Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun 21;6(6):CD015017.
doi: 10.1002/14651858.CD015017.pub3.

Ivermectin for preventing and treating COVID-19

Maria Popp  1 , Stefanie Reis  1 , Selina Schießer  1 , Renate Ilona Hausinger  2 , Miriam Stegemann  3 , Maria-Inti Metzendorf  4 , Peter Kranke  1 , Patrick Meybohm  1 , Nicole Skoetz  5 , Stephanie Weibel  1
Affiliations
Review

Ivermectin for preventing and treating COVID-19

Maria Popp et al. Cochrane Database Syst Rev. .

Abstract

Background: Ivermectin, an antiparasitic agent, inhibits the replication of viruses in vitro. The molecular hypothesis of ivermectin's antiviral mode of action suggests an inhibitory effect on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication in early stages of infection. Currently, evidence on ivermectin for prevention of SARS-CoV-2 infection and COVID-19 treatment is conflicting.

Objectives: To assess the efficacy and safety of ivermectin plus standard of care compared to standard of care plus/minus placebo, or any other proven intervention for people with COVID-19 receiving treatment as inpatients or outpatients, and for prevention of an infection with SARS-CoV-2 (postexposure prophylaxis).

Search methods: We searched the Cochrane COVID-19 Study Register, Web of Science (Emerging Citation Index and Science Citation Index), WHO COVID-19 Global literature on coronavirus disease, and HTA database weekly to identify completed and ongoing trials without language restrictions to 16 December 2021. Additionally, we included trials with > 1000 participants up to April 2022.

Selection criteria: We included randomized controlled trials (RCTs) comparing ivermectin to standard of care, placebo, or another proven intervention for treatment of people with confirmed COVID-19 diagnosis, irrespective of disease severity or treatment setting, and for prevention of SARS-CoV-2 infection. Co-interventions had to be the same in both study arms. For this review update, we reappraised eligible trials for research integrity: only RCTs prospectively registered in a trial registry according to WHO guidelines for clinical trial registration were eligible for inclusion.

Data collection and analysis: We assessed RCTs for bias, using the Cochrane RoB 2 tool. We used GRADE to rate the certainty of evidence for outcomes in the following settings and populations: 1) to treat inpatients with moderate-to-severe COVID-19, 2) to treat outpatients with mild COVID-19 (outcomes: mortality, clinical worsening or improvement, (serious) adverse events, quality of life, and viral clearance), and 3) to prevent SARS-CoV-2 infection (outcomes: SARS-CoV-2 infection, development of COVID-19 symptoms, admission to hospital, mortality, adverse events and quality of life).

