Summary of COVID-19 ivermectin studies
Studies
Meta Analysis
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Prophylaxis RCT for ivermectin and iota-carrageenan in Argentina, 117 healthcare workers treated with ivermectin and iota-carrageenan, and 117 controls, showing significantly lower cases with treatment. There were no moderate/severe cases with treatment vs. 10 in the control group. There were 4 cases with treatment (all mild) vs. 25 for the control group.
Jan 2021, American J. Therapeutics, https://journals.lww.com/10.1097/MJT.0000000000001433, https://c19p.org/ivercartuc
PEP RCT 399 patients in Bulgaria showing significantly lower COVID-19 cases with ivermectin prophylaxis, and significantly lower cases with high viral load. No participant had severe symptoms, required oxygen, or was hospitalized. All patients with COVID-19 were treated with vitamin C and vitamin D. This trial makes the Cochrane analysis report statistically significant efficacy for prophylaxis, although they do not appear to have acknowledged this yet. There are currently 4 prophylaxis RCTs, and all 4 show statistically significant efficacy of ivermectin. Cochrane ignored them by simply choosing to only include post-exposure prophylaxis RCTs, even though they were included for the paxlovid analysis with many of the same authors. At the time there were no post-exposure RCTs and they knew that including any one of the 3 pre-exposure prophylaxis RCTs would show statistically significant efficacy.
Jan 2023, ECCMID 2023, https://www.medincell.com/wp-content/uploads/2024/03/Poster-SAIVE-April2023-OK3.pdf, https://c19p.org/desorthenin
RCT for ivermectin+doxycycline showing improvements in mortality, recovery, progression, and virological cure. 183 treatment and 183 control patients with no deaths in the treatment arm vs. 3 in the control arm (the 3 control deaths are not included in the analysis of other outcomes). Results may reflect the use of ivermectin, doxycycline, and potential synergistic effects of the combination. In the PRINCIPLE trial, no mortality benefit was seen for doxycycline alone [thelancet.com] (0.6% mortality with doxycycline vs. 0.2% control).
Oct 2020, J. Int. Medical Research, https://journals.sagepub.com/doi/10.1177/03000605211013550, https://c19p.org/mahmud
89 patient ivermectin early treatment RCT: 70% lower hospitalization (p=0.34) and 62% improved viral clearance (p=0.02).
Double blind RCT for mild-moderate COVID-19 outpatients in Israel showing significantly faster reduction in viral load with treatment, and lower hospitalization with treatment. The one treatment hospitalization was a few hours after treatment and the patient improved and was discharged quickly. Authors also examine culture viability on days 2-6, with 13% positive in the ivermectin group vs. 48% in the control group. There were no safety issues. Ivermectin was taken one hour before a meal. Sheba IRB-7156/20.
Feb 2021, Int. J. Infectious Diseases, https://www.sciencedirect.com/science/article/pii/S120197122200399X, https://c19p.org/biber
PEP trial for asymptomatic close contacts of COVID-19 patients, 203 ivermectin patients and 101 control patients. 7.4% of contacts developed COVID-19 in the ivermectin group vs. 58.4% in the control group. Efficacy for symptomatic cases and severe cases is very similar. Adjusted results are provided only for symptomatic cases. See also [trialsitenews.com].
Aug 2020, J. Clinical and Diagnostic Research, https://www.jcdr.net/articles/PDF/14529/46795_CE[Ra]_F(Sh)_PF1(SY_OM)_PFA_(OM)_PN(KM).pdf, https://c19p.org/shouman
Cluster RCT outpatients in Argentina showing significantly faster recovery with ivermectin. There were no deaths. Outpatients in Tucumán were assigned to the ivermectin group and outpatients from San Miguel de Tucumán and Gran San Miguel de Tucumán were assigned to the control group. All comorbidities, percentage of male patients, and age were higher in the ivermectin group, favoring the control group.
Mar 2021, Research, Society and Development, https://rsdjournal.org/index.php/rsd/article/view/30844, https://c19p.org/chahla
248 patient ivermectin late treatment study: 87% lower mortality (p=0.02), 89% lower ICU admission (p=0.007), 83% lower progression (p=0.0004), and 87% improved recovery (p=0.02).
Retrospective 115 ivermectin patients and 133 control patients showing significantly lower death and faster viral clearance. Some potential issues and the authors' response can be found in [sciencedirect.com, sciencedirect.com].
Sep 2020, Archivos de Bronconeumología, https://www.archbronconeumol.org/en-ivermectin-treatment-may-improve-prognosis-articulo-S030028962030288X, https://c19p.org/khan
Prophylaxis RCT in Singapore with 3,037 low risk patients, showing lower serious cases, lower symptomatic cases, and lower confirmed cases of COVID-19 with all treatments (ivermectin, HCQ, PVP-I, and Zinc + vitamin C) compared to vitamin C. The ivermectin dosage was low for 42 days prophylaxis - only a single dose of 200µg/kg, with a maximum of 12mg. Meta-analysis of vitamin C in 6 previous trials shows a benefit of 16%, so the actual benefit of ivermectin, HCQ, and PVP-I may be higher. Cluster RCT with 40 clusters. There were no hospitalizations and no deaths.
Apr 2021, Int. J. Infectious Diseases, https://www.ijidonline.com/article/S1201-9712(21)00345-3/fulltext, https://c19p.org/seet
114 patient ivermectin early treatment RCT: 63% improved recovery (p=0.0001) and 79% improved viral clearance (p=0.004).
RCT 114 patients in Egypt, 57 treated with ivermectin mucoadhesive nanosuspension intranasal spray, showing faster recovery and viral clearance with treatment. NCT04716569.
Jun 2021, Int. J. Nanomedicine, https://www.dovepress.com/clinical-biochemical-and-molecular-evaluations-of-ivermectin-mucoadhes-peer-reviewed-fulltext-article-IJN, https://c19p.org/aref
Small 72 patient RCT of ivermectin and ivermectin + doxycycline showing faster recovery with ivermectin. The ivermectin + doxycycline group uses only a single dose of ivermectin vs. 5 daily doses for the ivermectin group. PCR testing was only done weekly after day 7, therefore hospitalization time may not match symptomatic recovery. Ivermectin group: 12mg daily for 5 days Ivermectin + doxycycline: 12mg ivermectin single dose, 200mg doxycycline + 100mg bid 4 days
Dec 2020, Int. J. Infectious Diseases, https://www.sciencedirect.com/science/article/pii/S1201971220325066, https://c19p.org/ahmed
Retrospective 88 ventilated COVID-19 patients in Japan, 39 treated with ivermectin within 3 days of admission, showing significantly reduced incidence of GI complications and mortality, and increased ventilator-free days with treatment.
Dec 2021, J. Infection and Chemotherapy, https://www.jiac-j.com/article/S1341-321X(21)00360-3/fulltext, https://c19p.org/shimizu
Double-blind RCT 110 hospitalized moderate to severe COVID-19 patients showing significantly reduced ICU admission, shorter hospitalization, faster resolution of symptoms, and improved CRP and LDH levels with ivermectin treatment compared to placebo. No deaths occurred in either group. There were no serious adverse events. Note that preclinical research predicts synergistic effects with the standard treatment protocol used in both groups.
Apr 2024, Jundishapur J. Health Sciences, https://brieflands.com/articles/jjhs-146703, https://c19p.org/varnaseri
490 patient ivermectin late treatment RCT: 69% lower mortality (p=0.09), 59% lower ventilation (p=0.17), 22% lower ICU admission (p=0.79), and 31% lower progression (p=0.29).
RCT 490 late stage (>65% lung change chest radiography at baseline) hospitalized patients in Malaysia, showing no significant differences. Mortality was 1.2% for ivermectin vs. 4% for control. If the same event rates continue, the trial would need to add ~13% more patients to reach statistical significance. i.e., by continuing the trial for ~2 weeks, there is a reasonable chance of the result being a statistically significant ~69% reduction in mortality, which would equate to ~4 million lives saved if adopted at the start of the pandemic. The mortality reduction is consistent with the results from all trials to date. While not reaching the significance threshold with the specified test, Bayesian analysis shows a 97% probability that ivermectin reduces mortality [normanfenton.com]. Authors describe the mortality results as "similar" and they are not mentioned in the visual abstract or the conclusion, suggesting substantial investigator bias with a preference for a null..
Nov 2021, JAMA, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2789362, https://c19p.org/lim
Small RCT for severe COVID-19 comparing the addition of ivermectin to SOC (low dose HCQ+AZ+favipiravir), with 30 treatment and 30 control patients in Turkey, showing lower mortality and faster clinical recovery. Authors also investigate the presence of gene mutations that alter ivermectin metabolism, predicting that ivermectin can be used safely without serious side effects in patients without MDR-1/ABCB1 and/or CYP3A4 gene mutation, and recommending monitoring and appropriate treatment if necessary when sequencing is unavailable. NCT04646109.
Jan 2021, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06104-9, https://c19p.org/okumus
RCT with 112 mild and moderate COVID-19 patients in India, showing lower mortality, ventilation, and ICU admission, although not statistically significant due to the small number of events. There was no mortality in the treatment arm (55 patients) versus 7% (4 of 57) in the control arm. The PCR result is subject to confounding by biased loss of followup, with 23 lost in the treatment group and 13 in the control group, and 8 more people in the treatment group discharged before day 6.
Jan 2021, J. Pharmacy & Pharmaceutical Sciences, https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/32105, https://c19p.org/ravikirti
Retrospective 21,232 patients in Argentina, 3,266 assigned to ivermectin treatment, showing lower mortality with treatment. Greater benefits were seen for patients >40, and a dose dependent response was found. For more discussion see [twitter.com].
Sep 2021, Frontiers in Public Health, https://www.frontiersin.org/articles/10.3389/fpubh.2022.813378/full, https://c19p.org/mayer
96 patient RCT showing faster resolution of post-COVID anosmia with an ivermectin nanosuspension nasal spray.
Sep 2022, Infection and Drug Resistance, https://www.dovepress.com/possible-role-of-ivermectin-mucoadhesive-nanosuspension-nasal-spray-in-peer-reviewed-fulltext-article-IDR, https://c19p.org/aref2
Retrospective 1,470 healthcare workers in India, showing significantly lower risk of symptomatic COVID-19 with ivermectin prophylaxis.
May 2021, J. the Indian Medical Association, https://onlinejima.com/read_journals.php?article=683, https://c19p.org/mondal
Prospective prophylaxis study with 3,532 healthcare workers, 2,199 receiving two-dose ivermectin prophylaxis, showing adjusted relative risk of confirmed COVID-19 with treatment 0.17 [0.12-0.23] p<0.001. 186 patients took only the first dose, and no significant difference was observed for this group. The same group published an earlier small study with 117 ivermectin patients. There were no serious adverse events. T/IM-NF/CM&FM/20/142.
Feb 2021, Cureus, https://www.cureus.com/articles/64807-prophylactic-role-of-ivermectin-in-severe-acute-respiratory-syndrome-coronavirus-2-infection-among-healthcare-workers, https://c19p.org/behera2
91% reduction in COVID-19 cases with ivermectin prophylaxis. 118 healthcare workers in Bangladesh, 58 receiving ivermectin 12mg monthly, showing RR 0.094, p < 0.0001.
Dec 2020, European J. Medical and Health Sciences, https://ejmed.org/index.php/ejmed/article/view/599, https://c19p.org/alam2
Retrospective matched case-control prophylaxis study for HCQ, ivermectin, and vitamin C with 372 healthcare workers, showing lower COVID-19 incidence for all treatments, with statistical significance reached for ivermectin. HCQ OR 0.56, p = 0.29 Ivermectin OR 0.27, p < 0.001 Vitamin C OR 0.82, p = 0.58
Nov 2020, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247163, https://c19p.org/beherai
Propensity matched retrospective prophylaxis study of healthcare workers in the Dominican Republic showing significantly lower cases with treatment, and no hospitalization with treatment (versus 2 in the PSM matched control group). The cases with treatment were mostly in the first week, with only one case in the second and third weeks, and none in the fourth week. There were no severe side effects. In post-hoc analysis, as the treatment group discontinued treatment over time, their protection also decreased. NCT04832945.
Apr 2021, Cureus, https://www.cureus.com/articles/63131-ivermectin-as-a-sars-cov-2-pre-exposure-prophylaxis-method-in-healthcare-workers-a-propensity-score-matched-retrospective-cohort-study, https://c19p.org/morgenstern2
RCT in India with low risk patients, comparing 24mg ivermectin, 12mg ivermectin, and placebo showing non-statistically significant improvements in recovery and PCR+ status (day 5 both arms, day 7 24mg only) with treatment, and showing greater improvement for the higher dose arm. Viral load decline was similar in all arms - absolute values are lower for ivermectin in a dose-dependent manner, however the baseline value for the ivermectin groups was lower, leaving less room for change. There were no deaths or use of mechanical ventilation. There were no serious adverse events. Note that our pre-specified protocol prioritizes clinical outcomes over PCR results.
Feb 2021, J. Infection and Chemotherapy, https://www.sciencedirect.com/science/article/pii/S1341321X21002397, https://c19p.org/mohan
Prospective trial of 768 COVID-19 outpatients in Mexico, 481 treated with ivermectin, AZ, montelukast, and aspirin, and 287 control patients with various treatments, showing significantly lower mortality and hospitalization, and significantly higher recovery at 14 days with treatment.
Feb 2021, Int. J. Infectious Diseases, https://www.sciencedirect.com/science/article/pii/S1201971221001004, https://c19p.org/limamorales
RCT 100 outpatients in Pakistan, 50 treated with ivermectin, showing faster recovery with ivermectin. All patients received AZ, zinc, vitamin C, vitamin D, and paracetemol. Details of randomization were not provided. No mortality or hospitalization was reported.
May 2021, The Professional Medical J., http://theprofesional.com/index.php/tpmj/article/view/5867, https://c19p.org/faisal
Retrospective 28,048 COVID+ patients in Mexico, 7,898 receiving a treatment kit including low dose ivermectin, AZ, aspirin, and acetaminophen, shower lower mortality/hospitalization for those receiving the kit. Delivery of the treatment kit was based on availability in the medical units. Adherence is unknown and may be low. Adjusted results are only provided for combined mortality/hospitalization.
Jan 2022, Archives of Medical Research, https://www.sciencedirect.com/science/article/pii/S0188440922000029, https://c19p.org/dejesusascenciomontiel
RCT with 35 single dose 24mg, 38 single dose 12mg, and 39 SOC hospitalized patients with hematological illnesses in India, showing no significant differences. Results were better for 24mg vs. 12mg for all symptomatic outcomes. Viral clearance results do not follow the randomization with less than 50% of patients tested at day 7, and no adjusted results are provided. Results were obtained for only 43.8% of ivermectin patients and 56.4% of control patients at day 7 and may not be comparable due to the large difference in the percentage of patients tested. Lower test coverage in the ivermectin group is likely related to faster recovery. Ct 40 for E or S was used for viral clearance which may also have low relevance to infectious disease.
May 2022, Indian J. Hematology and Blood Transfusion, https://link.springer.com/10.1007/s12288-022-01546-w, https://c19p.org/george
Small RCT with 72 low-risk patients in Thailand, showing improved recovery with ivermectin, without statistical significance. All patients recovered and there was no escalation of care in either group. There were no adverse events.
Feb 2022, Trials, https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-022-06649-3, https://c19p.org/manomaipiboon
69 residents of a French care home, median age 90, were treated with ivermectin for a scabies outbreak. 3,062 residents in 45 nearby comparable homes were used as controls. 7 of 69 treated patients had probable or certain COVID-19, with no serious cases and no deaths. In comparable care homes in the same district, matched by age and socio-economic level, there was 22.6% COVID-19 and 5% death.
Nov 2020, Annals of Dermatology and Venereology, https://www.sciencedirect.com/science/article/pii/S015196382030627X, https://c19p.org/bernigaud
RCT with 131 24mg ivermectin, 130 12mg ivermectin, and 130 placebo patients, showing no significant differences in outcomes. Lower ventilation and hospitalization was seen with treatment, in a dose-dependent manner, but not reaching statistical significance with the small number of events.
Jun 2022, Respirology, https://onlinelibrary.wiley.com/doi/10.1111/resp.14318, https://c19p.org/mirahmadizadeh
Retrospective 100 patients in India with 50 treated with ivermectin, and SOC for all patients including HCQ+AZ, showing much higher viral clearance with ivermectin. Baseline clinical status was worse in the control group. Time of testing after treatment initiation was longer in the control group (mean 7.24 days versus 5.22 days).
Mar 2021, Int. J. Health and Clinical Research, https://ijhcr.com/index.php/ijhcr/article/view/1263, https://c19p.org/mourya
Retrospective 280 hospitalized patients showing lower mortality with ivermectin (13.3% vs 24.5%), propensity matched odds ratio OR 0.47 [0.22-0.99], p=0.045.
Oct 2020, Chest, https://www.sciencedirect.com/science/article/pii/S0012369220348984, https://c19p.org/rajter
RCT of relatively low risk hospitalized patients with 50 ivermectin and 50 control patients showing significantly faster viral clearance with treatment. 9 patients in the treatment arm were lost to followup compared with 5 in the control arm, which could be in part due to faster recovery with treatment. There were no safety concerns. No mortality was reported. The numbers in Table 3 are the number of patients that became negative on that day, i.e., non-cumulative. SOC included vitamin C and vitamin D. NCT04392713.
Jan 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.02.02.21250840v1, https://c19p.org/bukhari
Small RCT comparing ivermectin 6mg & 12mg q84hr with lopinavir/ritonavir, showing a statistically significant and dose dependent effect of ivermectin on reducing the time to PCR-. The study does not report mortality, hospitalization, progression, recovery, etc. The paper does report change in SpO2 (Figure 3, ∆Spo2), where a similar improvement with a smaller p value is seen with ivermectin, however this result is unadjusted and there are large differences between groups. Specifically, baseline SpO2 is lower in the control group, giving the control group more room to improve, therefore the actual benefit of ivermectin is likely to be even larger than the benefit in ∆SpO2 shown. See also [doyourownresearch.substack.com].
Jan 2021, QJM: An Int. J. Medicine, https://academic.oup.com/qjmed/advance-article/doi/10.1093/qjmed/hcab035/6143037, https://c19p.org/babalola
Small 116 patient RCT with low-risk patients comparing ivermectin+doxycycline and HCQ+AZ, showing lower hospitalization, higher viral clearance, and faster symptom resolution and viral clearance with ivermectin+doxycycline. Mid-recovery resolution of symptoms is statistically significantly better with treatment, while other measures do not reach statistical significance. Instructions were to take ivermectin on an empty stomach, reducing lung tissue concentration.
