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All Studies   Meta Analysis    Recent:   

A Meta-analysis of Mortality, Need for ICU admission, Use of Mechanical Ventilation and Adverse Effects with Ivermectin Use in COVID-19 Patients

Karale et al., medRxiv, doi:10.1101/2021.04.30.21256415
May 2021  
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Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020
 
*, now with p < 0.00000000001 from 104 studies, recognized in 22 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19ivm.org
Systematic review and meta analysis with 30 studies included in quantitative analysis, showing mortality OR 0.39 [0.22-0.70]. Subgroup analysis of trials with severity data showed mortality OR 0.10 [0.03-0.33] for mild/moderate cases.
7 meta analyses show significant improvements with ivermectin for mortality1-6, hospitalization7, recovery3, and cases3.
Currently there are 104 ivermectin for COVID-19 studies, showing 48% lower mortality [35‑59%], 35% lower ventilation [17‑50%], 40% lower ICU admission [12‑58%], 34% lower hospitalization [21‑44%], and 81% fewer cases [71‑87%].
Karale et al., 4 May 2021, preprint, 12 authors.
This PaperIvermectinAll
An Updated Systematic Review and Meta-Analysis of Mortality, Need for ICU admission, Use of Mechanical Ventilation, Adverse effects and other Clinical Outcomes of Ivermectin Treatment in COVID-19 Patients
MBBS Smruti Karale, MBBS, MPH Vikas Bansal, MBBS Janaki Makadia, Muhammad Tayyeb, Hira Khan, Shree Spandana Ghanta, MBBS Romil Singh, MD Aysun Tekin, Abhishek Bhurwal, MD Hemant Mutneja, MBB Ishita Mehra, MBBS, MBA Rahul Kashyap
doi:10.1101/2021.04.30.21256415
Highlights What We Already Know about This Topic 1. COVID-19 is an ongoing global pandemic, for which Ivermectin has been tried on a therapeutic and prophylactic basis. 2. Results from several clinical trials and observational studies suggest that Ivermectin may improve survival and clinical outcomes with a good safety profile when compared with other treatments; however, the current evidence is limited. . What This Article Tells Us That Is New 1. This systematic review and meta-analysis provide a summary of the latest literature on the efficacy and safety of Ivermectin use for COVID-19. 2. Based on our analysis of the latest evidence, we found that Ivermectin's benefit in reducing mortality cannot be concluded with confidence . However, as an adjuvant
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{ 'institution': [{'name': 'medRxiv'}], 'indexed': {'date-parts': [[2024, 5, 1]], 'date-time': '2024-05-01T16:17:29Z', 'timestamp': 1714580249537}, 'posted': {'date-parts': [[2021, 5, 4]]}, 'group-title': 'Infectious Diseases (except HIV/AIDS)', 'reference-count': 149, 'publisher': 'Cold Spring Harbor Laboratory', 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'accepted': {'date-parts': [[2021, 9, 17]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Importance</jats:title><jats:p>Repurposing ' 'Ivermectin, a known anti-parasitic agent, for treating COVID-19 has demonstrated positive ' 'results in several studies. We aim to evaluate the benefit and risk of Ivermectin in ' 'COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We conducted a ' 'systematic search for full-text manuscripts published from February 1, 2020, to August 15th, ' '2021 focusing on Ivermectin therapy against COVID-19. The primary outcomes were mortality, ' 'need for intensive care unit (ICU) admission; secondary outcomes were - adverse effects, need ' 'for mechanical ventilation, viral clearance, time to viral clearance, need for ' 'hospitalization, and length of hospital stay. Random-effects models were used for all ' 'analyses.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We included a ' 'total of 52 studies (n=17561) in the qualitative analysis, out of these, 44 studies (n=14019) ' 'were included in the meta-analysis. In the mortality meta-analysis (N=29), odds of death were ' 'lower in the Ivermectin-arm compared to control (OR 0.54, p=0.009). Although lower odds of ' 'mortality were observed in various subgroup analyses of RCTs, they did not reach statistical ' 'significance: therapeutic RCTs: mild-moderate COVID-19 (OR 0.31, p=0.06), therapeutic RCTs: ' 'severe/critical COVID-19 (OR 0.86, p=0.56), inpatient RCTs: mild-moderate COVID-19 (OR 0.18, ' 'p=0.08), inpatient RCTs: severe/critical COVID-19 (OR 0.86, p=0.56). Ivermectin, mostly as ' 'adjuvant therapy, was associated with higher odds of viral clearance (N=22) (OR 3.52, ' 'p=0.0002), shorter duration to achieve viral clearance (N=8) (MD - 4.12, p=0.02), reduced ' 'need for hospitalization (N=6) (OR 0.34, ' 'p=008).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our ' 'meta-analysis suggests that the mortality benefit of Ivermectin in COVID-19 is uncertain. But ' 'as adjuvant therapy, Ivermectin may improve viral clearance and reduce the need for ' 'hospitalization.