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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality -5% Improvement Relative Risk Death/intubation -54% Death/intubation/ICU -62% Ivermectin  Ferreira et al.  LATE TREATMENT Is late treatment with ivermectin beneficial for COVID-19? Retrospective 102 patients in Brazil (March - July 2020) Higher death/intubation with ivermectin (not stat. sig., p=0.37) Ferreira et al., Revista da Associação.., Nov 2021 Favors ivermectin Favors control

Outcomes associated with Hydroxychloroquine and Ivermectin in hospitalized patients with COVID-19: a single-center experience

Ferreira et al., Revista da Associação Médica Brasileira, doi:10.1590/1806-9282.20210661
Nov 2021  
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Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020
*, now known with p < 0.00000000001 from 100 studies, recognized in 22 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 230 hospitalized patients in Brazil showing no significant difference with ivermectin treatment. Authors note that the treatments were more likely to be offered to sicker patients. Authors note that they do not know if treatment was started before or after ICU admission and intubation.
Baseline total chest CT opacities were higher for ivermectin (20% vs. 15%). 25% of control patients were admitted within 3 days, compared to 5 days for ivermectin. Only 38% of patients in the ivermectin arm were treated within 7 days, compared to 61% for HCQ. These are consistent with ivermectin being used for more severe patients. Dosage is unknown.
This is the 69th of 100 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 1 sextillion). 47 studies are RCTs, which show efficacy with p=0.0000002.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details; substantial unadjusted confounding by indication likely.
Study covers HCQ and ivermectin.
risk of death, 5.0% higher, RR 1.05, p = 1.00, treatment 3 of 21 (14.3%), control 11 of 81 (13.6%).
risk of death/intubation, 54.3% higher, RR 1.54, p = 0.37, treatment 6 of 21 (28.6%), control 15 of 81 (18.5%).
risk of death/intubation/ICU, 62.4% higher, RR 1.62, p = 0.27, treatment 8 of 21 (38.1%), control 19 of 81 (23.5%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ferreira et al., 26 Nov 2021, retrospective, Brazil, peer-reviewed, 5 authors, study period 12 March, 2020 - 8 July, 2020, average treatment delay 7.0 days, dosage not specified.
This PaperIvermectinAll
Outcomes associated with Hydroxychloroquine and Ivermectin in hospitalized patients with COVID-19: a single-center experience
Roberto Muniz Ferreira, Renata Wanderley Beranger, Pedro Paulo Noguères Sampaio, João Mansur Filho, Ricardo Antônio Correia Lima
Revista da Associação Médica Brasileira, doi:10.1590/1806-9282.20210661
OBJECTIVE: Hydroxychloroquine and Ivermectin are advocated as potential treatments for coronavirus disease 2019 (COVID-19) despite the lack of supportive clinical evidence. In this study, outcomes associated with Hydroxychloroquine and/or Ivermectin were determined in a series of patients with confirmed COVID-19 from a single institution in Brazil. METHODS: Consecutive patients admitted between March and July 2020 were retrospectively analyzed and divided into four treatment categories: no treatment (Group 0), Ivermectin only (Group I), Hydroxychloroquine only (Group II), and Hydroxychloroquine and Ivermectin (Group III). Intensive care unit admission, mechanical ventilation, and death were compared between the Groups. RESULTS: A total of 230 patients were included, with the following treatment distribution: 35.2% (0), 9.1% (I), 48.3% (II), and 7.4% (III). Groups I, II, and III had the higher rates of Intensive care unit admission, mechanical ventilation, or death (0: 23.5% versus I: 38.1% versus II: 37.8% versus III: 70.6%, p=0.002), and the greatest mortality was found in Group III (0 versus III: 13.6% versus 35.3%, p=0.03). In the multivariate analysis, Hydroxychloroquine remained significantly associated with death (OR 3.3, 95%CI 1.1-9.6, p=0.03). CONCLUSION: In a series of consecutive hospitalized patients with COVID-19, Ivermectin was not associated with improved outcomes and Hydroxychloroquine may have resulted in a harmful effect.
Alanagreh, Alzoughool, Atoum, Risk of using hydroxychloroquine as a treatment of COVID-19, Int J Risk Saf Med, doi:10.3233/JRS-200024
Ali, Hanif, Haider, Ahmed, Sundas et al., Treatment options for COVID-19: a review, Front Med, doi:10.3389/fmed.2020.00480
Axfors, Schmitt, Janiaud, Van't Hooft, Abd-Elsalam et al., Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials, Nat Commun, doi:10.1038/s41467-021-22446-z
Bhimraj, Morgan, Shumaker, Lavergne, Baden et al., IDSA guidelines on the treatment and management of patients with COVID-19
Cardoso, Fernandes, Santos, What happens in Brazil? A pandemic of misinformation that culminates in an endless disease burden, Rev Soc Bras Med Trop, doi:10.1590/0037-8682-0713-2020
Gupta, Sahoo, Singh, Ivermectin: potential candidate for the treatment of Covid 19, Braz J Infect Dis
Hallal, SOS Brazil: science under attack, The Lancet, doi:10.1016/S0140-6736(21)00141-0
López-Medina, López, Hurtado, Dávalos, Ramirez et al., Effect of Ivermectin on time to resolution of symptoms among adults with mild COVID-19, JAMA, doi:10.1001/jama.2021.3071
Mccullough, Kelly, Ruocco, Lerma, Tumlin et al., Pathophysiological basis and rationale for early outpatient treatment of SARS-CoV-2 (COVID-19) infection, Am J Med, doi:10.1016/j.amjmed.2020.07.003
Reis, Silva, Silva, Thabane, Singh et al., Effect of early treatment with Hydroxychloroquine or Lopinavir and Ritonavir on risk of hospitalization among patients with COVID-19, JAMA Netw Open, doi:10.1001/jamanetworkopen.2021.6468
Réa-Neto, Bernardelli, Câmara, Reese, Queiroga et al., An open-label randomized controlled trial evaluating the efficacy of chloroquine/hydroxychloroquine in severe COVID-19 patients, Sci Rep, doi:10.1038/s41598-021-88509-9
Virgínia, Infectious diseases society of America
Vora, Arora, Behera, Tripathy, White paper on Ivermectin as a potential therapy for COVID-19, Indian J Tuberc, doi:10.1016/j.ijtb.2020.07.031
Late treatment
is less effective
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