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Supplementary Data — Ivermectin for COVID-19: real-time meta analysis of 93 studies
https://c19ivm.org/meta.html
 
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Chowdhury (RCT) 81% 0.19 [0.01-3.96] 14mg viral+ 0/60 2/56 OT​1 CT​2 Improvement, RR [CI] Dose (4d) Treatment Control Espitia-Hernandez 97% 0.03 [0.01-0.10] 12mg viral+ 0/28 7/7 CT​2 Carvallo 85% 0.15 [0.02-1.28] 36mg death 1/32 3/14 CT​2 Mahmud (DB RCT) 27% 0.73 [0.60-0.90] 12mg recov. time 183 (n) 180 (n) CT​2 Szente Fonseca -14% 1.14 [0.75-1.66] 24mg hosp. 340 (n) 377 (n) Cadegiani 78% 0.22 [0.01-4.48] 42mg death 0/110 2/137 CT​2 Ahmed (DB RCT) 85% 0.15 [0.01-2.70] 48mg symptoms 0/17 3/19 Chaccour (DB RCT) 8% 0.92 [0.77-1.09] 28mg viral+ 12 (n) 12 (n) Ghauri 92% 0.08 [0.01-0.88] 48mg no recov. 0/37 7/53 Babalola (DB RCT) 49% 0.51 [0.29-0.88] 24mg viral time 20 (n) 20 (n) OT​1 Ravikirti (DB RCT) 89% 0.11 [0.01-2.05] 24mg death 0/55 4/57 Bukhari (RCT) 82% 0.18 [0.07-0.46] 12mg viral+ 4/41 25/45 Mohan (DB RCT) 24% 0.76 [0.53-1.09] 28mg viral+ 21/40 31/45 Biber (DB RCT) 39% 0.61 [0.29-1.07] 36mg viral+ 13/47 21/42 Elalfy 87% 0.13 [0.06-0.27] 36mg viral+ 7/62 44/51 CT​2 López-Me.. (DB RCT) 43% 0.57 [0.16-1.87] 84mg progression 4/200 7/198 Roy 6% 0.94 [0.52-1.93] n/a recov. time 14 (n) 15 (n) CT​2 Chahla (CLUS. RCT) 87% 0.13 [0.03-0.54] 24mg no disch. 2/110 20/144 Mourya 89% 0.11 [0.05-0.25] 48mg viral+ 5/50 47/50 Loue (QR) 70% 0.30 [0.04-2.20] 14mg death 1/10 5/15 Merino (QR) 74% 0.26 [0.11-0.57] 24mg hosp. population-based cohort censored, see notes CS​5 Faisal (RCT) 68% 0.32 [0.14-0.72] 48mg no recov. 6/50 19/50 Aref (RCT) 63% 0.37 [0.22-0.61] n/a recov. time 57 (n) 57 (n) Krolewiecki (RCT) 66% 0.34 [0.10-1.16] 168mg decay rate 20 (n) 14 (n) Vallejos (DB RCT) 33% 0.67 [0.34-1.28] 24mg hosp. 14/250 21/251 Reis (DB RCT) 10% 0.90 [0.70-1.16] 84mg hosp./ER 100/679 111/679 impossible data, see notes Buonfrate (DB RCT) 31% 0.69 [0.46-1.03] 336mg viral load 30 (n) 29 (n) Mayer 55% 0.45 [0.32-0.63] 151mg death 3,266 (n) 17,966 (n) Borody 93% 0.07 [0.04-0.13] 96mg hosp. 5/600 70/600 CT​2 SC​4 Abbas (DB RCT) 31% 0.69 [0.46-1.05] 84mg recov. time 99 (n) 103 (n) de Jesús Ascenci.. 59% 0.41 [0.36-0.47] 12mg death/hosp. 7,898 (n) 20,150 (n) CT​2 Manomai.. (DB RCT) 5% 0.95 [0.62-1.45] 48mg viral+ 19/36 20/36 de la Ro.. (DB RCT) -187% 2.87 [0.12-67.5] 36mg misc. 1/30 0/26 Rezai (DB RCT) -5% 1.05 [0.07-16.7] 84mg death 1/268 1/281 Mirahma.. (DB RCT) 27% 0.73 [0.30-1.75] 24mg hosp. 8/130 11/130 Schilling (RCT) -9% 1.09 [0.88-1.27] 168mg viral rate 45 (n) 45 (n) Bramante (DB RCT) -4% 1.04 [0.81-1.31] 90mg progression 105/407 96/391 OT​1 Tau​2 = 0.30, I​2 = 83.7%, p < 0.0001 Early treatment 55% 0.45 [0.36-0.57] 317/15,333 577/42,345 55% improvement Gorial 71% 0.29 [0.01-5.76] 14mg no recov. 0/16 2/71 Improvement, RR [CI] Dose (4d) Treatment Control Kishoria (RCT) -8% 1.08 [0.57-2.02] 12mg viral+ 11/19 7/13 Podder (RCT) 16% 0.84 [0.55-1.12] 14mg recov. time 32 (n) 30 (n) Khan 87% 0.13 [0.02-1.00] 12mg death 1/115 9/133 Chachar (RCT) 10% 0.90 [0.44-1.83] 36mg no recov. 