Jul 2020, Eurasian J. Medicine and Oncology, https://ejmo.org/10.14744/ejmo.2021.16263/, https://c19p.org/chowdhury
PSM retrospective 220,517 patients in Brazil,133,051 taking ivermectin as part of a citywide prophylaxis program, showing significantly lower hospitalization and mortality with treatment. Additional results are presented here: [odysee.com], including improved efficacy with analysis based on irregular/regular use, and a strong dose-response relationship. Confirmation from independent analysis of the raw data: [web.archive.org]. See [Mills] regarding [medrxiv.org].
Dec 2021, Cureus, https://www.cureus.com/articles/82162-ivermectin-prophylaxis-used-for-covid-19-a-citywide-prospective-observational-study-of-223128-subjects-using-propensity-score-matching, https://c19p.org/kerr
RCT 70 ivermectin+doxycycline patients and 70 control patients showing reduced time to recovery and reduced mortality with treatment. Earlier treatment was more successful. For ethical reasons, critical patients were all in the treatment group. NCT04591600.
Oct 2020, Iraqi J. Medical Science, http://www.iraqijms.net/upload/pdf/iraqijms60db8b76d3b1e.pdf, https://c19p.org/hashim
Analysis of Mexico City's use of an ivermectin-based medical kit, showing significantly lower hospitalization with use. Authors use logistic-regression models with matched observations, including adjustments for age, sex, COVID severity, and comorbidities. This preprint was censored by the original preprint host. Censors claim that the government treatment program, which used approved medications and saved over 500 people from hospitalization, was unethical. In part they also indicate that studies of "the effects of a medication on a disease outcome" are outside the scope of their site, however retroactively censoring a paper for this reason is not appropriate. The author's response (not provided by the censors) can be found here: [twitter.com]. Author's provide the data and code for the study, and the results have been independently verified. See also: [doyourownresearch.substack.com]. This study was censored.
May 2021, Preprint, http://web.archive.org/web/20211218011849/https://files.osf.io/v1/resources/r93g4/providers/osfstorage/609085945533b4031ee1c789?action=download&direct&version=1, https://c19p.org/merino
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.
Nov 2021, J. Medical Virology, https://onlinelibrary.wiley.com/doi/10.1002/jmv.27469, https://c19p.org/ozer
RCT 75 very late stage patients in Colombia, showing no significant difference in outcomes with a single dose of 400μg/kg ivermectin.
Oct 2022, Revista Infectio, http://revistainfectio.org/P_OJS/index.php/infectio/article/view/1105, https://c19p.org/ochoajaramillo
Small study with 28 patients treated with ivermectin + AZ + cholecalciferol and 7 control patients. All treated patients were PCR- at day 10 while all control patients remained PCR+. The mean duration of symptoms was 3 days in the treatment group and 10 days in the control group.
Aug 2020, Biomedical Research, https://www.biomedres.info/biomedical-research/effects-of-ivermectinazithromycincholecalciferol-combined-therapy-on-covid19-infected-patients-a-proof-of-concept-study-14435.html, https://c19p.org/espitiahernandez
Small quasi-randomized (patient choice) study with 25 PCR+ patients in a nursing home offered ivermectin, of which 10 chose to be treated. The mean age was 83.5 in the treatment group and 81.8 in the control group. There was lower mortality and fewer serious cases with treatment.
Apr 2021, J. Infectious Diseases and Epidemiology, https://www.clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-7-202.php?jid=jide, https://c19p.org/loue
Retrospective 1,387 hospitalized PCR confirmed COVID-19 patients in Tanzania, showing lower mortality with ivermectin treatment and with steroid treatment in multivariable analysis.
Jul 2023, medRxiv, https://www.medrxiv.org/content/10.1101/2023.07.13.23292643, https://c19p.org/osati
PSM retrospective 41,608 patients in the USA, 1,072 treated with ivermectin and 40,536 treated with remdesivir, showing lower mortality with ivermectin treatment. This study was presented at a conference (IMED 2021). Submissions were peer-reviewed. The treatment/control group sizes align with the estimated percentage of hospitals that used ivermectin vs. remdesivir. Hospitals in the USA receive financial incentives to use remdesivir. Authors have self-censored the conference report of this result, not due to any error in the analysis, but because they believe ivermectin "has proven to be ineffective in clinical trials". This is incorrect, while some studies show no statistically significant effect, studies show statistically significant positive results for one or more outcomes ( prospective and retrospective studies, including RCTs). The self-censorship and decision not to submit to a journal provide further evidence of a negative publication bias for ivermectin research. This study was self-censored by the authors.
Feb 2022, Int. J. Infectious Diseases, https://www.sciencedirect.com/science/article/pii/S1201971221009887, https://c19p.org/efimenko
Multicenter double-blind RCT with 100 hospitalized patients in Bulgaria showing faster viral clearance, greater clinical improvement, and improved biomarkers with treatment. Limited data has been reported currently. No serious adverse events were observed.
Mar 2021, Huvemek, Press Release, https://huvemec.bg/covid-19-huvemec-klinichno-izpitanie/za-isledvaneto/, https://c19p.org/petkov
RCT 609 inpatients in Iran. Reported outcomes are very different from the pre-specified outcomes [irct.ir]. The outpatient trial is listed separately. From the pre-specified outcomes, all are either positive or not reported. Pre-specified outcomes: - Reduction in persistent cough - RR 0.36 p = 0.06 - Negative RT-PCR - not reported - Main complaints recovery time - not reported - Mortality - RR 0.69 p = 0.36 - Side effects - reported as none (anomalous) - Reduction in tachypnea - RR 0.24 p = 0.38 - Oxygen saturation >94% - not reported All negative outcomes are protocol violations and are not listed in the protocol, including the novel "relative recovery" outcome. Authors include a researcher caught on video admitting that conclusions on ivermectin research were influenced by a funder [c19ivm.org]. Severe cases were more frequent in the ivermectin group, 49% vs. 43%. Dose was limited at a maximum of 30mg for 75+kg, resulting in underdosing for patients at higher risk. Almost..
Jun 2022, Frontiers in Medicine, https://www.frontiersin.org/articles/10.3389/fmed.2022.919708/full, https://c19p.org/rezai2
Physician survey in India with 164 ivermectin prophylaxis, 129 HCQ prophylaxis, and 81 control patients, showing significantly lower COVID-19 cases with treatment. Details of the treatment and control groups and the definition of cases are not provided, and the results are subject to survey bias. Authors also report on community prophylaxis but present only combined ivermectin/HCQ results.
Nov 2021, J. the Association of Physicians India, https://www.researchgate.net/publication/356294136_Ivermectin_and_Hydroxychloroquine_for_Chemo-Prophylaxis_of_COVID-19_A_Questionnaire_Survey_of_Perception_and_Prescribing_Practice_of_Physicians_vis-a-vis_Outcomes, https://c19p.org/samajdar
Non-randomized controlled trial with 62 mild and early moderate patients with home treatment with ivermectin + nitazoxanide + ribavirin + zinc, showing significantly faster viral clearance.
Feb 2021, J. Medical Virology, https://onlinelibrary.wiley.com/doi/10.1002/jmv.26880, https://c19p.org/elalfy
Analysis of COVID-19 cases vs. widespread prophylactic use of ivermectin for parasitic infections showing significantly lower incidence of COVID-19 cases.
Nov 2020, Int. J. Antimicrobial Agents, https://www.sciencedirect.com/science/article/pii/S0924857920304684, https://c19p.org/hellwig
Retrospective 976 hospitalized patients with 34 treated with ivermectin showing lower mortality with ivermectin in unadjusted results.
Nov 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.11.16.20232223v1, https://c19p.org/budhirajai
Retrospective 96 late stage patients receiving a single dose of 200 μg/kg ivermectin for strongyloides and 96 matched controls, showing no significant difference in outcomes. Authors note that this may be due to the low dose used.
May 2023, Viruses, https://www.mdpi.com/1999-4915/15/5/1138, https://c19p.org/llenasgarcia
Retrospective COVID+ hospitalized patients in Uganda, showing no statistically significant difference in mortality with ivermectin, however there were only 7 patients receiving ivermectin.
Dec 2021, Research Square, https://www.researchsquare.com/article/rs-1193578/v1, https://c19p.org/baguma
Very high conflict of interest RCT with design optimized for a null result: very low risk patients, high existing immunity, post-hoc change to exclude patients more likely to benefit. There was no significant difference in viral clearance among low risk patients with high viral load at baseline. All 3 progression events occured in the control arm - one hospitalization and two cases of COVID-19 related rhabdomyolysis. Patients in both arms cleared the virus quickly with a viral clearance half-life of 21.1 hours vs. 19.2 hours, which may be in part due to prior immunity. With rapid viral clearance and very low risk patients, infection is less likely to spread to other tissues. Systemic treatment is less applicable, and has less time to reach therapeutic concentrations before self-recovery. Treatment administered directly to the respiratory tract, e.g. as in 1 - 8 , may be more effective for COVID-19 in general, and extend applicability to fast-resolving cases with infection primarily..
Jul 2022, eLife, https://elifesciences.org/articles/83201, https://c19p.org/schilling
RCT 99 ivermectin and 103 control low risk patients in China, up to 7 days from symptom onset, showing statistically significant improvement in recovery with treatment, and non-statistically significant improvements in recovery time and deterioration. Authors selectively omitted the p-value for recovery which shows statistical significance. Very little information on the patients is provided (only age, gender, and insurance status). The table, text, and abstract show three different versions of recovery numbers. The table and abstract show two different versions of recovery time. The abstract contains a hazard ratio that is not in the text, and no statistical methods are reported. Given the selective omission of the statistically significant recovery p-value, three different sets of numbers for that outcome, and other inconsistencies, the data in this study does not appear to be very reliable. Patients >50 were excluded.
Dec 2021, Indian J. Pharmaceutical Sciences, https://www.ijpsonline.com/abstract/the-effect-of-ivermectin-on-reducing-viral-symptoms-in-patients-with-mild-covid19-4455.html, https://c19p.org/abbas2
100 patient prospective trial of ivermectin + doxycycline showing reduced time to symptom resolution and shorter hospital stay with treatment.
Nov 2020, IAIM, 2020, 177-182, http://iaimjournal.com/wp-content/uploads/2020/10/iaim_2020_0710_23.pdf, https://c19p.org/spoorthi
Late treatment (6.6 days after onset/PCR+) RCT with 221 low risk (no deaths) COVID-19 patients in Japan, showing no significant difference in viral clearance with a single dose of ivermectin under fasting. Authors note that a single 200 μg/kg dose under fasting was used as approved in Japan, and that the low dose, single day dosing, and fasting administration (~2.5 times lower plasma concentration according to [Guzzo]) limit applicability, and that studies with more favorable outcomes generally used a higher dose or multiday dosing. Details of PCR testing are not provided but the very slow clearance within the low risk population suggests a very high Ct value that may not accurately represent any reduction in replication-competent viral load. An erratum notes a conflict of interest for a reviewer that was a Merck employee: [frontiersin.org]
May 2023, Frontiers in Medicine, https://www.frontiersin.org/articles/10.3389/fmed.2023.1139046/full, https://c19p.org/wada
PSM retrospective 87 patients in Nigeria, 61 treated with ivermectin, showing lower mortality, faster recovery, and faster viral clearance with ivermectin treatment. All patients received zinc and vitamin C. A synergistic effect was seen for viral clearance when ivermectin and remdesivir were combined, as predicted by In Vitro research [Jeffreys]. Subject to confounding by time, with ivermectin patients from April-June 2021, and non-ivermectin patients from September-November 2021.
Feb 2022, J. Pharmaceutical Research Int., https://journaljpri.com/index.php/JPRI/article/view/36328, https://c19p.org/thairu
RCT 60 low-risk outpatients, median age 31, with mild to moderate COVID-19 showing no significant differences with combined favipiravir/ivermectin/niclosamide treatment compared to favipiravir alone. There was limited room for improvement with almost no progression and no hospitalization, ICU admission, supplemental oxygen, or mortality. The combined group showed significantly improved visual analog scale (VAS) scores for cough, runny nose, and diarrhea from day 3. Authors note that "the WHO-CPS were significantly decreased among FPV/IVM/NCL vs FPV alone on day 10", however the degree of improvement cannot be determined based on the values reported. Authors state that "All data generated or analyzed during this study are included in this published article", which is incorrect - only summary statistics are published. The trial registration states that data will not be made available. This raises concerns, especially given many inconsistencies in the published data:..
Mar 2024, J. Infection and Public Health, https://www.sciencedirect.com/science/article/pii/S1876034124001060, https://c19p.org/siripongboonsitti6
Retrospective study of the 31 onchocerciasis-endemic countries using the community-directed treatment with ivermectin (CDTI) and the 22 non-endemic countries in Africa, showing significantly lower mortality per capita in the countries using ivermectin.
Mar 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.03.26.21254377v1, https://c19p.org/tanioka
Prospective 320 hospitalized moderate COVID-19+ patients in Egypt, 160 treated with ivermectin, showing lower mortality, improved recovery, and decreased cytokine expression with treatment. All patients were treated with HCQ. 7890/26-8-2020.
Oct 2021, Zagazig University Medical J., https://journals.ekb.eg/article_202150_0.html, https://c19p.org/rezk
Prospective convenience sampling study of 210 hospitalized age-matched COVID-19 patients, showing faster viral clearance with ivermectin. Baseline information per group is not provided.
Aug 2022, Pakistan J. Medical and Health Sciences, https://pjmhsonline.com/index.php/pjmhs/article/view/2153, https://c19p.org/qadeer
Retrospective 95 outpatients in Pakistan with strong clinical suspicion of COVID-19 (testing was not widely available), with 40 patients treated with ivermectin, showing significantly shorter duration of febrile illness with treatment. Most patients also received HCQ, AZ, zinc, and aspirin. Authors note that there was a treatment delay-response relationship.
Dec 2020, Int. J. Clinical Studies & Medical Case Reports, https://ijclinmedcasereports.com/pdf/IJCMCR-RA-00320.pdf, https://c19p.org/ghauri
24 patient ivermectin early treatment RCT: 96% improved symptoms (p=0.05), 95% improved viral load (p=0.01), and 8% improved viral clearance (p=1).
Tiny RCT for early treatment of mild COVID-19 in low risk patients, with 12 400mcg/kg single dose ivermectin patients and 12 control patients, showing significantly faster viral load reduction and symptom improvement with ivermectin. Average median viral load for gene E and gene N mid-viral recovery at day 7: Ivermectin: 1637, control: 30175 (supplementary appendix).
Dec 2020, eClinicalMedicine, https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30464-8/fulltext, https://c19p.org/chaccour
RCT 164 hospitalized patients in Egypt showing lower mortality and shorter hospitalization, but without statistical significance. There were no serious adverse effects. Authors suggest the low dosage may have resulted in lower efficacy than other trials, and recommend increased dosage in future trials. Time from symptom onset is not specified. The trial was retrospectively registered and the recruitment start date in the trial registration (June 2020) differs from the paper (March 2020) [osf.io]. For other concerns see [onlinelibrary.wiley.com].
Jun 2021, J. Medical Virology, https://onlinelibrary.wiley.com/doi/10.1002/jmv.27122, https://c19p.org/abdelsalam3
Phone survey based RCT with low risk patients, 200 ivermectin and 198 control, showing lower mortality, lower disease progression, lower treatment escalation, and faster resolution of symptoms with treatment, without reaching statistical significance. Authors find the results of this trial alone do not support the use of ivermectin. However the effects are all positive, especially for serious outcomes which are unable to reach statistical significance with the very small number of events in the low risk population. An open letter, signed by >100 physicians, concluding this study is fatally flawed can be found at jamaletter.com . With the low risk patient population, there is little room for improvement with an effective treatment - 59/57% (IVM/control) recovered within the first 2 days to either "no symptoms" or "not hospitalized and no limitation of activities"; 73/69% within 5 days. Less than 3% of all patients ever deteriorated. The primary outcome was changed mid-trial, it was..
Mar 2021, JAMA, https://jamanetwork.com/journals/jama/fullarticle/2777389, https://c19p.org/lopezmedina
Retrospective 1,000 hospitalized COVID-19 patients in Pakistan, showing lower mortality with ivermectin without statistical significance.
Apr 2023, Healthcare, https://www.mdpi.com/2227-9032/11/8/1192, https://c19p.org/munir
Small RCT with 25 ivermectin and 25 control patients, not finding a significant difference in recovery at day 7.
Sep 2020, Int. J. Sciences-35, https://www.ijsciences.com/pub/article/2378, https://c19p.org/chachar
Small RCT with 32 ivermectin patients and 30 control patients. The mean recovery time after enrolment in the intervention arm was 5.31 ± 2.48 days vs. 6.33 ± 4.23 days in the control arm, p > 0.05. Negative PCR results were not significantly different between control and intervention arms, p>0.05. We are not sure what the results were because the abstract and Table 5 have switched the results.
Sep 2020, IMC J. Med. Science, http://imcjms.com/registration/journal_abstract/353, https://c19p.org/podder
Tiny 26 patient retrospective study of very late treatment with ivermectin 200 μg/kg, median 12 days after symptoms, not showing significant differences. Authors suggest the dose is too low and recommend evaluation of higher doses. All patients received HCQ which may reduce the potential benefit for adding ivermectin.
Nov 2020, PLoS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242184, https://c19p.org/camprubi
Small trial of hospitalized patients with 16 of 87 patients being treated with ivermectin, showing a significantly lower mean hospital stay with ivermectin: 7.62 vs. 13.22 days, p=0.00005. 0 of 16 ivermectin patients died vs. 2 of 71 control patients.
Jul 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.07.07.20145979v1, https://c19p.org/gorial
Very small RCT with 4 control patients and 28 ivermectin patients split across 3 different dosage levels, showing lower (non-statistically significant) ICU admission with treatment. Authors suggest that ivermectin for SARS-CoV-2 is safe and reduces symptoms and viral load, and that the antiviral effect appears to be dose-dependent. NCT04431466. Retraction/censorship: this paper appears to have been censored at the request of the journal's founding editor [pubmed.ncbi.nlm.nih.gov]. An external review is mentioned but is not provided, and there is no reply from the authors, or indication that the authors were notified. Conclusions in this study are limited due to the small size, however we should consider all information in the context of the full body of research.