Main results: We excluded seven of the 14 trials included in the previous review version; six were not prospectively registered and one was non-randomized. This updated review includes 11 trials with 3409 participants investigating ivermectin plus standard of care compared to standard of care plus/minus placebo. No trial investigated ivermectin for prevention of infection or compared ivermectin to an intervention with proven efficacy. Five trials treated participants with moderate COVID-19 (inpatient settings); six treated mild COVID-19 (outpatient settings). Eight trials were double-blind and placebo-controlled, and three were open-label. We assessed around 50% of the trial results as low risk of bias. We identified 31 ongoing trials. In addition, there are 28 potentially eligible trials without publication of results, or with disparities in the reporting of the methods and results, held in 'awaiting classification' until the trial authors clarify questions upon request. Ivermectin for treating COVID-19 in inpatient settings with moderate-to-severe disease We are uncertain whether ivermectin plus standard of care compared to standard of care plus/minus placebo reduces or increases all-cause mortality at 28 days (risk ratio (RR) 0.60, 95% confidence interval (CI) 0.14 to 2.51; 3 trials, 230 participants; very low-certainty evidence); or clinical worsening, assessed by participants with new need for invasive mechanical ventilation or death at day 28 (RR 0.82, 95% CI 0.33 to 2.04; 2 trials, 118 participants; very low-certainty evidence); or serious adverse events during the trial period (RR 1.55, 95% CI 0.07 to 35.89; 2 trials, 197 participants; very low-certainty evidence). Ivermectin plus standard of care compared to standard of care plus placebo may have little or no effect on clinical improvement, assessed by the number of participants discharged alive at day 28 (RR 1.03, 95% CI 0.78 to 1.35; 1 trial, 73 participants; low-certainty evidence); on any adverse events during the trial period (RR 1.04, 95% CI 0.61 to 1.79; 3 trials, 228 participants; low-certainty evidence); and on viral clearance at 7 days (RR 1.12, 95% CI 0.80 to 1.58; 3 trials, 231 participants; low-certainty evidence). No trial investigated quality of life at any time point. Ivermectin for treating COVID-19 in outpatient settings with asymptomatic or mild disease Ivermectin plus standard of care compared to standard of care plus/minus placebo probably has little or no effect on all-cause mortality at day 28 (RR 0.77, 95% CI 0.47 to 1.25; 6 trials, 2860 participants; moderate-certainty evidence) and little or no effect on quality of life, measured with the PROMIS Global-10 scale (physical component mean difference (MD) 0.00, 95% CI -0.98 to 0.98; and mental component MD 0.00, 95% CI -1.08 to 1.08; 1358 participants; high-certainty evidence). Ivermectin may have little or no effect on clinical worsening, assessed by admission to hospital or death within 28 days (RR 1.09, 95% CI 0.20 to 6.02; 2 trials, 590 participants; low-certainty evidence); on clinical improvement, assessed by the number of participants with all initial symptoms resolved up to 14 days (RR 0.90, 95% CI 0.60 to 1.36; 2 trials, 478 participants; low-certainty evidence); on serious adverse events (RR 2.27, 95% CI 0.62 to 8.31; 5 trials, 1502 participants; low-certainty evidence); on any adverse events during the trial period (RR 1.24, 95% CI 0.87 to 1.76; 5 trials, 1502 participants; low-certainty evidence); and on viral clearance at day 7 compared to placebo (RR 1.01, 95% CI 0.69 to 1.48; 2 trials, 331 participants; low-certainty evidence). None of the trials reporting duration of symptoms were eligible for meta-analysis.

Authors' conclusions: For outpatients, there is currently low- to high-certainty evidence that ivermectin has no beneficial effect for people with COVID-19. Based on the very low-certainty evidence for inpatients, we are still uncertain whether ivermectin prevents death or clinical worsening or increases serious adverse events, while there is low-certainty evidence that it has no beneficial effect regarding clinical improvement, viral clearance and adverse events. No evidence is available on ivermectin to prevent SARS-CoV-2 infection. In this update, certainty of evidence increased through higher quality trials including more participants. According to this review's living approach, we will continually update our search.

PubMed Disclaimer

Conflict of interest statement

MP: is partly funded by the Federal Ministry of Education and Research, Germany (NaFoUniMedCovid19, funding number: 01KX2021; part of the CEOsys project, which was paid to the institution).

SR: none

SS: none

RIH: none

MS: none

MIM: none

PK: none

PM: none

NS: none

SW: is partly funded by the Federal Ministry of Education and Research, Germany (NaFoUniMedCovid19, funding number: 01KX2021; part of the CEOsys project, which was paid to the institution).

