* currently taking an angiotensin converting enzyme inhibitor (acei) or angiotensin receptor blocker (arb). * patients who presents with severe conditions at the time of diagnosis requiring icu admission. * prior reaction or intolerance to an arb or ace inhibitor. * blood pressure less than 110/70 mmhg at presentation * potassium greater than 5.0 meq / l * pregnancy or breastfeeding * prior reaction to ivermectin. * patient currently enrolled in another research protocol

* currently taking an angiotensin converting enzyme inhibitor (acei) or angiotensin receptor blocker (arb). * patients who presents with severe conditions at the time of diagnosis requiring icu admission. * prior reaction or intolerance to an arb or ace inhibitor. * blood pressure less than 110/70 mmhg at presentation * potassium greater than 5.0 meq / l * pregnancy or breastfeeding * prior reaction to ivermectin. * patient currently enrolled in another research protocol

- currently taking an angiotensin converting enzyme inhibitor (acei) or angiotensin receptor blocker (arb). - patients who presents with severe conditions at the time of diagnosis requiring icu admission. - prior reaction or intolerance to an arb or ace inhibitor. - blood pressure less than 110/70 mmhg at presentation - potassium greater than 5.0 meq / l - pregnancy or breastfeeding - prior reaction to ivermectin. - patient currently enrolled in another research protocol

- currently taking an angiotensin converting enzyme inhibitor (acei) or angiotensin receptor blocker (arb). - patients who presents with severe conditions at the time of diagnosis requiring icu admission. - prior reaction or intolerance to an arb or ace inhibitor. - blood pressure less than 110/70 mmhg at presentation - potassium greater than 5.0 meq / l - pregnancy or breastfeeding - prior reaction to ivermectin. - patient currently enrolled in another research protocol