Mar 2021, Toxicology Reports, https://www.sciencedirect.com/science/article/pii/S2214750021000445, https://c19p.org/pottjunior
Early terminated REMAP-CAP results delayed >600 days, showing no significant differences with very low dose, poor administration, very late treatment of ICU patients. Results trend towards benefit for non-critical patients, with 32% lower mortality in unadjusted results, despite higher baseline severity in the treatment group. Results are currently only available in a CCR24 presentation. There are many critical issues as below. Authors appear to have post-hoc removed adjustment for severity to favor the control group. Preliminary analysis, please report errors or other issues. Severity Issue CRITICAL 1. Severity adjustment deleted in second post-hoc SAP CRITICAL 2. Baseline severity favors control CRITICAL 3. 32% lower mortality for non-critical patients CRITICAL 4. Expected failure based on design CRITICAL 5. Inclusion change to ICU only CRITICAL 6. >600 days delay in reporting CRITICAL 7. Adjustment direction different from expected CRITICAL 8. Remdesivir use CRITICAL 9. Bias in..
Jun 2024, Critical Care Reviews, CCR24, https://criticalcarereviews.com/meetings/ccr24#1, https://c19p.org/hashmi
Prophylaxis study using ivermectin and iota-carrageenan showing 0 of 788 cases from treated healthcare workers, compared to 237 of 407 control. See [doyourownresearch.substack.com] for discussion of issues with this trial.
Nov 2020, J. Biomedical Research and Clinical Investigation, https://medicalpressopenaccess.com/upload/1605709669_1007.pdf, https://c19p.org/carvalloprep
RCT late stage severe condition (93% SOFA ≥ 2, 96% APACHE ≥ 8) high comorbidity hospitalized patients in Mexico with 36 low dose ivermectin and 37 control patients not finding significant differences. NCT04391127. Another study reports results on a larger group of patients in the same hospital, showing ivermectin mortality RR 0.81 [0.53-1.24] 25 . Questions have been raised about this study and the early termination of the study and discontinuation of treatments, because the hospital statistics show a dramatically lower (~75%) case fatality rate during the period of the study 26 (data from gob.mx ). Date Cases Deaths CFR 3/2020 2 1 50% 4/2020 4 1 25% 5/2020 13 1 8% 6/2020 37 2 5% 7/2020 65 5 8% 8/2020 79 23 29% 9/2020 54 12 22% 10/2020 62 21 34% 11/2020 80 26 33% 12/2020 41 13 32% Several other inconsistencies have been reported 28 . Although the data from this study is reported to be available and has been shared with an anti-treatment group, independent researchers have been unable..
Feb 2021, Infectious Disease Reports, https://www.mdpi.com/2036-7449/14/2/20, https://c19p.org/beltrangonzalez
Retrospective 444 hospitalized patients in Pakistan, showing lower mortality with ivermectin treatment in unadjusted results, not reaching statistical significance. Ivermectin was mostly used with patients in severe condition. Dose ranged from 12mg to 36mg for up to seven days.
Dec 2021, Exploratory Research in Clinical and Social Pharmacy, https://www.sciencedirect.com/science/article/pii/S2667276621001013, https://c19p.org/mustafa
1,358 patient ivermectin early treatment RCT: while presented as negative, the co-principal investigator privately reported that "there is a clear signal that IVM works in COVID patients".
Together Trial Ivermectin: impossible data, critical issues, blinding broken, randomization failure, data pledge violation, protocol violations.
Aug 2021, New England J. Medicine, https://www.nejm.org/doi/full/10.1056/NEJMoa2115869, https://c19p.org/togetherivm
Small study of 24 consecutive patients in serious condition (9 days post symptoms, mean SpO2 87.4) using combined treatment with ivermectin, doxycycline, zinc, vitamin D, and vitamin C, showing no mortality or hospitalization with treatment. Two patients declined treatment and both died. This study uses a synthetic control arm.
Jul 2021, Future Microbiology, https://www.futuremedicine.com/doi/full/10.2217/fmb-2022-0014, https://c19p.org/hazan
Prophylaxis study using ivermectin and carrageenan showing 0 of 131 cases from treated healthcare workers, compared to 11 of 98 control. The effect is likely to be primarily due to ivermectin - the author has later reported that carrageenan is not necessary [youtube.com]. See [doyourownresearch.substack.com] for discussion of issues with this trial.
Oct 2020, NCT04425850, https://clinicaltrials.gov/ct2/show/results/NCT04425850, https://c19p.org/carvalloprep2
Retrospective 165 hospitalized patients in Pakistan showing unadjusted lower mortality with combined ivermectin and doxycycline treatment. Details of the ivermectin group compared to other patients are not provided, however ivermectin was given to a similar percentage of patients in the mild, moderate, and severe/critical groups (34.5%, 29.1%, and 36.4%), suggesting that ivermectin treatment was not based on severity.
Apr 2021, Cureus, https://www.cureus.com/articles/56545-clinical-variants-characteristics-and-outcomes-among-covid-19-patients-a-case-series-analysis-at-a-tertiary-care-hospital-in-karachi-pakistan, https://c19p.org/ahsan
247 patient ivermectin early treatment study: 94% lower ventilation (p=0.005) and 98% lower hospitalization (p<0.0001).
Comparison of HCQ, nitazoxanide, and ivermectin showing similar effectiveness for overall clinical outcomes in COVID-19 when used before seven days of symptoms, and overwhelmingly superior compared to the untreated COVID-19 population, even for those outcomes not influenced by placebo effect, at least when combined with azithromycin, and vitamin C, D and zinc in the majority of the cases. 585 patients with mean treatment delay 2.9 days. There was no hospitalization, mechanical ventilation, or mortality with treatment. Control group 1 was a retrospectively obtained group of untreated patients of the same population.
Nov 2020, New Microbes and New Infections, https://www.sciencedirect.com/science/article/pii/S2052297521000792, https://c19p.org/cadegianii
Retrospective 2017 hospitalized patients in India, showing lower mortality with ivermectin treatment in unadjusted results. No group details are provided and this result is subject to confounding by indication.
Aug 2021, Lung India, https://journals.lww.com/lungindia/Fulltext/2022/01000/Clinical_features,_demography,_and_predictors_of.5.aspx, https://c19p.org/elavarasi
Prospective trial of ivermectin, dexamethasone, enoxaparin, and aspirin, showing no hospitalization for mild cases, and lower mortality for moderate/severe patients.
Sep 2020, J. Clinical Trials, https://www.longdom.org/open-access/safety-and-efficacy-of-the-combined-use-of-ivermectin-dexamethasone-enoxaparin-and-aspirina-against-covid19-the-idea-protocol-70290.html, https://c19p.org/carvallo
Retrospective database study of 5683 patients, 692 received HCQ/CQ+AZ, 200 received HCQ/CQ, 203 received ivermectin, 1600 received AZ, 358 received ivermectin+AZ, and 2630 received standard of care. This study includes anyone with ICD-10 COVID-19 codes which includes asymptomatic PCR+ patients, therefore many patients in the control group are likely asymptomatic with regards to SARS-CoV-2, but in the hospital for another reason. For those that had symptomatic COVID-19, there is also likely significant confounding by indication. In this study all medications show higher mortality at day 30, which is consistent with asymptomatic (for COVID-19) or mild condition patients being more common in the control group. For ivermectin they show 30 day mortality aHR = 1.39 [0.88 - 2.22]. KM curves show that the treatment groups were in more serious condition, and also that after about day 35 survival became better with ivermectin. The last day available for ivermectin shows RR 0.83, p = 0.01. More..
Oct 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.10.06.20208066v1, https://c19p.org/sotobecerrai
Retrospective 965 late stage (44% severe, 27% ICU) hospitalized patients in India, showing no significant difference with ivermectin treatment. Overall mortality was very high, suggesting very late treatment. The low non-weight-adjusted dose may not be very effective with such late stage patients. 210 patients were excluded due to early discharge, which may have been patients with earlier onset that are more likely to benefit with ivermectin. Age grouping is very unusual with no breakdown of ages for the 71% of patients >45. Numbers may be unreliable, e.g., cardiovascular disease counts and/or percentages for IVM appear incorrect. Details of adjustments are not provided, there may be extreme confounding by age within the >45 groups which contain the majority of the patients, in addition to confounding by indication.
Apr 2022, Research Square, https://www.researchsquare.com/article/rs-1522422/v1, https://c19p.org/ravikirti2
Retrospective database analysis of 56 mild COVID-19 patients, all treated with vitamin C, vitamin D, and zinc, comparing ivermectin + doxycycline (n=14), AZ (n=13), HCQ (n=14), and SOC (n=15), finding that all groups recover quickly, and there was no significant difference between the groups. Subject to the usual limitation of a database study, very small size, and limited evaluation of patients.
Mar 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.03.08.21252883v1, https://c19p.org/roy
Report on ivermectin prophylaxis in a hospital in Argentina showing lower cases for healthcare workers taking ivermectin. Results have been published in the press [lanacion.com.ar] (interim results), and a presentation posted online: [web.archive.org], however there is no formal publication to date. These results would be expected to receive priority publication due to the predicted impact on the pandemic and confirmation of previous prophylaxis studies. The lack of formal publication suggests a negative publication bias that may be due to politicization in the authors' location. Note that this prophylaxis study is different to the Vallejos early treatment trial.
Dec 2020, IVERCOR PREP, Preliminary Results, https://web.archive.org/web/20210226215453/https://twitter.com/Covid19Crusher/status/1365420061859717124, https://c19p.org/vallejos
600 patient ivermectin early treatment study: 92% lower mortality (p=0.03) and 93% lower hospitalization (p<0.0001).
Retrospective 600 PCR+ outpatients in Australia treated with ivermectin, zinc, and doxycycline, showing significantly lower mortality and hospitalization with treatment. This trial uses a synthetic control group, and the preliminary report provides minimal details. For discussion of the use of a synthetic control group, see [doyourownresearch.substack.com]. Notably, advantages include less-biased recruitment (patients do not opt-out if they feel they need treatment and don't want to risk placebo), trials are cheaper, there is less delay in treatment, and trials can be run where it is not ethical to give patients placebo.
Oct 2021, TrialSite News, https://www.trialsitenews.com/a/combination-therapy-for-covid-19-based-on-ivermectin-in-an-australian-population, https://c19p.org/borody
RCT 249 hospitalized patients with mild to moderate COVID-19 in Sri Lanka, showing statistically significant lower viral load. There was no significant difference in clinical outcomes. Only one patient had a serious outcome. Mid-recovery 11/15 symptoms showed lower scores with treatment on day 5 and on day 10. On day 10, 19% of treatment patients were asymptomatic vs. 13% of placebo patients. WHO score analysis is limited by the large percentage of missing data. Authors report that ivermectin blood levels taken before or with meals were not significantly different, however authors note that most patients consumed low fat meals. [Guzzo] show that absorption of ivermectin was significantly higher when administered following a high-fat meal.
Jul 2024, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09563-y, https://c19p.org/wijewickrema
Retrospective 717 patients in Brazil showing OR 1.17 [0.72-1.90] for ivermectin. This paper focuses on HCQ, event counts for ivermectin are not provided. With significant correlation between the variables used, including overlap in the prescription of multiple treatments that show efficacy alone, and limited data for the model size, the model used here may be inaccurate due to multicollinearity [statisticsbyjim.com].
Oct 2020, Travel Medicine and Infectious Disease, https://www.sciencedirect.com/science/article/abs/pii/S1477893920304026, https://c19p.org/fonsecai
Significantly improved recovery and significantly lower risk of long COVID with ivermectin, despite very late treatment, low-risk patients, and poor administration. 36% lower ongoing persistent COVID-19 specific symptoms, p 0.999), missing from the abstract (details below). The p values for sustained recovery, early sustained recovery, alleviation of all symptoms, and sustained alleviation are all The efficacy seen for ivermectin here is despite the trial being the most clearly designed to fail trial, with major bias in design, operation, analysis, and reporting. This trial is a great example of bias in clinical trials which will be covered in detail in the future. c19 early .org Molnupiravir PANORAMIC 30 , 31 Ivermectin PRINCIPLE 32 Investigator Prof. Chris Butler Prof. Chris Butler Delay ≤5 days from onset median 2 days ≤14 days from onset median unknown Population 50+ or 18+ w/comorbidities 18+ (mid-trial change) Treatment 5 days, 2x per day 3 days, 1x per day, dose below real..
Feb 2024, J. Infection, https://www.sciencedirect.com/science/article/pii/S0163445324000641, https://c19p.org/principleivm
Retrospective 188 hospitalized patients in Pakistan, 90 treated with ivermectin, showing no significant differences with treatment. The ivermectin group had more severe disease (66% vs 58%, with 6x higher risk for severe disease patients), and more male patients (70% vs. 65%). Higher use of remdesivir and steroids in the ivermectin group also suggests that ivermectin was more likely to be given to patients in more severe condition. There were no side effects seen with ivermectin. Authors note that significantly improved ferritin levels were seen with treatment. Authors state that ivermectin patients received 2 12mg doses, 24 hours apart, but later state that the dosage was not standardized.
Jan 2022, Monaldi Archives for Chest Disease, https://monaldi-archives.org/index.php/macd/article/download/2062/1397, https://c19p.org/zubair
Small RCT of hospitalized patients in India with 19 ivermectin patients and 13 control patients, with all receiving SOC including HCQ, showing no significant differences. The patient population is biased because the study recruited patients that did not respond to standard treatment. Authors do not specify the treatment delay but it is likely relatively late because the patients had already undergone standard treatment. Criteria for discharge are not provided. The time of discharge status is not specified and may not have been an equal time since treatment initiation for all patients. Authors indicate 19 treatment and 16 control patients, but the results only show 13 control patients. Authors do not indicate why the other 3 are missing. Randomization in this small sample resulted in very large differences in the groups, with over twice as many in the ivermectin group with age >40, and the only 2 patients with age >60 both in the ivermectin group. Authors did not adjust for these..
Aug 2020, Paripex - Indian J. Research, https://www.worldwidejournals.com/paripex/recent_issues_pdf/2020/August/ivermectin-as-adjuvant-to-hydroxycholoroquine-in-patients-resistant-to-standard-treatment-for-sarscov2-results-of-an-openlabel-randomized-clinical-study_August_2020_1597492974_4801859.pdf, https://c19p.org/kishoria
Retrospective 1,418 very late stage (46% mortality) patients in Peru, showing higher mortality with ivermectin. There is strong confounding by indication, for example 48% of patients with baseline SpO2 <70% were treated compared with 22% for SpO2 >95%. The more extreme Cox result compared to the event counts also supports this. There may also be significant confounding by time with SOC changing substantially over the first few months of the pandemic. Patients may overlap with those in [Soto-Becerra]. The results in the table and text do not match.
Mar 2022, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264789, https://c19p.org/soto
Retrospective 230 hospitalized patients in Brazil showing no significant difference with ivermectin treatment. Authors note that the treatments were more likely to be offered to sicker patients. Authors note that they do not know if treatment was started before or after ICU admission and intubation. Baseline total chest CT opacities were higher for ivermectin (20% vs. 15%). 25% of control patients were admitted within 3 days, compared to 5 days for ivermectin. Only 38% of patients in the ivermectin arm were treated within 7 days, compared to 61% for HCQ. These are consistent with ivermectin being used for more severe patients. Dosage is unknown.
Nov 2021, Revista da Associação Médica Brasileira, https://www.scielo.br/j/ramb/a/kzbmDvJqjJdQR9GfqK65CZs/, https://c19p.org/ferreira2
RCT with 501 relatively low-risk outpatients in Argentina showing hospitalization OR 0.65 [0.32-1.31]. With only 7% hospitalization, this trial is underpowered. The trial primarily includes low-risk patients that recover quickly without treatment, leaving minimal room for improvement with treatment. 74 patients had symptoms for >= 7 days. Among the 7 patients requiring ventilation, authors note that the earlier requirement in the ivermectin group may be due to those patients having higher severity at baseline. However, authors know the answer to this - it is unclear why it is not reported. There were more adverse events in the placebo group than the ivermectin group, suggesting a possible issue with dispensing or non-trial medication usage. 25+% of patients were hospitalized within 2/3 days for the placebo/treatment groups (Figure S2). The companion prophylaxis study IVERCOR PREP has reported results in the press and an online presentation 75 , 76 , however these results have not yet..
Jul 2021, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06348-5, https://c19p.org/vallejos2
RCT 549 low risk outpatients in Iran. Reported outcomes are very different from the pre-specified outcomes [irct.ir]. The inpatient trial is listed separately. The pre-specified primary clinical outcome was not reported. The reported components of this outcome are both positive. Pre-specified outcomes (3 not reported) [irct.ir]: - reduction in persistent cough and tachypnea and O2 saturation above 94% - not reported - negative PCR - reported - main complaints recovery time - not reported (only individual symptoms) - hospitalization - reported - time to hospitalization - not reported - mortality - reported - side effects - reported in only one patient (anomalous) A new outcome "relative recovery" is reported but not mentioned in the trial registration. The reported percentages and RR do not match. Authors include a researcher caught on video admitting that conclusions on ivermectin research were influenced by a funder [c19ivm.org]. Most/many patients were also treated with..
Jun 2022, Frontiers in Medicine, https://www.frontiersin.org/articles/10.3389/fmed.2022.919708/full, https://c19p.org/rezai3
Early terminated 89 patient RCT with 29 high dose and 32 very high dose ivermectin patients, showing dose dependent viral load reduction, although not reaching statistical significance due to early termination. Since most patients have low viral load at day 7, there is little room for improvement with a treatment at day 7. Intermediate results may show significantly greater improvement, but are not provided. Authors note that ivermectin remained safe even at the very high dose used, although tolerability was reduced. Adherence was very low in the very high dose arm (~60%). The paper reports 4 SAEs, all resolved, with 3 patients hospitalized in the very high dose ivermectin arm, 1 in the high dose arm, and 0 in the control arm. However, the supplementary data is contradictory, showing 2 grade 3 events in both ivermectin arms (2 infections and infestations, and 2 COVID-19 pneumonia). While this result is not statistically significant, it may be in part due to randomization failure..
