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0 0.5 1 1.5 2+ Mortality 61% Improvement Relative Risk Ivermectin for COVID-19  Zein et al.  META ANALYSIS Favors ivermectin Favors control

Ivermectin and mortality in patients with COVID-19: A systematic review, meta-analysis, and meta-regression of randomized controlled trials

Zein et al., Diabetes & Metabolic Syndrome: Clinical Research & Reviews, doi:10.1016/j.dsx.2021.102186
Jul 2021  
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Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020
*, now known with p < 0.00000000001 from 102 studies, recognized in 22 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Systematic review and meta analysis showing lower mortality with ivermectin.
7 meta analyses show significant improvements with ivermectin for mortality Bryant, Hariyanto, Kory, Lawrie, Nardelli, Zein, hospitalization Schwartz, recovery Kory, and cases Kory.
Currently there are 102 ivermectin for COVID-19 studies, showing 49% lower mortality [35‑60%], 29% lower ventilation [12‑42%], 35% lower ICU admission [7‑54%], 34% lower hospitalization [20‑45%], and 81% fewer cases [71‑87%].
risk of death, 61.0% lower, RR 0.39, p = 0.005.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Zein et al., 31 Jul 2021, peer-reviewed, 4 authors. Contact:,,
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Ivermectin and mortality in patients with COVID-19: A systematic review, meta-analysis, and meta-regression of randomized controlled trials
Ahmad Fariz Malvi Zamzam Zein, Catur Setiya Sulistiyana, Wilson Matthew Raffaelo, Raymond Pranata
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, doi:10.1016/j.dsx.2021.102186
Aims: This systematic review and meta-analysis aims to investigate the effect of ivermectin on mortality in patients with COVID-19. Methods: A comprehensive systematic literature search was performed using PubMed, Scopus, Embase, and from the inception of databases up until April 9, 2021. The intervention group was ivermectin and the control group was standard of care or placebo. The primary outcome was mortality reported as risk ratio (RR). Results: There were 9 RCTs comprising of 1788 patients included in this meta-analysis. Ivermectin was associated with decreased mortality (RR 0.39 [95% 0.20e0.74], p ¼ 0.004; I 2 : 58.2%, p ¼ 0.051). Subgroup analysis in patients with severe COVID-19 showed borderline statistical significance towards mortality reduction (RR 0.42 [95% 0.18e1.00], p ¼ 0.052; I 2 : 68.3, p ¼ 0.013). The benefit of ivermectin and mortality was reduced by hypertension (RR 1.08 [95% CI 1.03e1.13], p ¼ 0.001); but was not influenced by age (p ¼ 0.657), sex (p ¼ 0.466), diabetes (p ¼ 0.429). Sensitivity analysis using fixed-effect model showed that ivermectin decreased mortality in general (RR 0.43 [95% CI 0.29e0.62], p < 0.001) and severe COVID-19 subgroup (RR 0.48 [95% CI 0.32e0.72], p < 0.001). Conclusions: Ivermectin was associated with decreased mortality in COVID-19 with a low certainty of evidence. Further adequately powered double-blinded placebo-controlled RCTs are required for definite conclusion.
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