tetano
Editor, Senior Moderator
BMC Infect Dis
. 2026 Mar 31.
doi: 10.1186/s12879-026-13195-9. Online ahead of print.
The role of ivermectin in the prevention and treatment of SARS-CoV-2 infection: a meta-analysis of randomized controlled trials
Xuanyu Wang[SUP] #[/SUP][SUP] 1 2 [/SUP], Jiahao Meng[SUP] #[/SUP][SUP] 1 3 [/SUP], Yinghui Li[SUP] 4 [/SUP], Yuqing Xiang[SUP] 1 2 [/SUP], Yumei Wu[SUP] 1 [/SUP], Yilin Xiong[SUP] 1 3 5 [/SUP], Pan Liu[SUP] 1 [/SUP], Shuguang Gao[SUP] 6 7 8 9 [/SUP]
Affiliations
Background: Ivermectin, as a potential drug for the treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, remains controversial regarding its efficacy and safety. This study aims to systematically evaluate the therapeutic and preventive effect of ivermectin in patients with SARS-CoV-2 infection.
Methods: A comprehensive literature search was conducted on October 11, 2025, to include randomized controlled trials (RCTs) assessing ivermectin for the treatment of SARS-CoV-2 infection. The primary outcome measures were mortality rate and adverse event rate for hospitalized patients and outpatient patients, while secondary outcomes included hospitalization time and recovery time. Given the anticipated clinical and methodological heterogeneity across the included RCTs (e.g., variations in ivermectin dosage, study population characteristics, trial implementation time and SARS-CoV-2 variants), a random-effects model was used for the meta-analysis to obtain a robust synthesis of heterogeneous study results and reliable estimation of pooled effect sizes.
Results: A total of 40 RCTs involving 23,243 participants were included. Among them, 4 studies evaluated the preventive effect of ivermectin on SARS-CoV-2 infection, and the other 36 studies evaluated the therapeutic effect of ivermectin in patients with SARS-CoV-2 infection. For prevention, there was no statistically significant difference between the ivermectin group and control group in SARS-CoV-2 infection rate [risk ratio (RR) 0.37; 95% Confidence Interval (CI) 0.12 to 1.20]. For treatment, all-cause mortality for both hospitalized patients (RR 0.94; 95%CI 0.74 to 1.20) and outpatients (RR 0.88; 95%CI 0.55 to 1.42) showed no statistically significant difference. Adverse events for hospitalized patients (RR 1.02; 95%CI 0.76 to 1.37) and outpatients (RR 0.96; 95%CI 0.82 to 1.13) also showed no statistically significant difference.
Conclusions: This meta-analysis provides evidence that ivermectin does not statistically significantly reduce the risk of SARS-CoV-2 infection or improve clinical outcomes in patients with COVID-19. Further high-quality trials are needed to clarify the potential benefits of ivermectin.
Clinical trial number: Not applicable.
. 2026 Mar 31.
doi: 10.1186/s12879-026-13195-9. Online ahead of print.
The role of ivermectin in the prevention and treatment of SARS-CoV-2 infection: a meta-analysis of randomized controlled trials
Xuanyu Wang[SUP] #[/SUP][SUP] 1 2 [/SUP], Jiahao Meng[SUP] #[/SUP][SUP] 1 3 [/SUP], Yinghui Li[SUP] 4 [/SUP], Yuqing Xiang[SUP] 1 2 [/SUP], Yumei Wu[SUP] 1 [/SUP], Yilin Xiong[SUP] 1 3 5 [/SUP], Pan Liu[SUP] 1 [/SUP], Shuguang Gao[SUP] 6 7 8 9 [/SUP]
Affiliations
- PMID: 41918076
- DOI: 10.1186/s12879-026-13195-9
Background: Ivermectin, as a potential drug for the treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, remains controversial regarding its efficacy and safety. This study aims to systematically evaluate the therapeutic and preventive effect of ivermectin in patients with SARS-CoV-2 infection.
Methods: A comprehensive literature search was conducted on October 11, 2025, to include randomized controlled trials (RCTs) assessing ivermectin for the treatment of SARS-CoV-2 infection. The primary outcome measures were mortality rate and adverse event rate for hospitalized patients and outpatient patients, while secondary outcomes included hospitalization time and recovery time. Given the anticipated clinical and methodological heterogeneity across the included RCTs (e.g., variations in ivermectin dosage, study population characteristics, trial implementation time and SARS-CoV-2 variants), a random-effects model was used for the meta-analysis to obtain a robust synthesis of heterogeneous study results and reliable estimation of pooled effect sizes.
Results: A total of 40 RCTs involving 23,243 participants were included. Among them, 4 studies evaluated the preventive effect of ivermectin on SARS-CoV-2 infection, and the other 36 studies evaluated the therapeutic effect of ivermectin in patients with SARS-CoV-2 infection. For prevention, there was no statistically significant difference between the ivermectin group and control group in SARS-CoV-2 infection rate [risk ratio (RR) 0.37; 95% Confidence Interval (CI) 0.12 to 1.20]. For treatment, all-cause mortality for both hospitalized patients (RR 0.94; 95%CI 0.74 to 1.20) and outpatients (RR 0.88; 95%CI 0.55 to 1.42) showed no statistically significant difference. Adverse events for hospitalized patients (RR 1.02; 95%CI 0.76 to 1.37) and outpatients (RR 0.96; 95%CI 0.82 to 1.13) also showed no statistically significant difference.
Conclusions: This meta-analysis provides evidence that ivermectin does not statistically significantly reduce the risk of SARS-CoV-2 infection or improve clinical outcomes in patients with COVID-19. Further high-quality trials are needed to clarify the potential benefits of ivermectin.
Clinical trial number: Not applicable.