Figures

1
1
aFor research integrity we had to reassess the study pool from the original review (new eligibility criteria) (Figure 1; Supplementary File_Ivermectin_Research Integrity); for details on changed decision see Table 3.
bAfter initially closing the study pool for this review update in February 2022, we identified one trial with > 1000 participants, previously classified as ongoing, that published its results in March 2022 (TOGETHER 2022). We included the trial in the review without an additional systematic search. We show it here as added after the initial screening process; we performed research integrity assessement before inclusion.
1.1
1.1. Analysis
Comparison 1: Ivermectin for treating COVID‐19 in inpatient settings with moderate to severe disease, Outcome 1: All‐cause mortality at day 28
1.2
1.2. Analysis
Comparison 1: Ivermectin for treating COVID‐19 in inpatient settings with moderate to severe disease, Outcome 2: Worsening of clinical status at day 28: participants with new need for invasive mechanical ventilation or death
1.3
1.3. Analysis
Comparison 1: Ivermectin for treating COVID‐19 in inpatient settings with moderate to severe disease, Outcome 3: Improvement of clinical status at day 28: participants discharged alive
1.4
1.4. Analysis
Comparison 1: Ivermectin for treating COVID‐19 in inpatient settings with moderate to severe disease, Outcome 4: Serious adverse events during the study period
1.5
1.5. Analysis
Comparison 1: Ivermectin for treating COVID‐19 in inpatient settings with moderate to severe disease, Outcome 5: Any adverse events during the study period
1.6
1.6. Analysis
Comparison 1: Ivermectin for treating COVID‐19 in inpatient settings with moderate to severe disease, Outcome 6: Viral clearance at day 3
1.7
1.7. Analysis
Comparison 1: Ivermectin for treating COVID‐19 in inpatient settings with moderate to severe disease, Outcome 7: Viral clearance at day 7
2.1
2.1. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 1: All‐cause mortality at day 28
2.2
2.2. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 2: Worsening of clinical status within 28 days: admission to hospital or death
2.3
2.3. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 3: Worsening of clinical status within 28 days: participants with need for ICU admission or death
2.4
2.4. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 4: Symptom resolution: all initial symptoms resolved (asymptomatic) at day 14
2.5
2.5. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 5: Symptom resolution: all initial symptoms resolved (asymptomatic) at day 28
2.6
2.6. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 6: Quality of life (physical component) at up to 28 days
2.7
2.7. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 7: Quality of life (mental component) at up to 28 days
2.8
2.8. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 8: Serious adverse events during the study period
2.9
2.9. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 9: Any adverse events during the study period
2.10
2.10. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 10: Viral clearance at day 3
2.11
2.11. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 11: Viral clearance at day 7
2.12
2.12. Analysis
Comparison 2: Ivermectin for treating COVID‐19 in outpatient settings with asymptomatic or mild disease, Outcome 12: Viral clearance at day 14
See this image and copyright information in PMC