Sep 2021, Int. J. Antimicrobial Agents, https://www.sciencedirect.com/science/article/pii/S0924857921013571, https://c19p.org/buonfrate
COVID-OUT remote RCT, showing no significant differences compared to a combined metformin/placebo "control" group. Results for other treatments are listed separately - metformin , fluvoxamine . Authors include metformin patients in the control group, allowing details of adjustments to affect results. Using standard treatment vs. placebo analysis shows 61% lower hospitalization, or 75% lower for patients with onset ≤5 days (not statistically significant with only 7 and 5 events). These results are not reported in the paper or the supplementary appendix, readers need to request the data. Authors note that "hospitalization is perhaps the most accurate and well-documented end point". There are many major issues as detailed below. We provide more detailed analysis of this study due to widespread incorrect press. Submit Updates or Corrections Severity Issue CRITICAL 1. Ivermectin vs. placebo analysis - 61% lower hospitalization CRITICAL 2. Severity mismatch for ivermectin treatment but not..
Aug 2022, NEJM, https://www.nejm.org/doi/10.1056/NEJMoa2201662, https://c19p.org/covidoutivm
RCT in Iran showing shorter time to recovery and shorter hospitalization time with ivermectin. There were no adverse effects. There was one death in the treatment group, the patient was in critical condition at baseline and died within 24 hours of admission. Also see [sciencedirect.com] and the author response [clinicaltherapeutics.com].
Jan 2021, Clinical Therapeutics, https://www.sciencedirect.com/science/article/abs/pii/S0149291821002010, https://c19p.org/shahbaznejad
Retrospective 266 COVID-19 ICU patients in India, showing significantly lower mortality with PVP-I oral gargling and topical nasal use, and non-statistically significant higher mortality with ivermectin and lower mortality with remdesivir.
Dec 2021, Cureus, https://www.cureus.com/articles/73667-determinants-of-outcome-among-critically-ill-police-personnel-with-covid-19-a-retrospective-observational-study-from-andhra-pradesh-india, https://c19p.org/jamir
RCT very low risk patients (mean age 35.7, SpO2 97.4) showing no significant differences with rapid recovery and almost no progression in both groups. The groups were unbalanced. There were 41% more patients with dyspnea at baseline in the treatment group. Similarly, at baseline patients with 4+ symptoms scored 2+ were more common in the treatment group - 7% for ivermectin vs. 4% for placebo. Table S8 shows only one case of COVID-19 pneumonia. Authors report 3 and 1 cases of progression, this matches the 3 and 1 cases of the adverse event "COVID-19" in Table S8. It's unclear how the COVID-19 adverse events were defined since all patients are meant to have COVID-19. Authors definition of progression includes "use of COVID-19 therapeutic agents" and therefore the significance for progression of disease is not clear. The study is designed to produce a null result with very low risk patients, administration on an empty stomach, the primary outcome including symptoms..
Sep 2022, J. Infection and Chemotherapy, https://www.sciencedirect.com/science/article/pii/S1341321X23003161, https://c19p.org/mikamo
Small low-risk patient RCT with 30 low-dose ivermectin and 26 control patients, with no primary outcome events in either arm. Viral load was significantly better with ivermectin on day 5, while there was no significant difference on day 1 or day 14. There was no significant difference in combined symptoms, however authors include cough which was the most frequent symptom and may persist long after infection has been cleared. Ivermectin patients were 4 years older with a higher standard deviation, had higher prevalence of obesity, diabetes, hypertension, and cardiovascular disease, and lower prevalence of hepatic and kidney disease. SOC included acetaminophen, which has . The slow viral clearance seen may be in part due to acetaminophen use. Authors conclude that "ivermectin is not effective to prevent progression to a severe state", however there was no progression to severe in either group. Authors report 92.9% of ivermectin patients compliant with the symptom diary,..
May 2022, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07890-6, https://c19p.org/delarocha
Proof of concept RCT with 30 ivermectin patients and 15 control patients, showing a concentration dependent antiviral activity, but no significant difference in clinical outcomes. There was no significant difference in viral load reduction between groups overall, but a significant difference was found in patients with higher median plasma ivermectin levels (72% vs. 42%, p=0.004). Mean ivermectin plasma concentration levels correlated with viral decay rate (r=0.47, p=0.02). The change in viral load is provided for the <160ng/mL and >160ng/mL groups, but not the overall treatment group. The corrigendum provides individual viral decay rates for computing the overall treatment group viral decay rate. Authors published a corrigendum: [sciencedirect.com].
Jun 2021, eClinicalMedicine, https://www.sciencedirect.com/science/article/pii/S258953702100239X, https://c19p.org/krolewiecki
RCT low-risk outpatients with very late treatment (median 6 days, 25% ≥8 days) in the USA, showing 98% probability of efficacy for clinical progression at day 14, a treatment delay-response relationship, and significant efficacy for patients with severe symptoms at baseline. The posterior probability ivermectin is effective was 99%, 98%, 97% for mean time unwell and clinical progression @14 and 7 days. All exceed the pre-specified threshold for superiority 80 . Note that the clinical progression results exceeding the superiority threshold in the preprint 81 changed in the journal version for the 400µg/kg arm, with no explanation for over 700 days). The 600µg/kg arm was reported separately 82 . When not specified, comments refer to the 400µg/kg arm. We provide more detailed analysis of this study due to widespread incorrect press. There was one death reported in each of the 400µg/kg and 600µg/kg ivermectin arms. For 400µg/kg, the patient did not take ivermectin. For 600µg/kg, authors..
Jun 2022, JAMA, https://jamanetwork.com/journals/jama/fullarticle/2797483, https://c19p.org/activ6ivm
RCT low risk hospitalized patients in Thailand showing no significant difference with the addition of ivermectin to favipiravir based SOC. Only the abstract is currently available. The trial was registered retrospectively [thaiclinicaltrials.org]. The primary outcome was WHO-category ordinal scale improvement of 2 points at days 3, 7, 14, 21, for which only a single unspecified time point (when almost all patients have recovered) is provided in the abstract (details may be in the full paper). The registration indicates that the intervention was only provided "after laboratory result", without explanation.
Dec 2022, Infection & Chemotherapy, https://icjournal.org/DOIx.php?id=10.3947/ic.2022.0127, https://c19p.org/sarojvisut
1. Chahla et al., Intensive Treatment With Ivermectin and Iota-Carrageenan as Pre-exposure Prophylaxis for COVID-19 in Health Care Workers From Tucuman, Argentina
234 patient ivermectin prophylaxis RCT: 95% fewer moderate/severe cases (p=0.002) and 84% fewer cases (p=0.004).Prophylaxis RCT for ivermectin and iota-carrageenan in Argentina, 117 healthcare workers treated with ivermectin and iota-carrageenan, and 117 controls, showing significantly lower cases with treatment. There were no moderate/severe cases with treatment vs. 10 in the control group. There were 4 cases with treatment (all mild) vs. 25 for the control group.
Jan 2021, American J. Therapeutics, https://journals.lww.com/10.1097/MJT.0000000000001433, https://c19p.org/ivercartuc
2. Desort-Henin et al., The SAIVE Trial, Post-Exposure use of ivermectin in Covid-19 prevention: Efficacy and Safety Results
399 patient ivermectin prophylaxis RCT: 96% fewer cases (p<0.0001).PEP RCT 399 patients in Bulgaria showing significantly lower COVID-19 cases with ivermectin prophylaxis, and significantly lower cases with high viral load. No participant had severe symptoms, required oxygen, or was hospitalized. All patients with COVID-19 were treated with vitamin C and vitamin D. This trial makes the Cochrane analysis report statistically significant efficacy for prophylaxis, although they do not appear to have acknowledged this yet. There are currently 4 prophylaxis RCTs, and all 4 show statistically significant efficacy of ivermectin. Cochrane ignored them by simply choosing to only include post-exposure prophylaxis RCTs, even though they were included for the paxlovid analysis with many of the same authors. At the time there were no post-exposure RCTs and they knew that including any one of the 3 pre-exposure prophylaxis RCTs would show statistically significant efficacy.
Jan 2023, ECCMID 2023, https://www.medincell.com/wp-content/uploads/2024/03/Poster-SAIVE-April2023-OK3.pdf, https://c19p.org/desorthenin
3. Mahmud et al., Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial
366 patient ivermectin early treatment RCT: 86% lower mortality (p=0.25), 57% lower progression (p=0.001), 94% improved recovery (p<0.0001), and 39% improved viral clearance (p=0.002).RCT for ivermectin+doxycycline showing improvements in mortality, recovery, progression, and virological cure. 183 treatment and 183 control patients with no deaths in the treatment arm vs. 3 in the control arm (the 3 control deaths are not included in the analysis of other outcomes). Results may reflect the use of ivermectin, doxycycline, and potential synergistic effects of the combination. In the PRINCIPLE trial, no mortality benefit was seen for doxycycline alone [thelancet.com] (0.6% mortality with doxycycline vs. 0.2% control).
Oct 2020, J. Int. Medical Research, https://journals.sagepub.com/doi/10.1177/03000605211013550, https://c19p.org/mahmud
89 patient ivermectin early treatment RCT: 70% lower hospitalization (p=0.34) and 62% improved viral clearance (p=0.02).
Double blind RCT for mild-moderate COVID-19 outpatients in Israel showing significantly faster reduction in viral load with treatment, and lower hospitalization with treatment. The one treatment hospitalization was a few hours after treatment and the patient improved and was discharged quickly. Authors also examine culture viability on days 2-6, with 13% positive in the ivermectin group vs. 48% in the control group. There were no safety issues. Ivermectin was taken one hour before a meal. Sheba IRB-7156/20.
Feb 2021, Int. J. Infectious Diseases, https://www.sciencedirect.com/science/article/pii/S120197122200399X, https://c19p.org/biber
5. Shouman et al., Use of Ivermectin as a Potential Chemoprophylaxis for COVID-19 in Egypt: A Randomised Clinical Trial
304 patient ivermectin prophylaxis RCT: 91% fewer symptomatic cases (p=0.001) and 93% lower severe cases (p=0.002).PEP trial for asymptomatic close contacts of COVID-19 patients, 203 ivermectin patients and 101 control patients. 7.4% of contacts developed COVID-19 in the ivermectin group vs. 58.4% in the control group. Efficacy for symptomatic cases and severe cases is very similar. Adjusted results are provided only for symptomatic cases. See also [trialsitenews.com].
Aug 2020, J. Clinical and Diagnostic Research, https://www.jcdr.net/articles/PDF/14529/46795_CE[Ra]_F(Sh)_PF1(SY_OM)_PFA_(OM)_PN(KM).pdf, https://c19p.org/shouman
6. Chahla et al., Randomized trials - Ivermectin repurposing for COVID-19 treatment of outpatients with mild disease in primary health care centers
254 patient ivermectin early treatment RCT: 87% higher hospital discharge (p=0.004).Cluster RCT outpatients in Argentina showing significantly faster recovery with ivermectin. There were no deaths. Outpatients in Tucumán were assigned to the ivermectin group and outpatients from San Miguel de Tucumán and Gran San Miguel de Tucumán were assigned to the control group. All comorbidities, percentage of male patients, and age were higher in the ivermectin group, favoring the control group.
Mar 2021, Research, Society and Development, https://rsdjournal.org/index.php/rsd/article/view/30844, https://c19p.org/chahla
248 patient ivermectin late treatment study: 87% lower mortality (p=0.02), 89% lower ICU admission (p=0.007), 83% lower progression (p=0.0004), and 87% improved recovery (p=0.02).
Retrospective 115 ivermectin patients and 133 control patients showing significantly lower death and faster viral clearance. Some potential issues and the authors' response can be found in [sciencedirect.com, sciencedirect.com].
Sep 2020, Archivos de Bronconeumología, https://www.archbronconeumol.org/en-ivermectin-treatment-may-improve-prognosis-articulo-S030028962030288X, https://c19p.org/khan
8. Seet et al., Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial
1,236 patient ivermectin prophylaxis RCT: 50% fewer symptomatic cases (p=0.0009) and 6% fewer cases (p=0.61).Prophylaxis RCT in Singapore with 3,037 low risk patients, showing lower serious cases, lower symptomatic cases, and lower confirmed cases of COVID-19 with all treatments (ivermectin, HCQ, PVP-I, and Zinc + vitamin C) compared to vitamin C. The ivermectin dosage was low for 42 days prophylaxis - only a single dose of 200µg/kg, with a maximum of 12mg. Meta-analysis of vitamin C in 6 previous trials shows a benefit of 16%, so the actual benefit of ivermectin, HCQ, and PVP-I may be higher. Cluster RCT with 40 clusters. There were no hospitalizations and no deaths.
Apr 2021, Int. J. Infectious Diseases, https://www.ijidonline.com/article/S1201-9712(21)00345-3/fulltext, https://c19p.org/seet
114 patient ivermectin early treatment RCT: 63% improved recovery (p=0.0001) and 79% improved viral clearance (p=0.004).
RCT 114 patients in Egypt, 57 treated with ivermectin mucoadhesive nanosuspension intranasal spray, showing faster recovery and viral clearance with treatment. NCT04716569.
Jun 2021, Int. J. Nanomedicine, https://www.dovepress.com/clinical-biochemical-and-molecular-evaluations-of-ivermectin-mucoadhes-peer-reviewed-fulltext-article-IJN, https://c19p.org/aref
10. Ahmed et al., A five day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness
72 patient ivermectin early treatment RCT: 85% improved symptoms (p=0.09), 76% improved viral clearance (p=0.03), and 1% shorter hospitalization.Small 72 patient RCT of ivermectin and ivermectin + doxycycline showing faster recovery with ivermectin. The ivermectin + doxycycline group uses only a single dose of ivermectin vs. 5 daily doses for the ivermectin group. PCR testing was only done weekly after day 7, therefore hospitalization time may not match symptomatic recovery. Ivermectin group: 12mg daily for 5 days Ivermectin + doxycycline: 12mg ivermectin single dose, 200mg doxycycline + 100mg bid 4 days
Dec 2020, Int. J. Infectious Diseases, https://www.sciencedirect.com/science/article/pii/S1201971220325066, https://c19p.org/ahmed
11. Shimizu et al., Ivermectin administration is associated with lower gastrointestinal complications and greater ventilator-free days in ventilated patients with COVID-19: A propensity score analysis
88 patient ivermectin late treatment study: 100% lower mortality (p=0.001), 48% lower ventilation (p=0.03), 43% lower ICU admission (p=0.06), and 78% lower progression (p=0.03).Retrospective 88 ventilated COVID-19 patients in Japan, 39 treated with ivermectin within 3 days of admission, showing significantly reduced incidence of GI complications and mortality, and increased ventilator-free days with treatment.
Dec 2021, J. Infection and Chemotherapy, https://www.jiac-j.com/article/S1341-321X(21)00360-3/fulltext, https://c19p.org/shimizu
12. Varnaseri et al., Ivermectin as a Potential Addition to the Limited Anti-COVID-19 Arsenal: A Double-Blinded Clinical Trial
110 patient ivermectin late treatment RCT: 82% lower ventilation (p=0.02), 83% lower ICU admission (p=0.0004), 33% shorter hospitalization (p=0.001), and 28% faster recovery (p<0.0001).Double-blind RCT 110 hospitalized moderate to severe COVID-19 patients showing significantly reduced ICU admission, shorter hospitalization, faster resolution of symptoms, and improved CRP and LDH levels with ivermectin treatment compared to placebo. No deaths occurred in either group. There were no serious adverse events. Note that preclinical research predicts synergistic effects with the standard treatment protocol used in both groups.
Apr 2024, Jundishapur J. Health Sciences, https://brieflands.com/articles/jjhs-146703, https://c19p.org/varnaseri
490 patient ivermectin late treatment RCT: 69% lower mortality (p=0.09), 59% lower ventilation (p=0.17), 22% lower ICU admission (p=0.79), and 31% lower progression (p=0.29).
RCT 490 late stage (>65% lung change chest radiography at baseline) hospitalized patients in Malaysia, showing no significant differences. Mortality was 1.2% for ivermectin vs. 4% for control. If the same event rates continue, the trial would need to add ~13% more patients to reach statistical significance. i.e., by continuing the trial for ~2 weeks, there is a reasonable chance of the result being a statistically significant ~69% reduction in mortality, which would equate to ~4 million lives saved if adopted at the start of the pandemic. The mortality reduction is consistent with the results from all trials to date. While not reaching the significance threshold with the specified test, Bayesian analysis shows a 97% probability that ivermectin reduces mortality [normanfenton.com]. Authors describe the mortality results as "similar" and they are not mentioned in the visual abstract or the conclusion, suggesting substantial investigator bias with a preference for a null..
Nov 2021, JAMA, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2789362, https://c19p.org/lim
14. Okumuş et al., Evaluation of the Effectiveness and Safety of Adding Ivermectin to Treatment in Severe COVID-19 Patients
60 patient ivermectin late treatment RCT: 33% lower mortality (p=0.55), 43% greater improvement (p=0.18), and 80% improved viral clearance (p=0.02).Small RCT for severe COVID-19 comparing the addition of ivermectin to SOC (low dose HCQ+AZ+favipiravir), with 30 treatment and 30 control patients in Turkey, showing lower mortality and faster clinical recovery. Authors also investigate the presence of gene mutations that alter ivermectin metabolism, predicting that ivermectin can be used safely without serious side effects in patients without MDR-1/ABCB1 and/or CYP3A4 gene mutation, and recommending monitoring and appropriate treatment if necessary when sequencing is unavailable. NCT04646109.
Jan 2021, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06104-9, https://c19p.org/okumus
15. Ravikirti et al., Ivermectin as a potential treatment for mild to moderate COVID-19: A double blind randomized placebo-controlled trial
112 patient ivermectin early treatment RCT: 89% lower mortality (p=0.12), 79% lower ventilation (p=0.1), 14% lower ICU admission (p=0.8), and 89% higher hospital discharge (p=0.12).RCT with 112 mild and moderate COVID-19 patients in India, showing lower mortality, ventilation, and ICU admission, although not statistically significant due to the small number of events. There was no mortality in the treatment arm (55 patients) versus 7% (4 of 57) in the control arm. The PCR result is subject to confounding by biased loss of followup, with 23 lost in the treatment group and 13 in the control group, and 8 more people in the treatment group discharged before day 6.
Jan 2021, J. Pharmacy & Pharmaceutical Sciences, https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/32105, https://c19p.org/ravikirti
16. Mayer et al., Safety and Efficacy of a MEURI Program for the Use of High Dose Ivermectin in COVID-19 Patients
21,232 patient ivermectin early treatment study: 55% lower mortality (p<0.0001) and 66% lower ICU admission (p<0.0001).Retrospective 21,232 patients in Argentina, 3,266 assigned to ivermectin treatment, showing lower mortality with treatment. Greater benefits were seen for patients >40, and a dose dependent response was found. For more discussion see [twitter.com].
