Abstract: EbMCsquared CiC Robert T. Schooley, MD, Editor-in-Chief Clinical Infectious Diseases 198 Madison Ave New York NY 10016 USA +1-919-677-0977 x 5175 E-mail: cid.editorialoffice@idsociety.org Dear Dr Schooley Open Letter Statement of Concern and Request for Retraction Re: Roman Y M, Burela P A, Paspuleti V, Piscoya A, Vidal J E and Hernandez A V “Ivermectin for the treatment of Covid-19: A systematic review and meta-analysis of randomized controlled trials” Clinical Infectious Diseases, ciab591 Accepted manuscript 28 June 2021 The above article, now an “Accepted Manuscript” in Clinical Infectious Diseases, does not meet the standards of accuracy and integrity that any learned journal should demand. In asserting Conclusions that are not defensible on the evidence presented, it makes no contribution to science or medicine. In its present form it should be retracted. The title closely parallels that of Bryant et al.1 but asserts diametrically opposite conclusions. The clinical trials selected ( n=1173 participants, 10 studies ) are a minor subset of those available and analysed in Bryant et al. ( n=3406, 24 studies ). The article commits several methodological fallacies, but first it is essential to be working with correct data. Roman et al. have in several instances mis-reported clinical trial data either published or in preprint. The most egregious such error was corrected after alerts on social media and in the Comments section2 of the manuscript’s preprint on medRciv; others however remain. It is inexplicable for the authors to have disregarded multiple public notices of substantive errors whilst on preprint. In failing to correct, the authors verge upon falsification of data. In the Journal’s statement of Publication Ethics this is deemed 1 (updated version as published) Bryant A, Lawrie T A et alia (2021) “Ivermectin for Prevention and Treatment of Covid-9 infection: a Systematic Review, Meta-Analysis and Trial Sequential Analysis to inform clinical guidelines” Am. J. Therapeutics e-publish ahead of print https://journals.lww.com/americantherapeutics/Abstract/9000/Ivermectin_for_Prevention_and_Treatment_o f.98040.aspx 2 Roman Y M et al., version 1: https://www.medrxiv.org/content/10.1101/2021.05.21.21257595v1 EbMCsquared CiC “unacceptable”. Most of the misreporting instances are conveniently collected on “PUBPEER”3 by various contributors. 1. Inversion of the treatment and control arms of Niaee4. This error was alerted (including personal protest from Dr Niaee2) and corrected prior to publication5 and in Figure 2. In spite of a dramatic change in the point estimates of mortality Risk Ratio (erroneous 1.11 changed to 0.37) there was however no change whatever in the Abstract Conclusions: “IVM did not reduce all-cause mortality”. The published statement is now indefensible, even on the authors’ own highly selective choice of sources. Our concern here is not that the data were not corrected; it is that conclusions are no longer based on the data. 2. Niaee4 is further mis-reported in Figure 3 (duration of hospital stay) where source data patently indicate a reduction (albeit modest) in hospitalization. Yet the primary data are plotted as “favours control” when the reverse is correct. There appear to be unexplained discrepancies in treatment and control arm patient numbers between Figure 3 and the source. This error is noted in the Comments section of medRciv2,5 and on PUBPEER3. 3. The study called “Karamat” (Dr Karamat Hussein Shah..