Update of

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Bounfrate 2021 {published data only}
    1. 2020-002283-32/IT. Randomized, double-blind, multi centre phase II, proof of concept, dose finding clinical trial on ivermectin for the early treatment of COVID-19. clinicaltrialsregister.eu/ctr-search/trial/2020-002283-32/IT (first received 10 August 2020).
    1. Buonfrate D, Chesini F, Martini D, Roncaglioni MC, Ojeda Fernandez ML, Alvisi MF, et al. High dose ivermectin for the early treatment of COVID-19 (COVER Study): a randomised, bouble-blind, multicentre, phase II, dose-finding, proof of concept clinical trial. papers.ssrn.com/sol3/papers.cfm?abstract_id=3918289 (first received 6 September 2021). [DOI: 10.2139/ssrn.3918289] - DOI - PMC - PubMed
    1. Buonfrate D, Chesini F, Martini D, Roncaglioni MC, Ojeda Fernandez ML, Alvisi MF, et al. High dose ivermectin for the early treatment of COVID-19 (COVER study): a randomised, double-blind, multicentre, phase II, dose-finding, proof of concept clinical trial. International Journal of Antimicrobial Agents 2022 Jan 6 [Epub ahead of print]:106516. [DOI: 10.1016/j.ijantimicag.2021.106516] - DOI - PMC - PubMed
    1. NCT04438850. COVidIVERmectin: ivermectin for treatment of Covid-19 (COVER). clinicaltrials.gov/ct2/show/NCT04438850 (first received 19 June 2020).
Chaccour 2021 {published data only}
    1. Chaccour C, Casellas A, Blanco-Di Matteo A, Pineda I, Fernandez-Montero A, Ruiz-Castillo P, et al. The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with mild COVID-19: a pilot, double-blind, placebo-controlled, randomized clinical trial. researchsquare.com/article/rs-116547/v1 (first received 7 December 2020). [DOI: 10.21203/rs.3.rs-116547/v1] - DOI - PMC - PubMed
    1. Chaccour C, Casellas A, Blanco-Di Matteo A, Pineda I, Fernandez-Montero A, Ruiz-Castillo P, et al. The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: a pilot, double-blind, placebo-controlled, randomized clinical trial. EClinicalMedicine 2021;32:100720. [PMID: ] - PMC - PubMed
    1. Chaccour C, Ruiz-Castillo P, Richardson MA, Moncunill G, Casellas A, Carmona-Torre F, et al. The SARS-CoV-2 ivermectin Navarra-ISGlobal Trial (SAINT) to evaluate the potential of ivermectin to reduce COVID-19 transmission in low risk, non-severe COVID-19 patients in the first 48 hours after symptoms onset: a structured summary of a study protocol for a randomized control pilot trial. Trials 2020;21(1):498. [PMID: ] - PMC - PubMed
    1. EUCTR2020-001474-29-ES. Pilot study to evaluate the potential of ivermectin to reduce COVID-19 transmission. www.clinicaltrialsregister.eu/ctr-search/trial/2020-001474-29/ES (first received 8 May 2020).
    1. NCT04390022. Sars-CoV-2/COVID-19 ivermectin Navarra-ISGlobal Trial (SAINT). clinicaltrials.gov/ct2/show/NCT04390022 (first received 17 December 2020).
Gonzalez 2021 {published data only}
    1. Gonzalez BJ, González Gámez M, Enciso EA, Maldonado RJ, Palacios HP, Dueñas Campos S, et al. Efficacy and safety of ivermectin and hydroxychloroquine in patients with severe COVID-19. A randomized controlled trial. medrxiv.org/content/early/2021/02/23/2021.02.18.21252037 (first received 23 February 2021). [DOI: 10.1101/2021.02.18.21252037] - DOI
    1. NCT04391127. Hydroxychloroquine and ivermectin for the treatment of COVID-19 infection. clinicaltrials.gov/ct2/show/NCT04391127 (first received 18 May 2020).
I‐TECH 2022 {published and unpublished data}
    1. Lim 2021 [pers comm]. Forwarding the results from our recently completed RCT on Ivermectin. Email to: S Weibel, M Popp 29 November 2021.
    1. Lim SC, Hor CP, Tay KH, Mat Jelani A, Tan WH, Ker HB, et al. Efficacy of ivermectin treatment on disease progression among adults with mild to moderate COVID-19 and comorbidities: the I-TECH randomized clinical trial. JAMA Internal Medicine 2022 Feb 18 [Epub ahead of print]. [DOI: 10.1001/jamainternmed.2022.0189] - DOI - PMC - PubMed
    1. NCT04920942. Ivermectin treatment efficacy in Covid-19 high risk patients (I-TECH). clinicaltrials.gov/ct2/show/NCT04920942 (first received 10 June 2021).
Kirti 2021 {published data only}
    1. CTRI/2020/08/027225. Ivermectin as a possible treatment for COVID-19. ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=46660&EncHid=&modid=... (first received 18 August 2020).
    1. Kirti R, Roy R, Pattadar C, Raj R, Agarwal N, Biswas B, et al. Evaluation of ivermectin as a potential treatment for mild to moderate COVID-19 – a double blind randomized placebo-controlled trial in Eastern India. Journal of Pharmacy & Pharmaceutical Sciences 2021;24:343-50. [DOI: 10.18433/jpps32105] - DOI - PubMed