9/25 10/25 Soto-Becerra -39% 1.39 [0.88-2.22] 14mg death 47/203 401/2,630 Rajter (PSM) 67% 0.33 [0.12-0.84] 14mg death 26/173 27/107 Hashim (SB RCT) 92% 0.08 [0.00-1.44] 28mg death 0/59 6/70 CT​2 Camprubí -25% 1.25 [0.43-3.63] 14mg viral+ 5/13 4/13 Spoorthi 21% 0.79 [0.64-0.98] n/a recov. time 50 (n) 50 (n) CT​2 Budhiraja 99% 0.01 [0.00-0.15] n/a death 0/34 103/942 Okumuş (DB RCT) 16% 0.84 [0.55-1.30] 56mg no improv. 16/30 19/30 Shahbazn.. (DB RCT) 19% 0.81 [0.67-0.97] 14mg recov. time 35 (n) 34 (n) Lima-Morales 78% 0.22 [0.12-0.41] 12mg death 15/481 52/287 CT​2 Beltran .. (DB RCT) -20% 1.20 [0.77-1.87] 12mg hosp. time 36 (n) 37 (n) Pott-Junior (RCT) -11% 1.11 [0.21-5.93] 14mg viral+ 10/27 1/3 censored, see notes Huvemek (DB RCT) 32% 0.68 [0.38-1.23] 84mg no improv. 13/50 19/50 Ahsan 50% 0.50 [0.28-0.90] 21mg death 17/110 17/55 CT​2 Abd-Elsalam (RCT) 25% 0.75 [0.17-3.06] 36mg death 3/82 4/82 Hazan 93% 0.07 [0.00-1.02] 24mg hosp. 0/24 synthetic CT​2 SC​4 Elavarasi 20% 0.80 [0.61-1.06] n/a death 48/283 311/1,475 Rezk 80% 0.20 [0.01-4.13] 72mg death 0/160 2/160 Lim (RCT) -25% 1.25 [0.87-1.80] 112mg progression 52/241 43/249 Ozer 75% 0.25 [0.06-1.13] 28mg death 2/60 8/60 Ferreira -5% 1.05 [0.32-3.43] n/a death 3/21 11/81 Jamir (ICU) -53% 1.53 [0.88-2.67] n/a death 32/76 69/190 ICU patients Baguma 97% 0.03 [0.00-11.7] n/a death 7 (n) 474 (n) Mustafa 64% 0.36 [0.12-1.14] varies death 3/73 42/371 Shimizu 48% 0.52 [0.29-0.93] 14mg ventilation 39 (n) 49 (n) Zubair -9% 1.09 [0.33-3.64] 12mg death 5/90 5/98 Thairu (PSM) 88% 0.12 [0.01-2.14] 56mg death 0/21 4/26 Efimenko (PSM) 69% 0.31 [0.20-0.48] n/a death 1,072 (n) 40,536 (n) self-censored, see notes OT​1 Soto -41% 1.41 [1.16-1.76] n/a death 280/484 374/934 Ravikirti 3% 0.97 [0.74-1.24] varies death 53/171 254/794 George (RCT) 30% 0.70 [0.25-1.93] 24mg death 5/35 8/39 Naggie (DB RCT) 7% 0.93 [0.85-1.04] 84mg no recov. 817 (n) 774 (n) Rezai (DB RCT) 31% 0.69 [0.35-1.39] 84mg death 13/311 18/298 Qadeer 58% 0.42 [0.31-0.56] 48mg viral+ 35/105 84/105 Aref (RCT) 74% 0.26 [0.12-0.55] n/a recov. time 49 (n) 47 (n) LONG COVID Ochoa-Ja.. (DB RCT) -37% 1.37 [0.53-3.57] 28mg ICU 8/37 6/38 Tau​2 = 0.17, I​2 = 82.8%, p < 0.0001 Late treatment 31% 0.69 [0.58-0.83] 712/5,766 1,920/51,460 31% improvement Shouman (RCT) 91% 0.09 [0.03-0.23] 36mg symp. case 15/203 59/101 Improvement, RR [CI] Dose (1m) Treatment Control Carvallo 96% 0.04 [0.00-0.63] 14mg cases 0/131 11/98 see notes CT​2 Behera 54% 0.46 [0.29-0.71] 42mg cases 41/117 145/255 Carvallo 100% 0.00 [0.00-0.02] 48mg cases 0/788 237/407 see notes CT​2 Hellwig (ECO.) 78% 0.22 [0.06-0.76] 14mg cases ecological Bernigaud 99% 0.01 [0.00-0.10] 84mg death 0/69 150/3,062 Alam 91% 0.09 [0.04-0.25] 12mg cases 4/58 44/60 IVERCOR PREP 73% 0.27 [0.15-0.48] 48mg cases 13/389 61/486 MD​3 Chahla (RCT) 84% 0.16 [0.04-0.46] 48mg cases 4/117 25/117 CT​2 Behera 83% 0.17 [0.12-0.23] 42mg cases 45/2,199 133/1,147 Tanioka (ECO.) 88% 0.12 [0.03-0.46] 14mg death ecological Seet (CLUS. RCT) 6% 0.94 [0.61-1.19] 12mg cases 398/617 433/619 OT​1 Morgenstern (PSM) 74% 0.26 [0.10-0.71] 56mg cases 5/271 18/271 Mondal 88% 0.12 [0.01-0.55] n/a symp. case 128 (n) 1,342 (n) Samajdar 80% 0.20 [0.11-0.38] n/a cases 12/164 29/81 Kerr (PSM) 70% 0.30 [0.19-0.46] 56mg death 25/3,034 79/3,034 Tau​2 = 1.05, I​2 = 95.3%, p < 0.0001 Prophylaxis 84% 0.16 [0.09-0.29] 562/8,285 1,424/11,080 84% improvement All studies 54% 0.46 [0.40-0.54] 1,591/29,384 3,921/104,885 54% improvement All 93 ivermectin COVID-19 primary outcome results c19ivm.org Dec 2022 Tau​2 = 0.31, I​2 = 89.6%, p < 0.0001 Effect extraction pre-specified, see appendix 1 OT: ivermectin vs. other treatment3 MD: minimal detail available currently5 CS: preprint censored, see details 2 CT: study uses combined treatment4 SC: study uses synthetic control arm Favors ivermectin Favors control
