Abstract: medRxiv preprint doi: https://doi.org/10.1101/2021.04.30.21256415; this version posted September 17, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . 1 An Updated Systematic Review and Meta-Analysis of Mortality, Need for ICU admission, 2 Use of Mechanical Ventilation, Adverse effects and other Clinical Outcomes of Ivermectin 3 Treatment in COVID-19 Patients 4 *Smruti Karale, MBBS1; *Vikas Bansal, MBBS, MPH2; Janaki Makadia, MBBS3; Muhammad 5 Tayyeb, MD4; Hira Khan, MBBS5; Shree Spandana Ghanta, MBBS6; Romil Singh, MBBS7; 6 Aysun Tekin, MD8; Abhishek Bhurwal, M98; Hemant Mutneja, MD10; Ishita Mehra, MBB11; 7 Rahul Kashyap, MBBS, MBA8 8 1 Medical Graduate, Government Medical College Kolhapur, Kolhapur, India 9 2 Division of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, MN, USA 10 3 Medical Graduate, GMERS Medical College, Vadodara, Gujarat, India 11 4 Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ, USA 12 5 Department of Neurology, Allegheny General Hospital, Pittsburgh, PA, USA 13 6 Department of Internal Medicine, St. Elizabeth's Medical Center, Boston, MA, USA 14 7 Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, PA 15 8 Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Rochester, MN, USA 16 9 Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of 17 Medicine, New Brunswick, NJ, USA 18 10 Division of Gastroenterology, Cook County Hospital, Chicago, Illinois 19 11 Department of Internal Medicine, North Alabama Medical Center, Florence, AL, USA 1 NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2021.04.30.21256415; this version posted September 17, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . 20 Corresponding Author: 21 Vikas Bansal, MBBS, MPH 22 Assistant Professor of Medicine 23 Division of Pulmonary and Critical Care Medicine 24 Mayo Clinic, Rochester, MN- 55905 25 Email: bansal.vikas@mayo.edu 26 Phone: +1-507-398-1595 27 Word count: Abstract: 250; Manuscript: 5041 28 Tables: 0 main, 8 supplemental 29 Figures: 6 main, 31 supplemental 30 Conflicts of Interest: None of the authors have reported any conflicts of interest. 31 Financial Support: There is no financial disclosure related to this study. 32 Author Contribution: *Authors 1(SK) and 2(VB) contributed equally in defining the study 33 outline and manuscript writing. Data review and collection were done by HK, JM, SG, RS, SK, 34 and MT; statistical analysis done by SK, VB, and AB. Quality assessment of studies was done by 35 AT,JM, HK, MT, SK, VB and GRADE quality rating was done by AB, HM and VB. Study 36 design, distribution of articles for critical review done by SK, VB and RK. Final approval was 37 received from all authors. SK and VB is the guarantor of the paper, taking responsibility for the 38 integrity of the work as a whole, from inception to..