    1. Kirti R, Roy R, Pattadar C, Raj R, Agarwal N, Biswas B, et al. Ivermectin as a potential treatment for mild to moderate COVID-19 – a double blind randomized placebo-controlled trial. medrxiv.org/content/10.1101/2021.01.05.21249310v1 (first received 9 January 2021). [DOI: 10.1101/2021.01.05.21249310] - DOI - PubMed
Krolewiecki 2021 {published data only}
    1. Krolewiecki A, Lifschitz A, Moragas M, Travacio M, Valentini R, Alonso D, et al. Antiviral effect of high-dose ivermectin in adults with COVID-19: a pilot randomised, controlled, open label, multicentre trial. ssrn.com/abstract=3714649 (first received 11 November 2020). [DOI: 10.2139/ssrn.3714649] - DOI
    1. Krolewiecki A, Lifschitz A, Moragas M, Travacio, M, Valentini R, Alonso DF, et al. Antiviral effect of high-dose ivermectin in adults with COVID-19: a proof-of-concept randomized trial. EClinicalMedicine 2021;37:100959. [DOI: 10.1016/j.eclinm.2021.100959] - DOI - PMC - PubMed
    1. Krolewiecki A, Lifschitz A, Moragas M, Travacio, M, Valentini R, Alonso DF, et al. Corrigendum to Antiviral effect of high-dose ivermectin in adults with COVID-19: a proof-of-concept randomized trial [EClinicalMedicine 37 (2021) 100, 959]. EClinicalMedicine ;39:101119. [DOI: 10.1016/j.eclinm.2021.101119] - DOI - PMC - PubMed
    1. NCT04381884. Ivermectin effect on SARS-CoV-2 replication in patients with COVID-19. clinicaltrials.gov/ct2/show/NCT04381884 (first received 11 May 2020).
López‐Medina 2021 {published data only}
    1. López-Medina E, López P, Hurtado IC, Dávalos DM, Ramirez O, Martínez E, et al. Effect of ivermectin on time to resolution of symptoms among adults with mild COVID-19: a randomized clinical trial. JAMA 2021;325(14):1426-35. [DOI: 10.1001/jama.2021.3071] [PMID: ] - DOI - PMC - PubMed
    1. NCT04405843. Efficacy of ivermectin in adult patients with early stages of COVID-19 (EPIC Trial) (EPIC). clinicaltrials.gov/ct2/show/NCT04405843 (first received 28 May 2020).
Mohan 2021 {published data only}
    1. CTRI/2020/06/026001. Ivermectin in COVID. ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=44196&EncHid=&modid=... (first received 21 June 2020).
    1. Mohan A, Tiwari P, Suri T, Mittal S, Patel A, Jain A, et al. Ivermectin in mild and moderate COVID-19 (RIVET-COV): a randomized, placebo-controlled trial. researchsquare.com/article/rs-191648/v1 (first received 2 February 2021). [DOI: 10.21203/rs.3.rs-191648/v1] - DOI - PMC - PubMed
    1. Mohan A, Tiwari P, Suri T, Mittal S, Patel A, Jain A, et al. Single-dose oral ivermectin in mild and moderate COVID-19 (RIVET-COV): a single-centre randomized, placebo-controlled trial. Journal of Infection and Chemotherapy 2021;27(12):1743-9. [DOI: 10.1016/j.jiac.2021.08.021] - DOI - PMC - PubMed
Pott‐Junior 2021 {published data only}
    1. NCT04431466. A study to compare the efficacy and safety of different doses of ivermectin for COVID-19. clinicaltrials.gov/ct2/show/NCT04431466 (first received 16 June 2020).
    1. Pott-Junior H, Bastos Paoliello MM, Miguel AQ, da Cunha AF, Melo Freire CC, Neves FF, et al. Use of ivermectin in the treatment of Covid-19: a pilot trial. Toxicology Reports 2021;8:505-10. [DOI: 10.1016/j.toxrep.2021.03.003] [PMID: ] - DOI - PMC - PubMed
TOGETHER 2022 {published data only}
    1. NCT04727424. Repurposed approved therapies for outpatient treatment of patients with early-onset COVID-19 and mild symptoms. clinicaltrials.gov/ct2/show/NCT04727424 (first received 27 January 2021).
    1. Reis G, Silva E, Silva D, Thabane L, Milagres A, Ferreira T, et al. Effect of early treatment with ivermectin among patients with Covid-19. New England Journal of Medicine 2022 March 30 [Epub ahead of print]. [DOI: 10.1056/NEJMoa2115869] - DOI - PMC - PubMed
Vallejos 2021 {published and unpublished data}
    1. NCT04529525. Ivermectin to prevent hospitalizations in COVID-19 (IVERCORCOVID19). clinicaltrials.gov/ct2/show/NCT04529525 (first received 27 August 2020).
    1. Vallejos J, Zoni R, Bangher M, Villamandos S, Bobadilla A, Plano F, et al. Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized, double-blind, placebo-controlled trial. BMC Infectious Diseases 2021;1:635. [DOI: 10.1186/s12879-021-06348-5] - DOI - PMC - PubMed
    1. Vallejos J, Zoni R, Bangher M, Villamandos S, Bobadilla A, Plano F, et al. Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19): a structured summary of a study protocol for a randomized controlled trial. Trials 2020;21(1):965. [DOI: 10.1186/s13063-020-04813-1] - DOI - PMC - PubMed