Sep 2021, Frontiers in Public Health, https://www.frontiersin.org/articles/10.3389/fpubh.2022.813378/full, https://c19p.org/mayer
17. Aref et al., Possible Role of Ivermectin Mucoadhesive Nanosuspension Nasal Spray in Recovery of Post-COVID-19 Anosmia
96 patient ivermectin long COVID RCT: 74% faster recovery (p=0.0005).96 patient RCT showing faster resolution of post-COVID anosmia with an ivermectin nanosuspension nasal spray.
Sep 2022, Infection and Drug Resistance, https://www.dovepress.com/possible-role-of-ivermectin-mucoadhesive-nanosuspension-nasal-spray-in-peer-reviewed-fulltext-article-IDR, https://c19p.org/aref2
18. Mondal et al., Prevalence of COVID-19 Infection and Identification of Risk Factors among Asymptomatic Healthcare Workers: A Serosurvey Involving Multiple Hospitals in West Bengal
1,470 patient ivermectin prophylaxis study: 88% fewer symptomatic cases (p=0.006).Retrospective 1,470 healthcare workers in India, showing significantly lower risk of symptomatic COVID-19 with ivermectin prophylaxis.
May 2021, J. the Indian Medical Association, https://onlinejima.com/read_journals.php?article=683, https://c19p.org/mondal
19. Behera et al., Prophylactic Role of Ivermectin in Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Healthcare Workers
3,346 patient ivermectin prophylaxis study: 83% fewer cases (p=0.001).Prospective prophylaxis study with 3,532 healthcare workers, 2,199 receiving two-dose ivermectin prophylaxis, showing adjusted relative risk of confirmed COVID-19 with treatment 0.17 [0.12-0.23] p<0.001. 186 patients took only the first dose, and no significant difference was observed for this group. The same group published an earlier small study with 117 ivermectin patients. There were no serious adverse events. T/IM-NF/CM&FM/20/142.
Feb 2021, Cureus, https://www.cureus.com/articles/64807-prophylactic-role-of-ivermectin-in-severe-acute-respiratory-syndrome-coronavirus-2-infection-among-healthcare-workers, https://c19p.org/behera2
20. Alam et al., Ivermectin as Pre-exposure Prophylaxis for COVID-19 among Healthcare Providers in a Selected Tertiary Hospital in Dhaka – An Observational Study
118 patient ivermectin prophylaxis study: 91% fewer cases (p<0.0001).91% reduction in COVID-19 cases with ivermectin prophylaxis. 118 healthcare workers in Bangladesh, 58 receiving ivermectin 12mg monthly, showing RR 0.094, p < 0.0001.
Dec 2020, European J. Medical and Health Sciences, https://ejmed.org/index.php/ejmed/article/view/599, https://c19p.org/alam2
21. Behera et al., Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study
372 patient ivermectin prophylaxis study: 54% fewer cases (p=0.0007).Retrospective matched case-control prophylaxis study for HCQ, ivermectin, and vitamin C with 372 healthcare workers, showing lower COVID-19 incidence for all treatments, with statistical significance reached for ivermectin. HCQ OR 0.56, p = 0.29 Ivermectin OR 0.27, p < 0.001 Vitamin C OR 0.82, p = 0.58
Nov 2020, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247163, https://c19p.org/beherai
22. Morgenstern et al., Ivermectin as a SARS-CoV-2 Pre-Exposure Prophylaxis Method in Healthcare Workers: A Propensity Score-Matched Retrospective Cohort Study
542 patient ivermectin prophylaxis PSM study: 74% fewer cases (p=0.008).Propensity matched retrospective prophylaxis study of healthcare workers in the Dominican Republic showing significantly lower cases with treatment, and no hospitalization with treatment (versus 2 in the PSM matched control group). The cases with treatment were mostly in the first week, with only one case in the second and third weeks, and none in the fourth week. There were no severe side effects. In post-hoc analysis, as the treatment group discontinued treatment over time, their protection also decreased. NCT04832945.
Apr 2021, Cureus, https://www.cureus.com/articles/63131-ivermectin-as-a-sars-cov-2-pre-exposure-prophylaxis-method-in-healthcare-workers-a-propensity-score-matched-retrospective-cohort-study, https://c19p.org/morgenstern2
23. Mohan et al., Single-dose oral ivermectin in mild and moderate COVID-19 (RIVET-COV): a single-centre randomized, placebo-controlled trial
157 patient ivermectin early treatment RCT: 62% improved recovery (p=0.27) and 24% improved viral clearance (p=0.18).RCT in India with low risk patients, comparing 24mg ivermectin, 12mg ivermectin, and placebo showing non-statistically significant improvements in recovery and PCR+ status (day 5 both arms, day 7 24mg only) with treatment, and showing greater improvement for the higher dose arm. Viral load decline was similar in all arms - absolute values are lower for ivermectin in a dose-dependent manner, however the baseline value for the ivermectin groups was lower, leaving less room for change. There were no deaths or use of mechanical ventilation. There were no serious adverse events. Note that our pre-specified protocol prioritizes clinical outcomes over PCR results.
Feb 2021, J. Infection and Chemotherapy, https://www.sciencedirect.com/science/article/pii/S1341321X21002397, https://c19p.org/mohan
24. Lima-Morales et al., Effectiveness of a multidrug therapy consisting of ivermectin, azithromycin, montelukast and acetylsalicylic acid to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico
768 patient ivermectin late treatment study: 78% lower mortality (p=0.001), 52% lower ventilation (p=0.15), 67% lower hospitalization (p=0.001), and 59% improved recovery (p=0.001).Prospective trial of 768 COVID-19 outpatients in Mexico, 481 treated with ivermectin, AZ, montelukast, and aspirin, and 287 control patients with various treatments, showing significantly lower mortality and hospitalization, and significantly higher recovery at 14 days with treatment.
Feb 2021, Int. J. Infectious Diseases, https://www.sciencedirect.com/science/article/pii/S1201971221001004, https://c19p.org/limamorales
25. Faisal et al., Potential use of azithromycin alone and in combination with ivermectin in fighting against the symptoms of COVID-19
100 patient ivermectin early treatment RCT: 68% improved recovery (p=0.005).RCT 100 outpatients in Pakistan, 50 treated with ivermectin, showing faster recovery with ivermectin. All patients received AZ, zinc, vitamin C, vitamin D, and paracetemol. Details of randomization were not provided. No mortality or hospitalization was reported.
May 2021, The Professional Medical J., http://theprofesional.com/index.php/tpmj/article/view/5867, https://c19p.org/faisal
26. de Jesús Ascencio-Montiel et al., A Multimodal Strategy to Reduce the Risk of Hospitalization/death in Ambulatory Patients with COVID-19
28,048 patient ivermectin early treatment study: 59% lower combined mortality/hospitalization (p<0.0001), 15% lower mortality (p=0.16), 9% lower ventilation (p=0.51), and 48% lower hospitalization (p<0.0001).Retrospective 28,048 COVID+ patients in Mexico, 7,898 receiving a treatment kit including low dose ivermectin, AZ, aspirin, and acetaminophen, shower lower mortality/hospitalization for those receiving the kit. Delivery of the treatment kit was based on availability in the medical units. Adherence is unknown and may be low. Adjusted results are only provided for combined mortality/hospitalization.
Jan 2022, Archives of Medical Research, https://www.sciencedirect.com/science/article/pii/S0188440922000029, https://c19p.org/dejesusascenciomontiel
27. George et al., Single Dose of Ivermectin is not Useful in Patients with Hematological Disorders and COVID-19 Illness: A Phase II B Open Labelled Randomized Controlled Trial
112 patient ivermectin late treatment RCT: 30% lower mortality (p=0.55), 19% faster recovery (p=0.37), 33% lower progression (p=0.41), and 33% worse viral clearance (p=0.5).RCT with 35 single dose 24mg, 38 single dose 12mg, and 39 SOC hospitalized patients with hematological illnesses in India, showing no significant differences. Results were better for 24mg vs. 12mg for all symptomatic outcomes. Viral clearance results do not follow the randomization with less than 50% of patients tested at day 7, and no adjusted results are provided. Results were obtained for only 43.8% of ivermectin patients and 56.4% of control patients at day 7 and may not be comparable due to the large difference in the percentage of patients tested. Lower test coverage in the ivermectin group is likely related to faster recovery. Ct 40 for E or S was used for viral clearance which may also have low relevance to infectious disease.
May 2022, Indian J. Hematology and Blood Transfusion, https://link.springer.com/10.1007/s12288-022-01546-w, https://c19p.org/george
28. Manomaipiboon et al., Efficacy and safety of ivermectin in the treatment of mild-to-moderate COVID-19 infection: A randomized, double blind, placebo, controlled trial
72 patient ivermectin early treatment RCT: 43% improved recovery (p=0.26) and 5% improved viral clearance (p=1).Small RCT with 72 low-risk patients in Thailand, showing improved recovery with ivermectin, without statistical significance. All patients recovered and there was no escalation of care in either group. There were no adverse events.
Feb 2022, Trials, https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-022-06649-3, https://c19p.org/manomaipiboon
29. Bernigaud et al., Ivermectin benefit: from scabies to COVID-19, an example of serendipity
3,131 patient ivermectin prophylaxis study: 99% lower mortality (p=0.08) and 55% fewer cases (p=0.01).69 residents of a French care home, median age 90, were treated with ivermectin for a scabies outbreak. 3,062 residents in 45 nearby comparable homes were used as controls. 7 of 69 treated patients had probable or certain COVID-19, with no serious cases and no deaths. In comparable care homes in the same district, matched by age and socio-economic level, there was 22.6% COVID-19 and 5% death.
Nov 2020, Annals of Dermatology and Venereology, https://www.sciencedirect.com/science/article/pii/S015196382030627X, https://c19p.org/bernigaud
30. Mirahmadizadeh et al., Efficacy of single-dose and double-dose ivermectin early treatment in preventing progression to hospitalization in mild COVID-19: A multi-arm, parallel-group randomized, double-blind, placebo-controlled trial
261 patient ivermectin early treatment RCT: 67% lower ventilation (p=0.37), 46% lower hospitalization (p=0.22), and 39% improved recovery (p=0.27).RCT with 131 24mg ivermectin, 130 12mg ivermectin, and 130 placebo patients, showing no significant differences in outcomes. Lower ventilation and hospitalization was seen with treatment, in a dose-dependent manner, but not reaching statistical significance with the small number of events.
Jun 2022, Respirology, https://onlinelibrary.wiley.com/doi/10.1111/resp.14318, https://c19p.org/mirahmadizadeh
31. Mourya et al., Comparative Analytical Study of Two Different Drug Regimens in Treatment of Covid 19 Positive Patients in Index Medical College Hospital and Research Center, Indore, India
100 patient ivermectin early treatment study: 89% improved viral clearance (p<0.0001).Retrospective 100 patients in India with 50 treated with ivermectin, and SOC for all patients including HCQ+AZ, showing much higher viral clearance with ivermectin. Baseline clinical status was worse in the control group. Time of testing after treatment initiation was longer in the control group (mean 7.24 days versus 5.22 days).
Mar 2021, Int. J. Health and Clinical Research, https://ijhcr.com/index.php/ijhcr/article/view/1263, https://c19p.org/mourya
32. Rajter et al., Use of Ivermectin is Associated with Lower Mortality in Hospitalized Patients with COVID-19 (ICON study)
280 patient ivermectin late treatment PSM study: 46% lower mortality (p=0.05) and 64% lower ventilation (p=0.1).Retrospective 280 hospitalized patients showing lower mortality with ivermectin (13.3% vs 24.5%), propensity matched odds ratio OR 0.47 [0.22-0.99], p=0.045.
Oct 2020, Chest, https://www.sciencedirect.com/science/article/pii/S0012369220348984, https://c19p.org/rajter
33. Bukhari et al., Efficacy of Ivermectin in COVID-19 Patients with Mild to Moderate Disease
86 patient ivermectin early treatment RCT: 82% improved viral clearance (p<0.0001).RCT of relatively low risk hospitalized patients with 50 ivermectin and 50 control patients showing significantly faster viral clearance with treatment. 9 patients in the treatment arm were lost to followup compared with 5 in the control arm, which could be in part due to faster recovery with treatment. There were no safety concerns. No mortality was reported. The numbers in Table 3 are the number of patients that became negative on that day, i.e., non-cumulative. SOC included vitamin C and vitamin D. NCT04392713.
Jan 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.02.02.21250840v1, https://c19p.org/bukhari
34. Babalola et al., Ivermectin shows clinical benefits in mild to moderate COVID19: A randomised controlled double-blind, dose-response study in Lagos
60 patient ivermectin early treatment RCT: 64% improved viral clearance (p=0.11) and 41% improved recovery (p=0.07).Small RCT comparing ivermectin 6mg & 12mg q84hr with lopinavir/ritonavir, showing a statistically significant and dose dependent effect of ivermectin on reducing the time to PCR-. The study does not report mortality, hospitalization, progression, recovery, etc. The paper does report change in SpO2 (Figure 3, ∆Spo2), where a similar improvement with a smaller p value is seen with ivermectin, however this result is unadjusted and there are large differences between groups. Specifically, baseline SpO2 is lower in the control group, giving the control group more room to improve, therefore the actual benefit of ivermectin is likely to be even larger than the benefit in ∆SpO2 shown. See also [doyourownresearch.substack.com].
Jan 2021, QJM: An Int. J. Medicine, https://academic.oup.com/qjmed/advance-article/doi/10.1093/qjmed/hcab035/6143037, https://c19p.org/babalola
35. Chowdhury et al., A Comparative Study on Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin Therapy on COVID-19 Patients
116 patient ivermectin early treatment RCT: 81% lower hospitalization (p=0.23), 46% improved recovery (p<0.0001), and 81% improved viral clearance (p=0.23).Small 116 patient RCT with low-risk patients comparing ivermectin+doxycycline and HCQ+AZ, showing lower hospitalization, higher viral clearance, and faster symptom resolution and viral clearance with ivermectin+doxycycline. Mid-recovery resolution of symptoms is statistically significantly better with treatment, while other measures do not reach statistical significance. Instructions were to take ivermectin on an empty stomach, reducing lung tissue concentration.
Jul 2020, Eurasian J. Medicine and Oncology, https://ejmo.org/10.14744/ejmo.2021.16263/, https://c19p.org/chowdhury
36. Kerr et al., Ivermectin Prophylaxis Used for COVID-19: A Citywide, Prospective, Observational Study of 223,128 Subjects Using Propensity Score Matching
159,561 patient ivermectin prophylaxis PSM study: 70% lower mortality (p<0.0001), 67% lower hospitalization (p<0.0001), and 44% fewer cases (p<0.0001).PSM retrospective 220,517 patients in Brazil,133,051 taking ivermectin as part of a citywide prophylaxis program, showing significantly lower hospitalization and mortality with treatment. Additional results are presented here: [odysee.com], including improved efficacy with analysis based on irregular/regular use, and a strong dose-response relationship. Confirmation from independent analysis of the raw data: [web.archive.org]. See [Mills] regarding [medrxiv.org].
Dec 2021, Cureus, https://www.cureus.com/articles/82162-ivermectin-prophylaxis-used-for-covid-19-a-citywide-prospective-observational-study-of-223128-subjects-using-propensity-score-matching, https://c19p.org/kerr
37. Hashim et al., Controlled randomized clinical trial on using Ivermectin with doxycycline for treating COVID-19 patients in Baghdad, Iraq
140 patient ivermectin late treatment RCT: 92% lower mortality (p=0.03), 83% lower progression (p=0.07), and 41% faster recovery (p=0.0001).RCT 70 ivermectin+doxycycline patients and 70 control patients showing reduced time to recovery and reduced mortality with treatment. Earlier treatment was more successful. For ethical reasons, critical patients were all in the treatment group. NCT04591600.
Oct 2020, Iraqi J. Medical Science, http://www.iraqijms.net/upload/pdf/iraqijms60db8b76d3b1e.pdf, https://c19p.org/hashim
38. Merino et al., Ivermectin and the odds of hospitalization due to COVID-19: evidence from a quasi-experimental analysis based on a public intervention in Mexico City
77,381 patient ivermectin early treatment study: 74% lower hospitalization (p=0.001).Analysis of Mexico City's use of an ivermectin-based medical kit, showing significantly lower hospitalization with use. Authors use logistic-regression models with matched observations, including adjustments for age, sex, COVID severity, and comorbidities. This preprint was censored by the original preprint host. Censors claim that the government treatment program, which used approved medications and saved over 500 people from hospitalization, was unethical. In part they also indicate that studies of "the effects of a medication on a disease outcome" are outside the scope of their site, however retroactively censoring a paper for this reason is not appropriate. The author's response (not provided by the censors) can be found here: [twitter.com]. Author's provide the data and code for the study, and the results have been independently verified. See also: [doyourownresearch.substack.com]. This study was censored.
May 2021, Preprint, http://web.archive.org/web/20211218011849/https://files.osf.io/v1/resources/r93g4/providers/osfstorage/609085945533b4031ee1c789?action=download&direct&version=1, https://c19p.org/merino
39. Ozer et al., Effectiveness and Safety of Ivermectin in COVID-19 Patients: A Prospective Study at A Safety-Net Hospital
120 patient ivermectin late treatment study: 75% lower mortality (p=0.09), 13% lower ventilation (p=0.2), and 9% longer hospitalization (p=0.09).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.
Nov 2021, J. Medical Virology, https://onlinelibrary.wiley.com/doi/10.1002/jmv.27469, https://c19p.org/ozer
40. Ochoa-Jaramillo et al., Clinical efficacy and safety of ivermectin (400 μg/kg, single dose) in patients with severe COVID-19: a randomized clinical trial
75 patient ivermectin late treatment RCT: 57% lower mortality (p=0.35), 34% higher ventilation (p=0.62), and 37% higher ICU admission (p=0.52).RCT 75 very late stage patients in Colombia, showing no significant difference in outcomes with a single dose of 400μg/kg ivermectin.
Oct 2022, Revista Infectio, http://revistainfectio.org/P_OJS/index.php/infectio/article/view/1105, https://c19p.org/ochoajaramillo
41. Espitia-Hernandez et al., Effects of Ivermectin-azithromycin-cholecalciferol combined therapy on COVID-19 infected patients: A proof of concept study
35 patient ivermectin early treatment study: 70% faster recovery (p=0.0001) and 97% improved viral clearance (p<0.0001).Small study with 28 patients treated with ivermectin + AZ + cholecalciferol and 7 control patients. All treated patients were PCR- at day 10 while all control patients remained PCR+. The mean duration of symptoms was 3 days in the treatment group and 10 days in the control group.
