Small prospective PSM study in the USA, showing 75% lower mortality with ivermectin treatment, without reaching statistical significance, significantly shorter ventilation and ICU time, and longer hospitalization time.
Authors leave the statistically significant improvements in ventilation and ICU time out of the abtract and conclusions, and incorrectly state that there were no differences in other outcomes (there were no statistically significant differences) [nature.com]
. Authors are ambiguous on the primary outcome, referring to the primary mortality outcome in one case, and "clinical outcomes, measured by the rate of intubation, length of hospital stay, and mechanical ventilation duration" in another case.
The longer hospitalization time may be partially due to the greater mortality in the control group.
This is the 68th of 97 COVID-19 controlled studies
for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 2 sextillion)
. 46 studies are RCTs
, which show efficacy with p=0.00000014
risk of death, 75.0% lower, RR 0.25, p = 0.09, treatment 2 of 60 (3.3%), control 8 of 60 (13.3%), NNT 10.0, PSM.
risk of mechanical ventilation, 12.6% lower, RR 0.87, p = 0.20, treatment 3 of 60 (5.0%), control 2 of 60 (3.3%), adjusted per study, odds ratio converted to relative risk, propensity score matching, multivariable.
ventilation time, 83.3% lower, relative time 0.17, p = 0.002, treatment 60, control 60.
risk of ICU admission, 48.7% lower, RR 0.51, p = 0.42, treatment 6 of 60 (10.0%), control 3 of 60 (5.0%), adjusted per study, odds ratio converted to relative risk, propensity score matching, multivariable.
ICU time, 70.6% lower, relative time 0.29, p < 0.001, treatment 60, control 60.
hospitalization time, 9.0% higher, relative time 1.09, p = 0.09, treatment 60, control 60, adjusted per study, propensity score matching, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ozer et al., 23 Nov 2021, prospective, USA, peer-reviewed, 12 authors, dosage 200μg/kg days 1, 3.
Effectiveness and safety of Ivermectin in COVID‐19 patients: A prospective study at a safety‐net hospital
M.D. Muhammet Ozer, Suleyman Yasin Goksu, Reena Conception, MD Esad Ulker, Rodolfo Magallanes Balderas, MD Mohammed Mahdi, MD Zulfiya Manning, PharmD, BCPS, BCIDP Kim To, Muhammad Effendi, MD Rajashree Anandakrishnan, MD Marc Whitman, MD Manish Gugnani
Journal of Medical Virology, doi:10.1002/jmv.27469
Background: Ivermectin has been found to inhibit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication in vitro. It is unknown whether this inhibition of SARS-CoV-2 replication correlates with improved clinical outcomes. Objective: To assess the effectiveness and safety of ivermectin in hospitalized patients with COVID-19. Methods and Materials: A total of 286 patients with COVID-19 were included in the study. Univariate analysis of the primary mortality outcome and comparisons between treatment groups were determined. Logistic regression and propensity score matching (PSM) was used to adjust for confounders. Results: Patients in the ivermectin group received 2 doses of ivermectin at 200 μg/kg in addition to usual clinical care on hospital days 1 and 3. The ivermectin group had a
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