Figure S1. Random effects meta-analysis for primary outcomes (as defined before the trial started).
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Figure S2. Random effects meta-analysis for peer-reviewed studies after exclusions. Effect extraction is pre-specified, using the most serious outcome reported, see the appendix for details.
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Figure S3. Random effects meta-analysis for RCT studies after exclusions. Effect extraction is pre-specified, using the most serious outcome reported, see the appendix for details.
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Figure S4. Random effects meta-analysis for mortality after exclusions.
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Figure S5. Random effects meta-analysis for mechanical ventilation after exclusions.
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Figure S6. Random effects meta-analysis for ICU admission after exclusions.
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Figure S7. Random effects meta-analysis for hospitalization after exclusions.
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Figure S8. Random effects meta-analysis for recovery results only after exclusions.
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Figure S9. Random effects meta-analysis for COVID-19 case results after exclusions.
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Figure S10. Random effects meta-analysis for viral clearance after exclusions.
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Figure S11. Random effects meta-analysis for studies grouped by strongyloides prevalence. Data is by country and from [Buonfrate]. Effect extraction follows the same pre-specified protocol as detailed in the appendix.
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Figure S12. Random effects meta-analysis with SSC exclusions. SSC has not reviewed late treatment and prophylaxis trials. SSC exclusions are from Nov 27, 2021.
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Figure S13. Random effects meta-analysis with GMK exclusions. Our main exclusion analyses already exclude all studies where the GMK team believes there are major data issues. This analysis corresponds with GMK's recommendation for meta analysis as of Oct 26, 2021. GMK excludes most non-RCT studies, with the notable exception of several studies with major issues that report negative or relatively poor results — [Szente Fonseca] which is likely affected by multicollinearity among treatments, [Elavarasi] which reports unadjusted results with no group details and is subject to confounding by indication, and [Soto-Becerra] which has several major issues described in the details.
Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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