Aug 2020, Biomedical Research, https://www.biomedres.info/biomedical-research/effects-of-ivermectinazithromycincholecalciferol-combined-therapy-on-covid19-infected-patients-a-proof-of-concept-study-14435.html, https://c19p.org/espitiahernandez
42. Loue et al., Ivermectin and COVID-19 in Care Home: Case Report
25 patient ivermectin early treatment study: 70% lower mortality (p=0.34) and 55% lower severe cases (p=0.11).Small quasi-randomized (patient choice) study with 25 PCR+ patients in a nursing home offered ivermectin, of which 10 chose to be treated. The mean age was 83.5 in the treatment group and 81.8 in the control group. There was lower mortality and fewer serious cases with treatment.
Apr 2021, J. Infectious Diseases and Epidemiology, https://www.clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-7-202.php?jid=jide, https://c19p.org/loue
43. Osati et al., Clinical manifestations and mortality among hospitalized COVID-19 patients in Tanzania, 2021-2022.
1,387 patient ivermectin late treatment study: 32% lower mortality (p=0.02).Retrospective 1,387 hospitalized PCR confirmed COVID-19 patients in Tanzania, showing lower mortality with ivermectin treatment and with steroid treatment in multivariable analysis.
Jul 2023, medRxiv, https://www.medrxiv.org/content/10.1101/2023.07.13.23292643, https://c19p.org/osati
44. Efimenko et al., Treatment with Ivermectin Is Associated with Decreased Mortality in COVID-19 Patients: Analysis of a National Federated Database
41,608 patient ivermectin late treatment PSM study: 69% lower mortality (p<0.0001).PSM retrospective 41,608 patients in the USA, 1,072 treated with ivermectin and 40,536 treated with remdesivir, showing lower mortality with ivermectin treatment. This study was presented at a conference (IMED 2021). Submissions were peer-reviewed. The treatment/control group sizes align with the estimated percentage of hospitals that used ivermectin vs. remdesivir. Hospitals in the USA receive financial incentives to use remdesivir. Authors have self-censored the conference report of this result, not due to any error in the analysis, but because they believe ivermectin "has proven to be ineffective in clinical trials". This is incorrect, while some studies show no statistically significant effect, studies show statistically significant positive results for one or more outcomes ( prospective and retrospective studies, including RCTs). The self-censorship and decision not to submit to a journal provide further evidence of a negative publication bias for ivermectin research. This study was self-censored by the authors.
Feb 2022, Int. J. Infectious Diseases, https://www.sciencedirect.com/science/article/pii/S1201971221009887, https://c19p.org/efimenko
45. Huvemek et al., Kovid-19 - Huvemek® Phase 2 clinical trial
100 patient ivermectin late treatment RCT: 32% greater improvement (p=0.28).Multicenter double-blind RCT with 100 hospitalized patients in Bulgaria showing faster viral clearance, greater clinical improvement, and improved biomarkers with treatment. Limited data has been reported currently. No serious adverse events were observed.
Mar 2021, Huvemek, Press Release, https://huvemec.bg/covid-19-huvemec-klinichno-izpitanie/za-isledvaneto/, https://c19p.org/petkov
46. Rezai et al., Non-effectiveness of Ivermectin on Inpatients and Outpatients With COVID-19; Results of Two Randomized, Double-Blinded, Placebo-Controlled Clinical Trials
609 patient ivermectin late treatment RCT: 31% lower mortality (p=0.36), 50% lower ventilation (p=0.07), 16% lower ICU admission (p=0.47), and 11% longer hospitalization (p=0.009).RCT 609 inpatients in Iran. Reported outcomes are very different from the pre-specified outcomes [irct.ir]. The outpatient trial is listed separately. From the pre-specified outcomes, all are either positive or not reported. Pre-specified outcomes: - Reduction in persistent cough - RR 0.36 p = 0.06 - Negative RT-PCR - not reported - Main complaints recovery time - not reported - Mortality - RR 0.69 p = 0.36 - Side effects - reported as none (anomalous) - Reduction in tachypnea - RR 0.24 p = 0.38 - Oxygen saturation >94% - not reported All negative outcomes are protocol violations and are not listed in the protocol, including the novel "relative recovery" outcome. Authors include a researcher caught on video admitting that conclusions on ivermectin research were influenced by a funder [c19ivm.org]. Severe cases were more frequent in the ivermectin group, 49% vs. 43%. Dose was limited at a maximum of 30mg for 75+kg, resulting in underdosing for patients at higher risk. Almost..
Jun 2022, Frontiers in Medicine, https://www.frontiersin.org/articles/10.3389/fmed.2022.919708/full, https://c19p.org/rezai2
47. Samajdar et al., Ivermectin and Hydroxychloroquine for Chemo-Prophylaxis of COVID-19: A Questionnaire Survey of Perception and Prescribing Practice of Physicians vis-a-vis Outcomes
309 patient ivermectin prophylaxis study: 80% fewer cases (p<0.0001).Physician survey in India with 164 ivermectin prophylaxis, 129 HCQ prophylaxis, and 81 control patients, showing significantly lower COVID-19 cases with treatment. Details of the treatment and control groups and the definition of cases are not provided, and the results are subject to survey bias. Authors also report on community prophylaxis but present only combined ivermectin/HCQ results.
Nov 2021, J. the Association of Physicians India, https://www.researchgate.net/publication/356294136_Ivermectin_and_Hydroxychloroquine_for_Chemo-Prophylaxis_of_COVID-19_A_Questionnaire_Survey_of_Perception_and_Prescribing_Practice_of_Physicians_vis-a-vis_Outcomes, https://c19p.org/samajdar
48. Elalfy et al., Effect of a combination of Nitazoxanide, Ribavirin and Ivermectin plus zinc supplement (MANS.NRIZ study) on the clearance of mild COVID-1
113 patient ivermectin early treatment study: 87% improved viral clearance (p<0.0001).Non-randomized controlled trial with 62 mild and early moderate patients with home treatment with ivermectin + nitazoxanide + ribavirin + zinc, showing significantly faster viral clearance.
Feb 2021, J. Medical Virology, https://onlinelibrary.wiley.com/doi/10.1002/jmv.26880, https://c19p.org/elalfy
49. Hellwig et al., A COVID-19 Prophylaxis? Lower incidence associated with prophylactic administration of Ivermectin
1,216,000,000 patient ivermectin prophylaxis study: 78% fewer cases (p=0.02).Analysis of COVID-19 cases vs. widespread prophylactic use of ivermectin for parasitic infections showing significantly lower incidence of COVID-19 cases.
Nov 2020, Int. J. Antimicrobial Agents, https://www.sciencedirect.com/science/article/pii/S0924857920304684, https://c19p.org/hellwig
50. Budhiraja et al., Clinical Profile of First 1000 COVID-19 Cases Admitted at Tertiary Care Hospitals and the Correlates of their Mortality: An Indian Experience
976 patient ivermectin late treatment study: 99% lower mortality (p=0.04).Retrospective 976 hospitalized patients with 34 treated with ivermectin showing lower mortality with ivermectin in unadjusted results.
Nov 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.11.16.20232223v1, https://c19p.org/budhirajai
51. Llenas-García et al., Ivermectin Effect on In-Hospital Mortality and Need for Respiratory Support in COVID-19 Pneumonia: Propensity Score-Matched Retrospective Study
192 patient ivermectin late treatment study: 17% lower mortality (p=0.82), 18% lower need for oxygen therapy (p=0.37), 23% lower progression (p=0.52), and 4% higher ICU admission (p=0.92).Retrospective 96 late stage patients receiving a single dose of 200 μg/kg ivermectin for strongyloides and 96 matched controls, showing no significant difference in outcomes. Authors note that this may be due to the low dose used.
May 2023, Viruses, https://www.mdpi.com/1999-4915/15/5/1138, https://c19p.org/llenasgarcia
52. Baguma et al., Characteristics of the COVID-19 patients treated at Gulu Regional Referral Hospital, Northern Uganda: A cross-sectional study
481 patient ivermectin late treatment study: 97% lower mortality (p=0.31).Retrospective COVID+ hospitalized patients in Uganda, showing no statistically significant difference in mortality with ivermectin, however there were only 7 patients receiving ivermectin.
Dec 2021, Research Square, https://www.researchsquare.com/article/rs-1193578/v1, https://c19p.org/baguma
53. Schilling et al., Pharmacometrics of high dose ivermectin in early COVID-19: an open label, randomized, controlled adaptive platform trial (PLATCOV)
90 patient ivermectin early treatment RCT: 86% lower progression (p=0.24) and 9% worse viral clearance (p=0.36).Very high conflict of interest RCT with design optimized for a null result: very low risk patients, high existing immunity, post-hoc change to exclude patients more likely to benefit. There was no significant difference in viral clearance among low risk patients with high viral load at baseline. All 3 progression events occured in the control arm - one hospitalization and two cases of COVID-19 related rhabdomyolysis. Patients in both arms cleared the virus quickly with a viral clearance half-life of 21.1 hours vs. 19.2 hours, which may be in part due to prior immunity. With rapid viral clearance and very low risk patients, infection is less likely to spread to other tissues. Systemic treatment is less applicable, and has less time to reach therapeutic concentrations before self-recovery. Treatment administered directly to the respiratory tract, e.g. as in 1 - 8 , may be more effective for COVID-19 in general, and extend applicability to fast-resolving cases with infection primarily..
Jul 2022, eLife, https://elifesciences.org/articles/83201, https://c19p.org/schilling
54. Abbas et al., The Effect of Ivermectin on Reducing Viral Symptoms in Patients with Mild COVID-19
202 patient ivermectin early treatment RCT: 41% lower progression (p=0.54) and 36% improved recovery (p=0.04).RCT 99 ivermectin and 103 control low risk patients in China, up to 7 days from symptom onset, showing statistically significant improvement in recovery with treatment, and non-statistically significant improvements in recovery time and deterioration. Authors selectively omitted the p-value for recovery which shows statistical significance. Very little information on the patients is provided (only age, gender, and insurance status). The table, text, and abstract show three different versions of recovery numbers. The table and abstract show two different versions of recovery time. The abstract contains a hazard ratio that is not in the text, and no statistical methods are reported. Given the selective omission of the statistically significant recovery p-value, three different sets of numbers for that outcome, and other inconsistencies, the data in this study does not appear to be very reliable. Patients >50 were excluded.
Dec 2021, Indian J. Pharmaceutical Sciences, https://www.ijpsonline.com/abstract/the-effect-of-ivermectin-on-reducing-viral-symptoms-in-patients-with-mild-covid19-4455.html, https://c19p.org/abbas2
55. Spoorthi et al., Utility of Ivermectin and Doxycycline combination for the treatment of SARSCoV-2
100 patient ivermectin late treatment study: 21% faster recovery (p=0.03) and 16% shorter hospitalization (p=0.01).100 patient prospective trial of ivermectin + doxycycline showing reduced time to symptom resolution and shorter hospital stay with treatment.
Nov 2020, IAIM, 2020, 177-182, http://iaimjournal.com/wp-content/uploads/2020/10/iaim_2020_0710_23.pdf, https://c19p.org/spoorthi
56. Wada et al., Efficacy and safety of single-dose ivermectin in mild-to-moderate COVID-19: the double-blind, randomized, placebo-controlled CORVETTE-01 trial
214 patient ivermectin late treatment RCT: 19% lower progression (p=0.46), 14% higher need for oxygen therapy (p=0.46), 23% worse improvement (p=0.61), and 60% improved recovery (p=0.17).Late treatment (6.6 days after onset/PCR+) RCT with 221 low risk (no deaths) COVID-19 patients in Japan, showing no significant difference in viral clearance with a single dose of ivermectin under fasting. Authors note that a single 200 μg/kg dose under fasting was used as approved in Japan, and that the low dose, single day dosing, and fasting administration (~2.5 times lower plasma concentration according to [Guzzo]) limit applicability, and that studies with more favorable outcomes generally used a higher dose or multiday dosing. Details of PCR testing are not provided but the very slow clearance within the low risk population suggests a very high Ct value that may not accurately represent any reduction in replication-competent viral load. An erratum notes a conflict of interest for a reviewer that was a Merck employee: [frontiersin.org]
May 2023, Frontiers in Medicine, https://www.frontiersin.org/articles/10.3389/fmed.2023.1139046/full, https://c19p.org/wada
57. Thairu et al., A Comparison of Ivermectin and Non Ivermectin Based Regimen for COVID-19 in Abuja: Effects on Virus Clearance, Days-to-discharge and Mortality
87 patient ivermectin late treatment PSM study: 88% lower mortality (p=0.12), 55% higher hospital discharge (p=0.0001), and 95% improved viral clearance (p=0.001).PSM retrospective 87 patients in Nigeria, 61 treated with ivermectin, showing lower mortality, faster recovery, and faster viral clearance with ivermectin treatment. All patients received zinc and vitamin C. A synergistic effect was seen for viral clearance when ivermectin and remdesivir were combined, as predicted by In Vitro research [Jeffreys]. Subject to confounding by time, with ivermectin patients from April-June 2021, and non-ivermectin patients from September-November 2021.
Feb 2022, J. Pharmaceutical Research Int., https://journaljpri.com/index.php/JPRI/article/view/36328, https://c19p.org/thairu
58. Siripongboonsitti et al., A Randomized Trial to Assess the Acceleration of Viral Clearance by the Combination Favipiravir/Ivermectin/Niclosamide in Mild-to-Moderate COVID-19 Adult Patients (FINCOV)
60 patient ivermectin early treatment RCT: 39% improved recovery (p=0.19) and 6% improved viral clearance (p=0.75).RCT 60 low-risk outpatients, median age 31, with mild to moderate COVID-19 showing no significant differences with combined favipiravir/ivermectin/niclosamide treatment compared to favipiravir alone. There was limited room for improvement with almost no progression and no hospitalization, ICU admission, supplemental oxygen, or mortality. The combined group showed significantly improved visual analog scale (VAS) scores for cough, runny nose, and diarrhea from day 3. Authors note that "the WHO-CPS were significantly decreased among FPV/IVM/NCL vs FPV alone on day 10", however the degree of improvement cannot be determined based on the values reported. Authors state that "All data generated or analyzed during this study are included in this published article", which is incorrect - only summary statistics are published. The trial registration states that data will not be made available. This raises concerns, especially given many inconsistencies in the published data:..
Mar 2024, J. Infection and Public Health, https://www.sciencedirect.com/science/article/pii/S1876034124001060, https://c19p.org/siripongboonsitti6
59. Tanioka et al., Why COVID-19 is not so spread in Africa: How does Ivermectin affect it?
1,216,000,000 patient ivermectin prophylaxis study: 88% lower mortality (p=0.002).Retrospective study of the 31 onchocerciasis-endemic countries using the community-directed treatment with ivermectin (CDTI) and the 22 non-endemic countries in Africa, showing significantly lower mortality per capita in the countries using ivermectin.
Mar 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.03.26.21254377v1, https://c19p.org/tanioka
60. Rezk et al., miRNA-223-3p, miRNA- 2909 and Cytokines Expression in COVID-19 Patients Treated with Ivermectin
320 patient ivermectin late treatment study: 56% lower progression (p=0.06), 33% improved recovery (p=0.27), and 27% faster viral clearance (p=0.01).Prospective 320 hospitalized moderate COVID-19+ patients in Egypt, 160 treated with ivermectin, showing lower mortality, improved recovery, and decreased cytokine expression with treatment. All patients were treated with HCQ. 7890/26-8-2020.
Oct 2021, Zagazig University Medical J., https://journals.ekb.eg/article_202150_0.html, https://c19p.org/rezk
61. Qadeer et al., Ivermectin A Potential Treatment In Covid-19, Related to Critical Illness
210 patient ivermectin late treatment study: 58% improved viral clearance (p<0.0001).Prospective convenience sampling study of 210 hospitalized age-matched COVID-19 patients, showing faster viral clearance with ivermectin. Baseline information per group is not provided.
Aug 2022, Pakistan J. Medical and Health Sciences, https://pjmhsonline.com/index.php/pjmhs/article/view/2153, https://c19p.org/qadeer
62. Ghauri et al., Ivermectin Use Associated with Reduced Duration of Covid-19 Febrile Illness in a Community Setting
90 patient ivermectin early treatment study: 92% improved recovery (p=0.04).Retrospective 95 outpatients in Pakistan with strong clinical suspicion of COVID-19 (testing was not widely available), with 40 patients treated with ivermectin, showing significantly shorter duration of febrile illness with treatment. Most patients also received HCQ, AZ, zinc, and aspirin. Authors note that there was a treatment delay-response relationship.
Dec 2020, Int. J. Clinical Studies & Medical Case Reports, https://ijclinmedcasereports.com/pdf/IJCMCR-RA-00320.pdf, https://c19p.org/ghauri
24 patient ivermectin early treatment RCT: 96% improved symptoms (p=0.05), 95% improved viral load (p=0.01), and 8% improved viral clearance (p=1).
Tiny RCT for early treatment of mild COVID-19 in low risk patients, with 12 400mcg/kg single dose ivermectin patients and 12 control patients, showing significantly faster viral load reduction and symptom improvement with ivermectin. Average median viral load for gene E and gene N mid-viral recovery at day 7: Ivermectin: 1637, control: 30175 (supplementary appendix).
Dec 2020, eClinicalMedicine, https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30464-8/fulltext, https://c19p.org/chaccour
64. Abd-Elsalam et al., Clinical Study Evaluating the Efficacy of Ivermectin in COVID-19 Treatment: A Randomized Controlled Study
164 patient ivermectin late treatment RCT: 20% shorter hospitalization (p=0.09).RCT 164 hospitalized patients in Egypt showing lower mortality and shorter hospitalization, but without statistical significance. There were no serious adverse effects. Authors suggest the low dosage may have resulted in lower efficacy than other trials, and recommend increased dosage in future trials. Time from symptom onset is not specified. The trial was retrospectively registered and the recruitment start date in the trial registration (June 2020) differs from the paper (March 2020) [osf.io]. For other concerns see [onlinelibrary.wiley.com].
