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Efficacy and safety of ivermectin for the treatment of COVID-19: a systematic review and meta-analysis.
Deng, J; Zhou, F; Ali, S; Heybati, K; Hou, W; Huang, E; Wong, C Y.
  • Deng J; From the Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
  • Zhou F; From the Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
  • Ali S; From the Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
  • Heybati K; Mayo Clinic Alix School of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
  • Hou W; From the Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
  • Huang E; School of Medicine, University of Ottawa, 75 Laurier Ave. E, Ottawa, ON K1N 6N5, Canada.
  • Wong CY; From the Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
QJM ; 114(10): 721-732, 2021 Dec 20.
Article in English | MEDLINE | ID: covidwho-1440648
ABSTRACT

BACKGROUND:

Ivermectin became a popular choice for COVID-19 treatment among clinicians and the public following encouraging results from pre-print trials and in vitro studies. Early reviews recommended the use of ivermectin based largely on non-peer-reviewed evidence, which may not be robust. This systematic review and meta-analysis assessed the efficacy and safety of ivermectin for treating COVID-19 based on peer-reviewed randomized controlled trials (RCTs) and observational studies (OSs).

METHODS:

MEDLINE, EMBASE and PubMed were searched from 1 January 2020 to 1 September 2021 for relevant studies. Outcomes included time to viral clearance, duration of hospitalization, mortality, incidence of mechanical ventilation and incidence of adverse events. RoB2 and ROBINS-I were used to assess risk of bias. Random-effects meta-analyses were conducted. GRADE was used to evaluate quality of evidence.

RESULTS:

Three OSs and 14 RCTs were included in the review. Most RCTs were rated as having some concerns in regards to risk of bias, while OSs were mainly rated as having a moderate risk of bias. Based on meta-analysis of RCTs, the use of ivermectin was not associated with reduction in time to viral clearance, duration of hospitalization, incidence of mortality and incidence of mechanical ventilation. Ivermectin did not significantly increase incidence of adverse events. Meta-analysis of OSs agrees with findings from RCT studies.

CONCLUSIONS:

Based on very low to moderate quality of evidence, ivermectin was not efficacious at managing COVID-19. Its safety profile permits its use in trial settings to further clarify its role in COVID-19 treatment. PROTOCOL REGISTRATION The review was prospectively registered in PROSPERO (CRD42021275302).
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Ivermectin / COVID-19 Type of study: Controlled clinical trial / Clinical Practice Guide / Randomized controlled trials / Reviews / Systematic review Limits: Humans Language: English Journal: QJM Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Qjmed

Full text: Available Collection: International databases Database: MEDLINE Main subject: Ivermectin / COVID-19 Type of study: Controlled clinical trial / Clinical Practice Guide / Randomized controlled trials / Reviews / Systematic review Limits: Humans Language: English Journal: QJM Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Qjmed