References to studies excluded from this review

Abd‐Elsalam 2021 {published data only}
    1. Abd-Elsalam S, Noor RA, Badawi R, Khalaf M, Esmail ES, Soliman S, et al. Clinical study evaluating the efficacy of ivermectin in COVID-19 treatment: a randomized controlled study. Journal of Medical Virology 2021;93(10):5833-8. [DOI: 10.1002/jmv.27122] - DOI - PMC - PubMed
    1. NCT04403555. Ivermectin as a novel therapy in COVID-19 treatment. clinicaltrials.gov/ct2/show/NCT04403555 (first received 27 May 2020).
Ahmed 2020 {published data only}
    1. Ahmed S, Karim MM, Ross AG, Hossain MS, Clemens JD, Sumiya MK, et al. A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness. International Journal of Infectious Diseases 2020;103:214-6. [DOI: 10.1016/j.ijid.2020.11.191] [PMID: ] - DOI - PMC - PubMed
Babalola 2021 {published data only}
    1. Babalola OE, Bode CO, Ajayi AA, Alakaloko FM, Akase IE, Otrofanowei E, et al. Ivermectin shows clinical benefits in mild to moderate COVID19: a randomised controlled double blind dose response study in Lagos. medrxiv.org/content/10.1101/2021.01.05.21249131v1 (first received 6 January 2021). [DOI: 10.1101/2021.01.05.21249131] - DOI - PMC - PubMed
    1. Babalola OE, Bode CO, Ajayi AA, Alakaloko FM, Akase IE, Otrofanowei E, et al. Ivermectin shows clinical benefits in mild to moderate COVID19: a randomised controlled double-blind, dose-response study in Lagos. Quarterly Journal of Medicine 2021 Feb 18 [Epub ahead of print]. [DOI: 10.1093/qjmed/hcab035] - DOI - PMC - PubMed
    1. ISRCTN40302986. Does ivermectin cure and/or prevent COVID-19? isrctn.com/ISRCTN40302986 (first received 23 April 2020). [DOI: 10.1186/ISRCTN40302986] - DOI
Behera 2020 {published data only}
    1. Behera P, Patro BK, Singh AK, Chandanshive PD, Ravi K, Pradhan SK, et al. Role of ivermectin in the prevention of COVID-19 infection among healthcare workers in India: a matched case-control study. 10.1101/2020.10.29.20222661 (first received 3 November 2020). [DOI: 10.1101/2020.10.29.20222661] - DOI
Biber 2021 {published data only}
    1. Biber A, Mandelboim M, Harmelin G, Lev D, Ram L, Shaham A, et al. Favorable outcome on viral load and culture viability using ivermectin in early treatment of non-hospitalized patients with mild COVID-19 – a double-blind, randomized placebo-controlled trial. medrxiv.org/content/10.1101/2021.05.31.21258081v1 (first received 31 May 2021). [DOI: 10.1101/2021.05.31.21258081] - DOI
    1. NCT04429711. Ivermectin vs placebo for the treatment of patients with mild to moderate COVID-19. clinicaltrials.gov/ct2/show/NCT04429711 (first received 12 June 2020).
Cadegiani 2020 {published data only}
    1. Cadegiani F, Goren A, McCoy J, Wambier CG. Hydroxychloroquine, nitazoxanide and ivermectin have similar effects in early COVID-19: a head-to-head comparison of the Pre-AndroCoV Trial. researchsquare.com/article/rs-98106/v1 (first received 29 October 2020). [DOI: 10.21203/rs.3.rs-98106/v1] - DOI
    1. Cadegiani F, Goren A, Wambier CG, McCoy J. An open-label prospective observational study of antiandrogen and non-antiandrogen early pharmacological approaches in females with mild-to-moderate COVID-19. The Pre-AndroCoV Female Trial. medrxiv.org/content/10.1101/2020.10.05.20206870v1 (first received 6 October 2020). [DOI: 10.1101/2020.10.05.20206870] - DOI
