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Open Forum Infect Dis
. 2021 Jul 6;8(11):ofab358.
doi: 10.1093/ofid/ofab358. eCollection 2021 Nov.
Meta-analysis of Randomized Trials of Ivermectin to Treat SARS-CoV-2 Infection
Andrew Hill 1 , Anna Garratt 2 , Jacob Levi 3 , Jonathan Falconer 4 , Leah Ellis 5 , Kaitlyn McCann 5 , Victoria Pilkington 6 , Ambar Qavi 5 , Junzheng Wang 5 , Hannah Wentzel 5
Affiliations
- PMID: 34796244
- PMCID: PMC8420640
- DOI: 10.1093/ofid/ofab358
Abstract
Ivermectin is an antiparasitic drug being investigated for repurposing against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Ivermectin showed in vitro activity against SARS-COV-2, but only at high concentrations. This meta-analysis investigated ivermectin in 23 randomized clinical trials (3349 patients) identified through systematic searches of PUBMED, EMBASE, MedRxiv, and trial registries. The primary meta-analysis was carried out by excluding studies at a high risk of bias. Ivermectin did not show a statistically significant effect on survival (risk ratio [RR], 0.90; 95% CI, 0.57 to 1.42; P = .66) or hospitalizations (RR, 0.63; 95% CI, 0.36 to 1.11; P = .11). Ivermectin displayed a borderline significant effect on duration of hospitalization in comparison with standard of care (mean difference, -1.14 days; 95% CI, -2.27 to -0.00; P = .05). There was no significant effect of ivermectin on time to clinical recovery (mean difference, -0.57 days; 95% CI, -1.31 to 0.17; P = .13) or binary clinical recovery (RR, 1.19; 95% CI, 0.94 to 1.50; P = .15). Currently, the World Health Organization recommends the use of ivermectin only inside clinical trials. A network of large clinical trials is in progress to validate the results seen to date.
Keywords: COVID-19; SARS-CoV-2; ivermectin; repurposed.