Jun 2021, J. Medical Virology, https://onlinelibrary.wiley.com/doi/10.1002/jmv.27122, https://c19p.org/abdelsalam3
65. López-Medina et al., Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19: A Randomized Clinical Trial
398 patient ivermectin early treatment RCT: 61% lower progression (p=0.11) and 15% improved recovery (p=0.53).Phone survey based RCT with low risk patients, 200 ivermectin and 198 control, showing lower mortality, lower disease progression, lower treatment escalation, and faster resolution of symptoms with treatment, without reaching statistical significance. Authors find the results of this trial alone do not support the use of ivermectin. However the effects are all positive, especially for serious outcomes which are unable to reach statistical significance with the very small number of events in the low risk population. An open letter, signed by >100 physicians, concluding this study is fatally flawed can be found at jamaletter.com . With the low risk patient population, there is little room for improvement with an effective treatment - 59/57% (IVM/control) recovered within the first 2 days to either "no symptoms" or "not hospitalized and no limitation of activities"; 73/69% within 5 days. Less than 3% of all patients ever deteriorated. The primary outcome was changed mid-trial, it was..
Mar 2021, JAMA, https://jamanetwork.com/journals/jama/fullarticle/2777389, https://c19p.org/lopezmedina
66. Munir et al., Clinical Disease Characteristics and Treatment Trajectories Associated with Mortality among COVID-19 Patients in Punjab, Pakistan
1,000 patient ivermectin late treatment study: 48% lower mortality (p=0.13).Retrospective 1,000 hospitalized COVID-19 patients in Pakistan, showing lower mortality with ivermectin without statistical significance.
Apr 2023, Healthcare, https://www.mdpi.com/2227-9032/11/8/1192, https://c19p.org/munir
67. Chachar et al., Effectiveness of Ivermectin in SARS-CoV-2/COVID-19 Patients
50 patient ivermectin late treatment RCT: 10% improved recovery (p=0.5).Small RCT with 25 ivermectin and 25 control patients, not finding a significant difference in recovery at day 7.
Sep 2020, Int. J. Sciences-35, https://www.ijsciences.com/pub/article/2378, https://c19p.org/chachar
68. Podder et al., Outcome of ivermectin treated mild to moderate COVID-19 cases: a single-centre, open-label, randomised controlled study
62 patient ivermectin late treatment RCT: 16% faster recovery (p=0.34).Small RCT with 32 ivermectin patients and 30 control patients. The mean recovery time after enrolment in the intervention arm was 5.31 ± 2.48 days vs. 6.33 ± 4.23 days in the control arm, p > 0.05. Negative PCR results were not significantly different between control and intervention arms, p>0.05. We are not sure what the results were because the abstract and Table 5 have switched the results.
Sep 2020, IMC J. Med. Science, http://imcjms.com/registration/journal_abstract/353, https://c19p.org/podder
69. Camprubí et al., Lack of efficacy of standard doses of ivermectin in severe COVID-19 patients
26 patient ivermectin late treatment study: 40% lower ventilation (p=0.67), 33% lower ICU admission (p=1), 33% worse improvement (p=1), and 25% worse viral clearance (p=1).Tiny 26 patient retrospective study of very late treatment with ivermectin 200 μg/kg, median 12 days after symptoms, not showing significant differences. Authors suggest the dose is too low and recommend evaluation of higher doses. All patients received HCQ which may reduce the potential benefit for adding ivermectin.
Nov 2020, PLoS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242184, https://c19p.org/camprubi
70. Gorial et al., Effectiveness of Ivermectin as add-on Therapy in COVID-19 Management (Pilot Trial)
87 patient ivermectin late treatment study: 42% shorter hospitalization (p<0.0001).Small trial of hospitalized patients with 16 of 87 patients being treated with ivermectin, showing a significantly lower mean hospital stay with ivermectin: 7.62 vs. 13.22 days, p=0.00005. 0 of 16 ivermectin patients died vs. 2 of 71 control patients.
Jul 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.07.07.20145979v1, https://c19p.org/gorial
71. Pott-Junior et al., Use of ivermectin in the treatment of Covid-19: a pilot trial
31 patient ivermectin late treatment RCT: 85% lower ventilation (p=0.25), 85% lower ICU admission (p=0.25), and 1% improved viral clearance (p=1).Very small RCT with 4 control patients and 28 ivermectin patients split across 3 different dosage levels, showing lower (non-statistically significant) ICU admission with treatment. Authors suggest that ivermectin for SARS-CoV-2 is safe and reduces symptoms and viral load, and that the antiviral effect appears to be dose-dependent. NCT04431466. Retraction/censorship: this paper appears to have been censored at the request of the journal's founding editor [pubmed.ncbi.nlm.nih.gov]. An external review is mentioned but is not provided, and there is no reply from the authors, or indication that the authors were notified. Conclusions in this study are limited due to the small size, however we should consider all information in the context of the full body of research.
Mar 2021, Toxicology Reports, https://www.sciencedirect.com/science/article/pii/S2214750021000445, https://c19p.org/pottjunior
72. Hashmi et al., Ivermectin for patients admitted to an ICU with COVID-19: REMAP-CAP randomized controlled trial
150 patient ivermectin ICU RCT: 15% lower mortality (p=0.64) and 24% improvement (p=0.57).Early terminated REMAP-CAP results delayed >600 days, showing no significant differences with very low dose, poor administration, very late treatment of ICU patients. Results trend towards benefit for non-critical patients, with 32% lower mortality in unadjusted results, despite higher baseline severity in the treatment group. Results are currently only available in a CCR24 presentation. There are many critical issues as below. Authors appear to have post-hoc removed adjustment for severity to favor the control group. Preliminary analysis, please report errors or other issues. Severity Issue CRITICAL 1. Severity adjustment deleted in second post-hoc SAP CRITICAL 2. Baseline severity favors control CRITICAL 3. 32% lower mortality for non-critical patients CRITICAL 4. Expected failure based on design CRITICAL 5. Inclusion change to ICU only CRITICAL 6. >600 days delay in reporting CRITICAL 7. Adjustment direction different from expected CRITICAL 8. Remdesivir use CRITICAL 9. Bias in..
Jun 2024, Critical Care Reviews, CCR24, https://criticalcarereviews.com/meetings/ccr24#1, https://c19p.org/hashmi
73. Carvallo et al., Study of the Efficacy and Safety of Topical Ivermectin + Iota-Carrageenan in the Prophylaxis against COVID-19 in Health Personnel
1,195 patient ivermectin prophylaxis study: 100% fewer cases (p<0.0001).Prophylaxis study using ivermectin and iota-carrageenan showing 0 of 788 cases from treated healthcare workers, compared to 237 of 407 control. See [doyourownresearch.substack.com] for discussion of issues with this trial.
Nov 2020, J. Biomedical Research and Clinical Investigation, https://medicalpressopenaccess.com/upload/1605709669_1007.pdf, https://c19p.org/carvalloprep
74. Beltran Gonzalez et al., Efficacy and Safety of Ivermectin and Hydroxychloroquine in Patients with Severe COVID-19: A Randomized Controlled Trial
73 patient ivermectin late treatment RCT: 14% lower mortality (p=1), 9% lower progression (p=1), 37% lower hospital discharge (p=0.71), and 20% longer hospitalization (p=0.43).RCT late stage severe condition (93% SOFA ≥ 2, 96% APACHE ≥ 8) high comorbidity hospitalized patients in Mexico with 36 low dose ivermectin and 37 control patients not finding significant differences. NCT04391127. Another study reports results on a larger group of patients in the same hospital, showing ivermectin mortality RR 0.81 [0.53-1.24] 25 . Questions have been raised about this study and the early termination of the study and discontinuation of treatments, because the hospital statistics show a dramatically lower (~75%) case fatality rate during the period of the study 26 (data from gob.mx ). Date Cases Deaths CFR 3/2020 2 1 50% 4/2020 4 1 25% 5/2020 13 1 8% 6/2020 37 2 5% 7/2020 65 5 8% 8/2020 79 23 29% 9/2020 54 12 22% 10/2020 62 21 34% 11/2020 80 26 33% 12/2020 41 13 32% Several other inconsistencies have been reported 28 . Although the data from this study is reported to be available and has been shared with an anti-treatment group, independent researchers have been unable..
Feb 2021, Infectious Disease Reports, https://www.mdpi.com/2036-7449/14/2/20, https://c19p.org/beltrangonzalez
75. Mustafa et al., Pattern of medication utilization in hospitalized patients with COVID-19 in three District Headquarters Hospitals in the Punjab province of Pakistan
444 patient ivermectin late treatment study: 64% lower mortality (p=0.09).Retrospective 444 hospitalized patients in Pakistan, showing lower mortality with ivermectin treatment in unadjusted results, not reaching statistical significance. Ivermectin was mostly used with patients in severe condition. Dose ranged from 12mg to 36mg for up to seven days.
Dec 2021, Exploratory Research in Clinical and Social Pharmacy, https://www.sciencedirect.com/science/article/pii/S2667276621001013, https://c19p.org/mustafa
1,358 patient ivermectin early treatment RCT: while presented as negative, the co-principal investigator privately reported that "there is a clear signal that IVM works in COVID patients".
Together Trial Ivermectin: impossible data, critical issues, blinding broken, randomization failure, data pledge violation, protocol violations.
Aug 2021, New England J. Medicine, https://www.nejm.org/doi/full/10.1056/NEJMoa2115869, https://c19p.org/togetherivm
77. Hazan et al., Effectiveness of ivermectin-based multidrug therapy in severely hypoxic, ambulatory COVID-19 patients
24 patient ivermectin late treatment study: 86% lower mortality (p=0.04) and 93% lower hospitalization (p=0.001).Small study of 24 consecutive patients in serious condition (9 days post symptoms, mean SpO2 87.4) using combined treatment with ivermectin, doxycycline, zinc, vitamin D, and vitamin C, showing no mortality or hospitalization with treatment. Two patients declined treatment and both died. This study uses a synthetic control arm.
Jul 2021, Future Microbiology, https://www.futuremedicine.com/doi/full/10.2217/fmb-2022-0014, https://c19p.org/hazan
78. Carvallo et al., Usefulness of Topic Ivermectin and Carrageenan to Prevent Contagion of Covid 19 (IVERCAR)
229 patient ivermectin prophylaxis study: 96% fewer cases (p<0.0001).Prophylaxis study using ivermectin and carrageenan showing 0 of 131 cases from treated healthcare workers, compared to 11 of 98 control. The effect is likely to be primarily due to ivermectin - the author has later reported that carrageenan is not necessary [youtube.com]. See [doyourownresearch.substack.com] for discussion of issues with this trial.
Oct 2020, NCT04425850, https://clinicaltrials.gov/ct2/show/results/NCT04425850, https://c19p.org/carvalloprep2
79. Ahsan et al., Clinical Variants, Characteristics, and Outcomes Among COVID-19 Patients: A Case Series Analysis at a Tertiary Care Hospital in Karachi, Pakistan
165 patient ivermectin late treatment study: 50% lower mortality (p=0.03).Retrospective 165 hospitalized patients in Pakistan showing unadjusted lower mortality with combined ivermectin and doxycycline treatment. Details of the ivermectin group compared to other patients are not provided, however ivermectin was given to a similar percentage of patients in the mild, moderate, and severe/critical groups (34.5%, 29.1%, and 36.4%), suggesting that ivermectin treatment was not based on severity.
Apr 2021, Cureus, https://www.cureus.com/articles/56545-clinical-variants-characteristics-and-outcomes-among-covid-19-patients-a-case-series-analysis-at-a-tertiary-care-hospital-in-karachi-pakistan, https://c19p.org/ahsan
247 patient ivermectin early treatment study: 94% lower ventilation (p=0.005) and 98% lower hospitalization (p<0.0001).
Comparison of HCQ, nitazoxanide, and ivermectin showing similar effectiveness for overall clinical outcomes in COVID-19 when used before seven days of symptoms, and overwhelmingly superior compared to the untreated COVID-19 population, even for those outcomes not influenced by placebo effect, at least when combined with azithromycin, and vitamin C, D and zinc in the majority of the cases. 585 patients with mean treatment delay 2.9 days. There was no hospitalization, mechanical ventilation, or mortality with treatment. Control group 1 was a retrospectively obtained group of untreated patients of the same population.
Nov 2020, New Microbes and New Infections, https://www.sciencedirect.com/science/article/pii/S2052297521000792, https://c19p.org/cadegianii
81. Elavarasi et al., Clinical features, demography, and predictors of outcomes of SARS-CoV-2 infection at a tertiary care hospital in India: A cohort study
1,758 patient ivermectin late treatment study: 20% lower mortality (p=0.12).Retrospective 2017 hospitalized patients in India, showing lower mortality with ivermectin treatment in unadjusted results. No group details are provided and this result is subject to confounding by indication.
Aug 2021, Lung India, https://journals.lww.com/lungindia/Fulltext/2022/01000/Clinical_features,_demography,_and_predictors_of.5.aspx, https://c19p.org/elavarasi
82. Carvallo et al., Safety and Efficacy of the Combined Use of Ivermectin, Dexamethasone, Enoxaparin and Aspirina against COVID-19 the I.D.E.A. Protocol
46 patient ivermectin early treatment study: 85% lower mortality (p=0.08).Prospective trial of ivermectin, dexamethasone, enoxaparin, and aspirin, showing no hospitalization for mild cases, and lower mortality for moderate/severe patients.
Sep 2020, J. Clinical Trials, https://www.longdom.org/open-access/safety-and-efficacy-of-the-combined-use-of-ivermectin-dexamethasone-enoxaparin-and-aspirina-against-covid19-the-idea-protocol-70290.html, https://c19p.org/carvallo
83. Soto-Becerra et al., Real-World Effectiveness of hydroxychloroquine, azithromycin, and ivermectin among hospitalized COVID-19 patients: Results of a target trial emulation using observational data from a nationwide Healthcare System in Peru
2,833 patient ivermectin late treatment study: 17% lower mortality (p=0.01).Retrospective database study of 5683 patients, 692 received HCQ/CQ+AZ, 200 received HCQ/CQ, 203 received ivermectin, 1600 received AZ, 358 received ivermectin+AZ, and 2630 received standard of care. This study includes anyone with ICD-10 COVID-19 codes which includes asymptomatic PCR+ patients, therefore many patients in the control group are likely asymptomatic with regards to SARS-CoV-2, but in the hospital for another reason. For those that had symptomatic COVID-19, there is also likely significant confounding by indication. In this study all medications show higher mortality at day 30, which is consistent with asymptomatic (for COVID-19) or mild condition patients being more common in the control group. For ivermectin they show 30 day mortality aHR = 1.39 [0.88 - 2.22]. KM curves show that the treatment groups were in more serious condition, and also that after about day 35 survival became better with ivermectin. The last day available for ivermectin shows RR 0.83, p = 0.01. More..
Oct 2020, medRxiv, https://www.medrxiv.org/content/10.1101/2020.10.06.20208066v1, https://c19p.org/sotobecerrai
84. Ravikirti et al., Association between Ivermectin treatment and mortality in Covid-19: A hospital-based case-control study
965 patient ivermectin late treatment study: 3% lower mortality (p=0.82).Retrospective 965 late stage (44% severe, 27% ICU) hospitalized patients in India, showing no significant difference with ivermectin treatment. Overall mortality was very high, suggesting very late treatment. The low non-weight-adjusted dose may not be very effective with such late stage patients. 210 patients were excluded due to early discharge, which may have been patients with earlier onset that are more likely to benefit with ivermectin. Age grouping is very unusual with no breakdown of ages for the 71% of patients >45. Numbers may be unreliable, e.g., cardiovascular disease counts and/or percentages for IVM appear incorrect. Details of adjustments are not provided, there may be extreme confounding by age within the >45 groups which contain the majority of the patients, in addition to confounding by indication.
Apr 2022, Research Square, https://www.researchsquare.com/article/rs-1522422/v1, https://c19p.org/ravikirti2
85. Roy et al., Outcome of Different Therapeutic Interventions in Mild COVID-19 Patients in a Single OPD Clinic of West Bengal: A Retrospective study
29 patient ivermectin early treatment study: 6% faster recovery (p=0.87).Retrospective database analysis of 56 mild COVID-19 patients, all treated with vitamin C, vitamin D, and zinc, comparing ivermectin + doxycycline (n=14), AZ (n=13), HCQ (n=14), and SOC (n=15), finding that all groups recover quickly, and there was no significant difference between the groups. Subject to the usual limitation of a database study, very small size, and limited evaluation of patients.
Mar 2021, medRxiv, https://www.medrxiv.org/content/10.1101/2021.03.08.21252883v1, https://c19p.org/roy
86. IVERCOR PREP et al., Ivermectina en agentes de salud e IVERCOR COVID19
875 patient ivermectin prophylaxis study: 73% fewer cases (p<0.0001).Report on ivermectin prophylaxis in a hospital in Argentina showing lower cases for healthcare workers taking ivermectin. Results have been published in the press [lanacion.com.ar] (interim results), and a presentation posted online: [web.archive.org], however there is no formal publication to date. These results would be expected to receive priority publication due to the predicted impact on the pandemic and confirmation of previous prophylaxis studies. The lack of formal publication suggests a negative publication bias that may be due to politicization in the authors' location. Note that this prophylaxis study is different to the Vallejos early treatment trial.
Dec 2020, IVERCOR PREP, Preliminary Results, https://web.archive.org/web/20210226215453/https://twitter.com/Covid19Crusher/status/1365420061859717124, https://c19p.org/vallejos
600 patient ivermectin early treatment study: 92% lower mortality (p=0.03) and 93% lower hospitalization (p<0.0001).
Retrospective 600 PCR+ outpatients in Australia treated with ivermectin, zinc, and doxycycline, showing significantly lower mortality and hospitalization with treatment. This trial uses a synthetic control group, and the preliminary report provides minimal details. For discussion of the use of a synthetic control group, see [doyourownresearch.substack.com]. Notably, advantages include less-biased recruitment (patients do not opt-out if they feel they need treatment and don't want to risk placebo), trials are cheaper, there is less delay in treatment, and trials can be run where it is not ethical to give patients placebo.
Oct 2021, TrialSite News, https://www.trialsitenews.com/a/combination-therapy-for-covid-19-based-on-ivermectin-in-an-australian-population, https://c19p.org/borody
88. Wijewickrema et al., Efficacy and safety of oral ivermectin in the treatment of mild to moderate Covid-19 patients: a multi-centre double-blind randomized controlled clinical trial
249 patient ivermectin early treatment RCT: 51% improved viral clearance (p=0.03).RCT 249 hospitalized patients with mild to moderate COVID-19 in Sri Lanka, showing statistically significant lower viral load. There was no significant difference in clinical outcomes. Only one patient had a serious outcome. Mid-recovery 11/15 symptoms showed lower scores with treatment on day 5 and on day 10. On day 10, 19% of treatment patients were asymptomatic vs. 13% of placebo patients. WHO score analysis is limited by the large percentage of missing data. Authors report that ivermectin blood levels taken before or with meals were not significantly different, however authors note that most patients consumed low fat meals. [Guzzo] show that absorption of ivermectin was significantly higher when administered following a high-fat meal.