    1. Cadegiani F, Wambier CG, Goren A, McCoy J. Early COVID-19 therapy with azithromycin plus nitazoxanide, ivermectin or hydroxychloroquine in outpatient settings significantly reduced symptoms compared to known outcomes in untreated patients. researchsquare.com/article/rs-100994/v1 (first received 3 November 2020). [DOI: 10.21203/rs.3.rs-100994/v1] - DOI
    1. Cadegiani F, Goren A, Wambier CG, McCoy J. Early COVID-19 therapy with azithromycin plus nitazoxanide, ivermectin or hydroxychloroquine in outpatient settings significantly reduced symptoms compared to known outcomes in untreated patients. medrxiv.org/content/10.1101/2020.10.31.20223883v1 (first received 4 November 2020). [DOI: 10.1101/2020.10.31.20223883] - DOI - PMC - PubMed
Camprubi 2020 {published data only}
    1. Camprubi D, Almuedo-Riera A, Marti-Soler H, Soriano A, Hurtado JC, Subira C, et al. Lack of efficacy of standard doses of ivermectin in severe COVID-19 patients. PloS One 2020;15(11):e024218. [DOI: 10.1371/journal.pone.0242184] - DOI - PMC - PubMed
Carvallo 2020 {published data only}
    1. Carvallo H, Hirsch R, Farinella EM. Safety and efficacy of the combined use of ivermectin, dexamethasone, enoxaparin and aspirin against COVID 19. medrxiv.org/content/10.1101/2020.09.10.20191619v1 (first received 15 September 2020). [DOI: 10.1101/2020.09.10.20191619] - DOI
    1. NCT04425863. Ivermectin, aspirin, dexamethasone and enoxaparin as treatment of Covid 19 (IDEA). clinicaltrials.gov/ct2/show/NCT04425863 (first received 11 June 2020).
Chachar 2020 {published data only}
    1. Chachar AZ, Khan KA, Asif M, Tanveer K, Khaqan A, Basri R. Effectiveness of ivermectin in SARS-CoV-2/COVID-19 patients. International Journal of Sciences 2020;9:31-5. [DOI: 10.18483/ijSci.2378] - DOI
    1. NCT04739410. Effectiveness of ivermectin in SARS-CoV-2/COVID-19 patients. clinicaltrials.gov/ct2/show/NCT04739410 (first received 4 February 2021).
Chahla 2021a {published data only}
    1. Chahla RE, Medina Ruiz L, Mena T, Brepe Y, Terranova P, Ortega ES, et al. A randomized trial – intensive treatment based in ivermectin and iota-carrageenan as pre-exposure prophylaxis for COVID-19 in healthcare agents. medrxiv.org/content/10.1101/2021.03.26.21254398v1 (first received 30 March 2021). [DOI: 10.1101/2021.03.26.21254398v1] - DOI
    1. NCT04701710. Prophylaxis Covid-19 in healthcare agents by intensive treatment with ivermectin and Iota-carrageenan (Ivercar-Tuc). clinicaltrials.gov/ct2/show/NCT04701710 (first received 8 January 2021).
Chahla 2021b {published data only}
    1. Chahla RE, Medina Ruiz L, Mena T, Brepe Y, Terranova P, Ortega ES, et al. Cluster randomised trials – ivermectin repurposing for COVID-19 treatment of outpatients with mild disease In primary health care centers. researchsquare.com/article/rs-495945/v1 (first received 6 May 2021). [DOI: 10.21203/rs.3.rs-495945/v1] - DOI
    1. Chahla RE, Medina Ruiz L, Mena T, Brepe Y, Terranova P, Ortega ES, et al. Ivermectin reproposing for COVID-19 treatment outpatients in mild stage in primary health care centers. medrxiv.org/content/10.1101/2021.03.29.21254554v1 (first received 20 March 2021). [DOI: 10.1101/2021.03.29.21254554v1] - DOI
Chowdhury 2021 {published data only}
