Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients
et al., Virology Journal, doi:10.1186/s12985-022-01829-8
, Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of.., Virology Journal, doi:10.1186/s12985-022-01829-8
Meta analysis including 17 of 95 studies (45 RCTs), finding significantly lower mortality with ivermectin. All seven outcomes favor ivermectin, while statistical significance is reached only for mortality. The conclusion is incorrect, authors find significantly lower mortality. Authors suggest lower risk of bias studies show lower effects, however their analysis is unreliable. For example consider Reis et al., authors give the study a perfect rating in risk of bias analysis, however this study not only has a very high theoretical risk of bias, but shows very high actual bias, randomization failure, blinding failure, and reports conflicting data that is impossible to be correct [Reis].Currently there are 95 ivermectin studies and meta analysis shows:
| Outcome | Improvement |
|---|---|
| Mortality | 51% lower [37‑62%] |
| Ventilation | 29% lower [13‑42%] |
| ICU admission | 41% lower [16‑58%] |
| Hospitalization | 34% lower [20‑45%] |
| Cases | 78% fewer [67‑85%] |
Shafiee et al., 13 Jun 2022, peer-reviewed, 6 authors.
Contact:
hamidrezamozhgani@gmail.com (corresponding author).
Abstract: (2022) 19:102
Shafiee et al. Virology Journal
https://doi.org/10.1186/s12985-022-01829-8
Open Access
RESEARCH
Ivermectin under scrutiny: a systematic
review and meta‑analysis of efficacy
and possible sources of controversies
in COVID‑19 patients
Arman Shafiee1,2, Mohammad Mobin Teymouri Athar3, Omid Kohandel Gargari1, Kyana Jafarabady1,
Sepehr Siahvoshi4 and Sayed‑Hamidreza Mozhgani5,6*
Abstract
Background: We conducted a systematic review and meta-analysis to evaluate the efficacy of ivermectin for COVID19 patients based on current peer-reviewed RCTs and to address disputes over the existing evidence.
Methods: MEDLINE (Pubmed), Scopus, Web of Science, Cochrane library, Google scholar and Clinicaltrials.gov were
searched for RCTs assessing the efficacy of Ivermectin up to 20 February 2022. A systematic review and meta-analysis
of studies was performed based on the PRISMA 2020 statement criteria.
Results: 19 and 17 studies were included in this systematic review and meta-analysis, respectively. There was no
significant difference in progression to severe disease (log OR − 0.27 [95% CI − 0.61 to 0.08], I2 = 42.29%), nega‑
tive RT-PCR (log OR 0.25 [95% CI − 0.18–0.68], I2 = 58.73%), recovery (log OR 0.11 [95% CI − 0.22–0.45], I2 = 13.84%),
duration of hospitalization (SMD − 0.40 [95% CI − 0.85–0.06], I2 = 88.90%), time to negative RT-PCR (SMD − 0.36
[95% CI − 0.89–0.17], I2 = 46.2%), and viral load (SMD -0.17 [95% CI -0.45 to 0.12], I^2 = 0%). It is worth noting that,
based on low-certainty evidence, ivermectin may possibly reduce mortality (log OR − 0.67 [95% CI − 1.20 to − 0.13],
I2 = 28.96%). However, studies with a higher risk of bias were more likely to indicate positive effects on the efficacy of
this drug, according to our subgroup analyses based on study quality.
Conclusion: Ivermectin did not have any significant effect on outcomes of COVID-19 patients and as WHO recom‑
mends, use of ivermectin should be limited to clinical trials.
Keywords: COVID-19, SARS-CoV-2, Ivermectin, Treatment, Meta-analysis, Mortality
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