Jul 2024, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09563-y, https://c19p.org/wijewickrema
89. Szente Fonseca et al., Risk of Hospitalization for Covid-19 Outpatients Treated with Various Drug Regimens in Brazil: Comparative Analysis
717 patient ivermectin early treatment study: 14% higher hospitalization (p=0.53).Retrospective 717 patients in Brazil showing OR 1.17 [0.72-1.90] for ivermectin. This paper focuses on HCQ, event counts for ivermectin are not provided. With significant correlation between the variables used, including overlap in the prescription of multiple treatments that show efficacy alone, and limited data for the model size, the model used here may be inaccurate due to multicollinearity [statisticsbyjim.com].
Oct 2020, Travel Medicine and Infectious Disease, https://www.sciencedirect.com/science/article/abs/pii/S1477893920304026, https://c19p.org/fonsecai
90. Hayward et al., Ivermectin for COVID-19 in adults in the community (PRINCIPLE): an open, randomised, controlled, adaptive platform trial of short- and longer-term outcomes
5,413 patient ivermectin late treatment RCT: 36% lower long COVID and 16% faster recovery despite very late treatment, low-risk patients, and poor administration. Probability of superiority > 0.999.Significantly improved recovery and significantly lower risk of long COVID with ivermectin, despite very late treatment, low-risk patients, and poor administration. 36% lower ongoing persistent COVID-19 specific symptoms, p 0.999), missing from the abstract (details below). The p values for sustained recovery, early sustained recovery, alleviation of all symptoms, and sustained alleviation are all The efficacy seen for ivermectin here is despite the trial being the most clearly designed to fail trial, with major bias in design, operation, analysis, and reporting. This trial is a great example of bias in clinical trials which will be covered in detail in the future. c19 early .org Molnupiravir PANORAMIC 30 , 31 Ivermectin PRINCIPLE 32 Investigator Prof. Chris Butler Prof. Chris Butler Delay ≤5 days from onset median 2 days ≤14 days from onset median unknown Population 50+ or 18+ w/comorbidities 18+ (mid-trial change) Treatment 5 days, 2x per day 3 days, 1x per day, dose below real..
Feb 2024, J. Infection, https://www.sciencedirect.com/science/article/pii/S0163445324000641, https://c19p.org/principleivm
91. Zubair et al., The effect of ivermectin on non-severe and severe COVID-19 disease and gender-based difference of its effectiveness
188 patient ivermectin late treatment study: 9% higher mortality (p=1) and 8% longer hospitalization (p=0.4).Retrospective 188 hospitalized patients in Pakistan, 90 treated with ivermectin, showing no significant differences with treatment. The ivermectin group had more severe disease (66% vs 58%, with 6x higher risk for severe disease patients), and more male patients (70% vs. 65%). Higher use of remdesivir and steroids in the ivermectin group also suggests that ivermectin was more likely to be given to patients in more severe condition. There were no side effects seen with ivermectin. Authors note that significantly improved ferritin levels were seen with treatment. Authors state that ivermectin patients received 2 12mg doses, 24 hours apart, but later state that the dosage was not standardized.
Jan 2022, Monaldi Archives for Chest Disease, https://monaldi-archives.org/index.php/macd/article/download/2062/1397, https://c19p.org/zubair
92. Kishoria et al., Ivermectin as adjuvant to hydroxychloroquine in patients resistant to standard treatment for SARS-CoV-2: results of an open-label randomized clinical study
32 patient ivermectin late treatment RCT: 8% lower hospital discharge (p=1) and 8% worse viral clearance (p=1).Small RCT of hospitalized patients in India with 19 ivermectin patients and 13 control patients, with all receiving SOC including HCQ, showing no significant differences. The patient population is biased because the study recruited patients that did not respond to standard treatment. Authors do not specify the treatment delay but it is likely relatively late because the patients had already undergone standard treatment. Criteria for discharge are not provided. The time of discharge status is not specified and may not have been an equal time since treatment initiation for all patients. Authors indicate 19 treatment and 16 control patients, but the results only show 13 control patients. Authors do not indicate why the other 3 are missing. Randomization in this small sample resulted in very large differences in the groups, with over twice as many in the ivermectin group with age >40, and the only 2 patients with age >60 both in the ivermectin group. Authors did not adjust for these..
Aug 2020, Paripex - Indian J. Research, https://www.worldwidejournals.com/paripex/recent_issues_pdf/2020/August/ivermectin-as-adjuvant-to-hydroxycholoroquine-in-patients-resistant-to-standard-treatment-for-sarscov2-results-of-an-openlabel-randomized-clinical-study_August_2020_1597492974_4801859.pdf, https://c19p.org/kishoria
93. Soto et al., Mortality and associated risk factors in patients hospitalized due to COVID-19 in a Peruvian reference hospital
1,418 patient ivermectin late treatment study: 41% higher mortality (p=0.001).Retrospective 1,418 very late stage (46% mortality) patients in Peru, showing higher mortality with ivermectin. There is strong confounding by indication, for example 48% of patients with baseline SpO2 <70% were treated compared with 22% for SpO2 >95%. The more extreme Cox result compared to the event counts also supports this. There may also be significant confounding by time with SOC changing substantially over the first few months of the pandemic. Patients may overlap with those in [Soto-Becerra]. The results in the table and text do not match.
Mar 2022, PLOS ONE, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264789, https://c19p.org/soto
94. Ferreira et al., Outcomes associated with Hydroxychloroquine and Ivermectin in hospitalized patients with COVID-19: a single-center experience
102 patient ivermectin late treatment study: 54% higher combined mortality/intubation (p=0.37).Retrospective 230 hospitalized patients in Brazil showing no significant difference with ivermectin treatment. Authors note that the treatments were more likely to be offered to sicker patients. Authors note that they do not know if treatment was started before or after ICU admission and intubation. Baseline total chest CT opacities were higher for ivermectin (20% vs. 15%). 25% of control patients were admitted within 3 days, compared to 5 days for ivermectin. Only 38% of patients in the ivermectin arm were treated within 7 days, compared to 61% for HCQ. These are consistent with ivermectin being used for more severe patients. Dosage is unknown.
Nov 2021, Revista da Associação Médica Brasileira, https://www.scielo.br/j/ramb/a/kzbmDvJqjJdQR9GfqK65CZs/, https://c19p.org/ferreira2
95. Vallejos et al., Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized, double-blind, placebo-controlled trial
501 patient ivermectin early treatment RCT: 33% lower hospitalization (p=0.23) and 5% worse viral clearance (p=0.55).RCT with 501 relatively low-risk outpatients in Argentina showing hospitalization OR 0.65 [0.32-1.31]. With only 7% hospitalization, this trial is underpowered. The trial primarily includes low-risk patients that recover quickly without treatment, leaving minimal room for improvement with treatment. 74 patients had symptoms for >= 7 days. Among the 7 patients requiring ventilation, authors note that the earlier requirement in the ivermectin group may be due to those patients having higher severity at baseline. However, authors know the answer to this - it is unclear why it is not reported. There were more adverse events in the placebo group than the ivermectin group, suggesting a possible issue with dispensing or non-trial medication usage. 25+% of patients were hospitalized within 2/3 days for the placebo/treatment groups (Figure S2). The companion prophylaxis study IVERCOR PREP has reported results in the press and an online presentation 75 , 76 , however these results have not yet..
Jul 2021, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06348-5, https://c19p.org/vallejos2
96. Rezai et al., Non-effectiveness of Ivermectin on Inpatients and Outpatients With COVID-19; Results of Two Randomized, Double-Blinded, Placebo-Controlled Clinical Trials
549 patient ivermectin early treatment RCT: 9% higher ICU admission (p=0.95), 36% higher hospitalization (p=0.41), 2% worse recovery (p=0.49), and 23% worse viral clearance (p=0.16).RCT 549 low risk outpatients in Iran. Reported outcomes are very different from the pre-specified outcomes [irct.ir]. The inpatient trial is listed separately. The pre-specified primary clinical outcome was not reported. The reported components of this outcome are both positive. Pre-specified outcomes (3 not reported) [irct.ir]: - reduction in persistent cough and tachypnea and O2 saturation above 94% - not reported - negative PCR - reported - main complaints recovery time - not reported (only individual symptoms) - hospitalization - reported - time to hospitalization - not reported - mortality - reported - side effects - reported in only one patient (anomalous) A new outcome "relative recovery" is reported but not mentioned in the trial registration. The reported percentages and RR do not match. Authors include a researcher caught on video admitting that conclusions on ivermectin research were influenced by a funder [c19ivm.org]. Most/many patients were also treated with..
Jun 2022, Frontiers in Medicine, https://www.frontiersin.org/articles/10.3389/fmed.2022.919708/full, https://c19p.org/rezai3
97. Buonfrate et al., High dose ivermectin for the early treatment of COVID-19 (COVER study): a randomised, double-blind, multicentre, phase II, dose-finding, proof of concept trial
61 patient ivermectin early treatment RCT: 20% improved viral clearance (p=0.59).Early terminated 89 patient RCT with 29 high dose and 32 very high dose ivermectin patients, showing dose dependent viral load reduction, although not reaching statistical significance due to early termination. Since most patients have low viral load at day 7, there is little room for improvement with a treatment at day 7. Intermediate results may show significantly greater improvement, but are not provided. Authors note that ivermectin remained safe even at the very high dose used, although tolerability was reduced. Adherence was very low in the very high dose arm (~60%). The paper reports 4 SAEs, all resolved, with 3 patients hospitalized in the very high dose ivermectin arm, 1 in the high dose arm, and 0 in the control arm. However, the supplementary data is contradictory, showing 2 grade 3 events in both ivermectin arms (2 infections and infestations, and 2 COVID-19 pneumonia). While this result is not statistically significant, it may be in part due to randomization failure..
Sep 2021, Int. J. Antimicrobial Agents, https://www.sciencedirect.com/science/article/pii/S0924857921013571, https://c19p.org/buonfrate
98. Bramante et al., Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19
804 patient ivermectin early treatment RCT: 61% lower hospitalization for ivermectin vs. placebo (not reported in the paper which uses a control group including metformin), despite very late treatment, low-risk patients, and poor administration. ER results do not match symptoms.COVID-OUT remote RCT, showing no significant differences compared to a combined metformin/placebo "control" group. Results for other treatments are listed separately - metformin , fluvoxamine . Authors include metformin patients in the control group, allowing details of adjustments to affect results. Using standard treatment vs. placebo analysis shows 61% lower hospitalization, or 75% lower for patients with onset ≤5 days (not statistically significant with only 7 and 5 events). These results are not reported in the paper or the supplementary appendix, readers need to request the data. Authors note that "hospitalization is perhaps the most accurate and well-documented end point". There are many major issues as detailed below. We provide more detailed analysis of this study due to widespread incorrect press. Submit Updates or Corrections Severity Issue CRITICAL 1. Ivermectin vs. placebo analysis - 61% lower hospitalization CRITICAL 2. Severity mismatch for ivermectin treatment but not..
Aug 2022, NEJM, https://www.nejm.org/doi/10.1056/NEJMoa2201662, https://c19p.org/covidoutivm
99. Shahbaznejad et al., Effects of Ivermectin in Patients With COVID-19: A Multicenter, Double-blind, Randomized, Controlled Clinical Trial
69 patient ivermectin late treatment RCT: 32% faster recovery (p=0.05) and 15% shorter hospitalization (p=0.02).RCT in Iran showing shorter time to recovery and shorter hospitalization time with ivermectin. There were no adverse effects. There was one death in the treatment group, the patient was in critical condition at baseline and died within 24 hours of admission. Also see [sciencedirect.com] and the author response [clinicaltherapeutics.com].
Jan 2021, Clinical Therapeutics, https://www.sciencedirect.com/science/article/abs/pii/S0149291821002010, https://c19p.org/shahbaznejad
100. Jamir et al., Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India
266 patient ivermectin ICU study: 53% higher mortality (p=0.13).Retrospective 266 COVID-19 ICU patients in India, showing significantly lower mortality with PVP-I oral gargling and topical nasal use, and non-statistically significant higher mortality with ivermectin and lower mortality with remdesivir.
Dec 2021, Cureus, https://www.cureus.com/articles/73667-determinants-of-outcome-among-critically-ill-police-personnel-with-covid-19-a-retrospective-observational-study-from-andhra-pradesh-india, https://c19p.org/jamir
101. Mikamo et al., Efficacy and safety of ivermectin in patients with mild COVID-19 in Japan and Thailand
1,029 patient ivermectin early treatment RCT: 205% higher progression (p=0.49), 4% worse improvement (p=0.62), and 4% improved recovery (p=0.72).RCT very low risk patients (mean age 35.7, SpO2 97.4) showing no significant differences with rapid recovery and almost no progression in both groups. The groups were unbalanced. There were 41% more patients with dyspnea at baseline in the treatment group. Similarly, at baseline patients with 4+ symptoms scored 2+ were more common in the treatment group - 7% for ivermectin vs. 4% for placebo. Table S8 shows only one case of COVID-19 pneumonia. Authors report 3 and 1 cases of progression, this matches the 3 and 1 cases of the adverse event "COVID-19" in Table S8. It's unclear how the COVID-19 adverse events were defined since all patients are meant to have COVID-19. Authors definition of progression includes "use of COVID-19 therapeutic agents" and therefore the significance for progression of disease is not clear. The study is designed to produce a null result with very low risk patients, administration on an empty stomach, the primary outcome including symptoms..
Sep 2022, J. Infection and Chemotherapy, https://www.sciencedirect.com/science/article/pii/S1341321X23003161, https://c19p.org/mikamo
102. de la Rocha et al., Ivermectin compared with placebo in the clinical course in Mexican patients with asymptomatic and mild COVID-19: a randomized clinical trial
56 patient ivermectin early treatment RCT: 15% worse recovery (p=0.58) and 2% improved viral clearance (p=0.64).Small low-risk patient RCT with 30 low-dose ivermectin and 26 control patients, with no primary outcome events in either arm. Viral load was significantly better with ivermectin on day 5, while there was no significant difference on day 1 or day 14. There was no significant difference in combined symptoms, however authors include cough which was the most frequent symptom and may persist long after infection has been cleared. Ivermectin patients were 4 years older with a higher standard deviation, had higher prevalence of obesity, diabetes, hypertension, and cardiovascular disease, and lower prevalence of hepatic and kidney disease. SOC included acetaminophen, which has . The slow viral clearance seen may be in part due to acetaminophen use. Authors conclude that "ivermectin is not effective to prevent progression to a severe state", however there was no progression to severe in either group. Authors report 92.9% of ivermectin patients compliant with the symptom diary,..
May 2022, BMC Infectious Diseases, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07890-6, https://c19p.org/delarocha
103. Krolewiecki et al., Antiviral effect of high-dose ivermectin in adults with COVID-19: A proof-of-concept randomized trial
41 patient ivermectin early treatment RCT: 66% improved viral load (p=0.09).Proof of concept RCT with 30 ivermectin patients and 15 control patients, showing a concentration dependent antiviral activity, but no significant difference in clinical outcomes. There was no significant difference in viral load reduction between groups overall, but a significant difference was found in patients with higher median plasma ivermectin levels (72% vs. 42%, p=0.004). Mean ivermectin plasma concentration levels correlated with viral decay rate (r=0.47, p=0.02). The change in viral load is provided for the <160ng/mL and >160ng/mL groups, but not the overall treatment group. The corrigendum provides individual viral decay rates for computing the overall treatment group viral decay rate. Authors published a corrigendum: [sciencedirect.com].
Jun 2021, eClinicalMedicine, https://www.sciencedirect.com/science/article/pii/S258953702100239X, https://c19p.org/krolewiecki
104. Naggie et al., Effect of Ivermectin vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial
1,591 patient ivermectin late treatment RCT: 99%, 98%, 97% posterior probability of efficacy for mean time unwell and clinical progression @14 and 7 days, despite very late treatment, low-risk patients, and poor administration. All exceed the pre-specified threshold for superiority. Clinical progression results were changed without explanation in a later version.RCT low-risk outpatients with very late treatment (median 6 days, 25% ≥8 days) in the USA, showing 98% probability of efficacy for clinical progression at day 14, a treatment delay-response relationship, and significant efficacy for patients with severe symptoms at baseline. The posterior probability ivermectin is effective was 99%, 98%, 97% for mean time unwell and clinical progression @14 and 7 days. All exceed the pre-specified threshold for superiority 80 . Note that the clinical progression results exceeding the superiority threshold in the preprint 81 changed in the journal version for the 400µg/kg arm, with no explanation for over 700 days). The 600µg/kg arm was reported separately 82 . When not specified, comments refer to the 400µg/kg arm. We provide more detailed analysis of this study due to widespread incorrect press. There was one death reported in each of the 400µg/kg and 600µg/kg ivermectin arms. For 400µg/kg, the patient did not take ivermectin. For 600µg/kg, authors..
Jun 2022, JAMA, https://jamanetwork.com/journals/jama/fullarticle/2797483, https://c19p.org/activ6ivm
105. Sarojvisut et al., An Open Label Randomized Controlled Trial of Ivermectin Plus Favipiravir-Based Standard of Care versus Favipiravir-Based Standard of Care for Treatment of Moderate COVID-19 in Thailand
317 patient ivermectin late treatment RCT: 104% higher ICU admission (p=0.62), 104% worse improvement (p=0.62), and 4% faster recovery (p=0.63).RCT low risk hospitalized patients in Thailand showing no significant difference with the addition of ivermectin to favipiravir based SOC. Only the abstract is currently available. The trial was registered retrospectively [thaiclinicaltrials.org]. The primary outcome was WHO-category ordinal scale improvement of 2 points at days 3, 7, 14, 21, for which only a single unspecified time point (when almost all patients have recovered) is provided in the abstract (details may be in the full paper). The registration indicates that the intervention was only provided "after laboratory result", without explanation.
Dec 2022, Infection & Chemotherapy, https://icjournal.org/DOIx.php?id=10.3947/ic.2022.0127, https://c19p.org/sarojvisut
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