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0 0.5 1 1.5 2+ Mortality -4% Improvement Relative Risk Deterioration of 2 or more.. 41% Escalation of care 15% Fever during study 18% Recovery 36% primary Recovery time 31% primary Abbas et al. Ivermectin for COVID-19 RCT EARLY TREATMENT Is early treatment with ivermectin beneficial for COVID-19? Double-blind RCT 202 patients in China Improved recovery with ivermectin (p=0.037) Abbas et al., Indian J. Pharmaceutical Sciences, doi:10.36468/pharmaceutical-sciences.spl.416 Favors ivermectin Favors control
The Effect of Ivermectin on Reducing Viral Symptoms in Patients with Mild COVID-19
Abbas et al., Indian Journal of Pharmaceutical Sciences, doi:10.36468/pharmaceutical-sciences.spl.416
Abbas et al., The Effect of Ivermectin on Reducing Viral Symptoms in Patients with Mild COVID-19, Indian Journal of Pharmaceutical Sciences, doi:10.36468/pharmaceutical-sciences.spl.416
Dec 2021   Source   PDF  
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RCT 99 ivermectin and 103 control low risk patients in China, up to 7 days from symptom onset, showing statistically significant improvement in recovery with treatment, and non-statistically significant improvements in recovery time and deterioration.
Authors selectively omitted the p-value for recovery which shows statistical significance. Very little information on the patients is provided (only age, gender, and insurance status). The table, text, and abstract show three different versions of recovery numbers. The table and abstract show two different versions of recovery time. The abstract contains a hazard ratio that is not in the text, and no statistical methods are reported. Given the selective omission of the statistically significant recovery p-value, three different sets of numbers for that outcome, and other inconsistencies, the data in this study does not appear to be very reliable. Administration was specified on an empty stomach, reducing lung tissue concentration by ~2.5x according to Guzzo et al. Patients >50 were excluded. This study is excluded in the after exclusion results of meta analysis: very minimal patient information, three different results for the recovery outcome, selective omission of the statistically significant recovery p-value, and other inconsistencies.
risk of death, 4.0% higher, RR 1.04, p = 1.00, treatment 1 of 99 (1.0%), control 1 of 103 (1.0%).
deterioration of 2 or more points, 40.5% lower, RR 0.59, p = 0.54, treatment 4 of 99 (4.0%), control 7 of 103 (6.8%), NNT 36.
escalation of care, 14.9% lower, RR 0.85, p = 0.82, treatment 9 of 99 (9.1%), control 11 of 103 (10.7%), NNT 63.
fever during study, 17.9% lower, RR 0.82, p = 0.58, treatment 15 of 99 (15.2%), control 19 of 103 (18.4%), NNT 30.
risk of no recovery, 35.6% lower, RR 0.64, p = 0.04, treatment 26 of 99 (26.3%), control 42 of 103 (40.8%), NNT 6.9, primary outcome.
recovery time, 30.8% lower, relative time 0.69, p = 0.08, treatment 99, control 103, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Abbas et al., 31 Dec 2021, Double Blind Randomized Controlled Trial, placebo-controlled, China, peer-reviewed, 3 authors, dosage 300μg/kg days 1-5.
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Abstract: Short Communication The Effect of Ivermectin on Reducing Viral Symptoms in Patients with Mild COVID-19 K. U. ABBAS, S. MUHAMMAD1,2,3 AND S. F. DING* Department of Critical Care Medicine, 1Department of Radiology, Qilu Hospital of Shandong University, 2Center for Sectional and Imaging Anatomy Digital Human Institute, School of Basic Medical Sciences, Shandong University, 3Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong 250000, China Abbas et al.: Effect of Ivermectin in Patients with Mild COVID-19 Ivermectin is widely prescribed as a potential treatment for coronavirus disease 2019, despite uncertainty about its clinical benefit. To determine whether ivermectin is an efficacious treatment for mild coronavirus disease 2019 is the objective of the study. A total of 476 adult patients with mild symptoms for 7 d or fewer in Jinan, China, were enrolled and followed up. Patients were randomly selected to receive ivermectin, 300 μg/ kg body weight per day for 5 d or placebo. The median time to resolution of symptoms was 10 d (interquartile range, 9-13) in the ivermectin group whereas it was 12 d (interquartile range, 9-13) in the placebo group (hazard ratio for resolution of symptoms, 1.07 [95 % confidence interval, 0.87 to 1.32]; p=0.53 by log-rank test). By d 21, 82 % in the ivermectin group and 79 % in the placebo group had resolved symptoms. The most common solicited adverse event was headache, reported by 104 patients (52 %) who received ivermectin and 111 patients (56 %) who received placebo. The most serious adverse event was multiorgan failure. Among adults with mild coronavirus disease 2019, a 5 d course of ivermectin, compared with placebo, did not significantly improve the time to resolution of symptoms. The findings do not support the use of ivermectin for treatment of mild coronavirus disease 2019. Key words: Ivermectin, coronavirus disease 2019, pneumonia, severe acute respiratory syndrome coronavirus 2 Coronavirus Disease 2019 (COVID-19) has four clinical levels: Mild, moderate, severe and critical illness (Acute Respiratory Distress Syndrome (ARDS)) and more than half of people experience mild to moderate levels of disease[1]. Among COVID-19 patients referred to the hospital, 32 % were ARDS, 32 % require intensive care and 15 % of these patients die[2]. Findings reported from specialized hospitals approximately 20 % to 30 % of patients admitted with COVID-19 due to pneumonia need intensive care for respiratory support of which 4.42 % are supported by advanced organs with endotracheal intubation and ventilation. They needed mechanics[3,4]. According to World Health Organization epidemiological findings by the end of September 2021, about 5 million people in the world have been evacuated[5]. Despite consecutive mutations, especially in delta variant, there is a possibility that the effectiveness of anti-corona vaccine will be further reduced. Recent studies have shown that delta strain is more pathogenic and more contagious, which increases the need for more attention to treatment[6]. There are several treatments available for corona virus disease. These treatments include remdesivir 200 mg daily[7], hydroxychloroquine 400 mg for 5 d and azithromycin[8]. Studies also show that lithium carbonate has been effective in recovery of patients along with the use of antibiotics[9]. Because the treatments used on patients are not specific treatments, therapeutic approaches are needed to improve..
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