Indomethacin trial. I hope the findings will be useful in the event of any further waves of COVID-19.”

The work was chosen for peer reviewed by Rapid Reviews; COVID-19, run by a team from Univ. California Berkeley and MIT Press. The review stated, “Reviewers deemed the results compelling and reliable”.

The two reviewers, Prof. Vikas Sukhatme, an internationally acclaimed expert in immunology from Emory University and Dr. Colin Brown, an infectious disease specialist from the UK have rated the article as 4 out of 5.

Ref: https://rapidreviewscovid19.mitpress.mit.edu/pub/7cf47wou/release/1

The results in this work support and extend an earlier study by the team that was published in the Journal of the Indian Medical Association. In the earlier study, 72 patients were administered Indomethacin and 72 other patients, Paracetamol. This study also showed that only one patient under Indomethacin treatment developed hypoxia, compared to 28 in the Paracetamol group. Furthermore, the administration of Indomethacin to patients having severe COVID symptoms, prevented the need for ventilation.

Dr. Rajan Ravichandran added, “Indomethacin works with all variants. We had done two trials, one in the first wave and the other in the second wave. The results were the same. I sincerely hope ICMR takes note of this study and includes indomethacin in COVID treatment protocol.

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