</jats:p></jats:sec><jats:sec><jats:title>Highlights</jats:title><jats:sec><jats:title>What ' 'We Already Know about This Topic</jats:title><jats:list ' 'list-type="order"><jats:list-item><jats:p>COVID-19 is an ongoing global pandemic, for which ' 'Ivermectin has been tried on a therapeutic and prophylactic ' 'basis.</jats:p></jats:list-item><jats:list-item><jats:p>Results from several clinical trials ' 'and observational studies suggest that Ivermectin may improve survival and clinical outcomes ' 'with a good safety profile when compared with other treatments; however, the current evidence ' 'is limited..</jats:p></jats:list-item></jats:list></jats:sec><jats:sec><jats:title>What This ' 'Article Tells Us That Is New</jats:title><jats:list ' 'list-type="order"><jats:list-item><jats:p>This systematic review and meta-analysis provide a ' 'summary of the latest literature on the efficacy and safety of Ivermectin use for ' 'COVID-19.</jats:p></jats:list-item><jats:list-item><jats:p>Based on our analysis of the ' 'latest evidence, we found that Ivermectin’s benefit in reducing mortality cannot be concluded ' 'with confidence. However, as an adjuvant therapy it may help reduce the need for ' 'hospitalization, duration for viral clearance while increasing the likelihood of achieving ' 'viral clearance.</jats:p></jats:list-item><jats:list-item><jats:p>We need more high-quality ' 'data for conclusive evidence regarding the benefit of Ivermectin in reducing the need for ICU ' 'admissions, mechanical ventilation and duration of hospital stay in COVID-19 ' 'patients.</jats:p></jats:list-item></jats:list></jats:sec></jats:sec>', 'DOI': '10.1101/2021.04.30.21256415', 'type': 'posted-content', 'created': {'date-parts': [[2021, 5, 6]], 'date-time': '2021-05-06T16:08:53Z', 'timestamp': 1620317333000}, 'source': 'Crossref', 'is-referenced-by-count': 10, 'title': 'An Updated Systematic Review and Meta-Analysis of Mortality, Need for ICU admission, Use of ' 'Mechanical Ventilation, Adverse effects and other Clinical Outcomes of Ivermectin Treatment in ' 'COVID-19 Patients', 'prefix': '10.1101', 'author': [ {'given': 'Smruti', 'family': 'Karale', 'sequence': 'first', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-6047-5559', 'authenticated-orcid': False, 'given': 'Vikas', 'family': 'Bansal', 'sequence': 'additional', 'affiliation': []}, {'given': 'Janaki', 'family': 'Makadia', 'sequence': 'additional', 'affiliation': []}, {'given': 'Muhammad', 'family': 'Tayyeb', 'sequence': 'additional', 'affiliation': []}, {'given': 'Hira', 'family': 'Khan', 'sequence': 'additional', 'affiliation': []}, {'given': 'Shree Spandana', 'family': 'Ghanta', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-3777-5670', 'authenticated-orcid': False, 'given': 'Romil', 'family': 'Singh', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-1891-2118', 'authenticated-orcid': False, 'given': 'Aysun', 'family': 'Tekin', 'sequence': 'additional', 'affiliation': []}, {'given': 'Abhishek', 'family': 'Bhurwal', 'sequence': 'additional', 'affiliation': []}, {'given': 'Hemant', 'family': 'Mutneja', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ishita', 'family': 'Mehra', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-4383-3411', 'authenticated-orcid': False, 'given': 'Rahul', 'family': 'Kashyap', 'sequence': 'additional', 'affiliation': []}], 'member': '246', 'reference': [ { 'key': '2021092001550866000_2021.04.30.21256415v2.1', 'doi-asserted-by': 'publisher', 'DOI': '10.23750/abm.v91i1.9397'}, { 'key': '2021092001550866000_2021.04.30.21256415v2.2', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S1473-3099(20)30120-1'}, { 'key': '2021092001550866000_2021.04.30.21256415v2.3', 'unstructured': 'Domecq JP , Lal A , Sheldrick CR , et al. 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FDA experts discuss COVID-19 therapeutic clinical trials | American ' 'Medical Association. AMA Webinar Series. ' 'https://www.ama-assn.org/delivering-care/public-health/fda-experts-discuss-covid-19-therapeutic-clinical-trials. ' 'Updated 03/17/2021. Accessed 04/15/2021.'}], 'container-title': [], 'original-title': [], 'link': [ { 'URL': 'https://syndication.highwire.org/content/doi/10.1101/2021.04.30.21256415', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 9, 20]], 'date-time': '2021-09-20T08:59:03Z', 'timestamp': 1632128343000}, 'score': 1, 'resource': {'primary': {'URL': 'http://medrxiv.org/lookup/doi/10.1101/2021.04.30.21256415'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 5, 4]]}, 'references-count': 149, 'URL': 'http://dx.doi.org/10.1101/2021.04.30.21256415', 'relation': {}, 'subject': [], 'published': {'date-parts': [[2021, 5, 4]]}, 'subtype': 'preprint'}
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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