Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients

DOI record: { "DOI": "10.1186/s12985-022-01829-8", "ISSN": [ "1743-422X" ], "URL": "http://dx.doi.org/10.1186/s12985-022-01829-8", "abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>We conducted a systematic review and meta-analysis to evaluate the efficacy of ivermectin for COVID-19 patients based on current peer-reviewed RCTs and to address disputes over the existing evidence.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>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.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>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%), negative 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.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusion</jats:title>\n <jats:p>Ivermectin did not have any significant effect on outcomes of COVID-19 patients and as WHO recommends, use of ivermectin should be limited to clinical trials.</jats:p>\n </jats:sec>", "alternative-id": [ "1829" ], "article-number": "102", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "24 March 2022" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "2 June 2022" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "13 June 2022" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Ethics approval and consent to participate", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "Not applicable." }, { "group": { "label": "Consent for publication", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "Not applicable." }, { "group": { "label": "Competing interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 4, "value": "The authors declare that they have no Competing interests." } ], "author": [ { "affiliation": [], "family": "Shafiee", "given": "Arman", "sequence": "first" }, { "affiliation": [], "family": "Teymouri Athar", "given": "Mohammad Mobin", "sequence": "additional" }, { "affiliation": [], "family": "Kohandel Gargari", "given": "Omid", "sequence": "additional" }, { "affiliation": [], "family": "Jafarabady", "given": "Kyana", "sequence": "additional" }, { "affiliation": [], "family": "Siahvoshi", "given": "Sepehr", "sequence": "additional" }, { "affiliation": [], "family": "Mozhgani", "given": "Sayed-Hamidreza", "sequence": "additional" } ], "container-title": "Virology Journal", "container-title-short": "Virol J", "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2022, 6, 13 ] ], "date-time": "2022-06-13T17:03:52Z", "timestamp": 1655139832000 }, "deposited": { "date-parts": [ [ 2022, 11, 14 ] ], "date-time": "2022-11-14T01:07:58Z", "timestamp": 1668388078000 }, "indexed": { "date-parts": [ [ 2022, 12, 7 ] ], "date-time": "2022-12-07T11:27:41Z", "timestamp": 1670412461615 }, "is-referenced-by-count": 5, "issue": "1", "issued": { "date-parts": [ [ 2022, 6, 13 ] ] }, "journal-issue": { "issue": "1", "published-online": { "date-parts": [ [ 2022, 12 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2022, 6, 13 ] ], "date-time": "2022-06-13T00:00:00Z", "timestamp": 1655078400000 } }, { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2022, 6, 13 ] ], "date-time": "2022-06-13T00:00:00Z", "timestamp": 1655078400000 } } ], "link": [ { "URL": "https://link.springer.com/content/pdf/10.1186/s12985-022-01829-8.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/article/10.1186/s12985-022-01829-8/fulltext.html", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/content/pdf/10.1186/s12985-022-01829-8.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1186", "published": { "date-parts": [ [ 2022, 6, 13 ] ] }, "published-online": { "date-parts": [ [ 2022, 6, 13 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "DOI": "10.1002/jmv.25678", "author": "H Lu", "doi-asserted-by": "publisher", "first-page": "401", "journal-title": "J Med Virol", "key": "1829_CR1", "unstructured": "Lu H, Stratton CW, Tang Y-W. 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