    1. Chowdhury AT, Shahbaz M, Karim R, Islam J, Dan G, Shuixiang H. A comparative study on ivermectin-doxycycline and hydroxychloroquine-azithromycin therapy on COVID-19 patients. Eurasian Journal of Medicine and Oncology 2021;5(1):63-70. [DOI: 10.14744/ejmo.2021.16263] - DOI
    1. Chowdhury AT, Shahbaz M, Karim R, Islam J, Dan G, Shuixiang H. A randomized trial of ivermectin-doxycycline and hydroxychloroquine-azithromycin therapy on COVID19 patients. researchsquare.com/article/rs-38896/v1 (first received 14 July 2020). [DOI: 10.21203/rs.3.rs-38896/v1] - DOI
    1. NCT04434144. A comparative study on ivermectin and hydroxychloroquine on the COVID19 patients in Bangladesh. clinicaltrials.gov/ct2/show/NCT04434144 (first received 16 June 2020).
CTRI/2020/08/027282 {published data only}
    1. CTRI/2020/08/027282. Prophylactic ivermectin in COVID 19 contacts. ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=46676&EncHid=&modid=... (first received 20 August 2020).
CTRI/2020/08/027394 {published data only}
    1. CTRI/2020/08/027394. Assessment of response of ivermectin on virological clearance in COVID-19 patients. ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=46873&EncHid=&modid=... (first received 26 August 2020).
CTRI/2020/10/028335 {published data only}
    1. CTRI/2020/10/028335. A clinical study to assess the efficacy and safety of Tinefcon in patients with moderate COVID-19 infection. cochranelibrary.com/es/central/doi/10.1002/central/CN-02186249/full (first received 30 November 2020).
CTRI/2021/03/031665 {published data only}
    1. CTRI/2021/03/031665. Ivermectin prophylaxis for Covid-19 infection in health care personnel. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=53325&EncHid=&userName=... (first received 1 March 2021).
Elgazzar 2020 {published data only}
    1. Elgazzar A, Eltaweel A, Youssef SA, Hany B, Hafez M, Moussa H. Efficacy and safety of ivermectin for treatment and prophylaxis of COVID-19 pandemic (preprint). researchsquare.com/article/rs-100956/v3 (first received 28 December 2020). [DOI: 10.21203/rs.3.rs-100956/v3] - DOI
    1. NCT04668469. Efficacy and safety of ivermectin for treatment and prophylaxis of COVID-19 pandemic. clinicaltrials.gov/ct2/show/NCT04668469 (first received 16 December 2020).
Faisal 2020 {published data only}
    1. Faisal R, Ali Shah SF, Hussain M. Potential use of azithromycin alone and in combination with ivermectin in fighting against the symptoms of COVID-19. Professional Medical Journal 2020;28(5):737-41. [DOI: 10.29309/TPMJ/2021.28.05.5867] - DOI
Galan 2021 {published data only}
    1. Galan LE, Melo dos Santos N, Asato MS, Araújo JV, Moreira A, Marques-Araújo AM. Phase 2 randomized study on chloroquine, hydroxychloroquine or ivermectin in hospitalized patients with severe manifestations of SARS-CoV-2 infection. Pathology Global Health 2021;115(4):235-42. [DOI: 10.1080/20477724.2021.1890887] - DOI - PMC - PubMed
    1. RBR-8h7q82. The effect of chloroquine, hydroxychloroquine or ivermectin in patients with severe manifestations of coronavirus. ensaiosclinicos.gov.br/rg/RBR-8h7q82/ (first received 2 October 2020).
Gorial 2020 {published data only}
    1. Gorial FI, Mashhadani S, Sayaly HM, Dakhil BD, AlMashhadani MM, Aljabory AM, et al. Effectiveness of ivermectin as add-on therapy in COVID-19 management (pilot trial). medrxiv.org/content/10.1101/2020.07.07.20145979v1 (first received 8 July 2020). [DOI: 10.1101/2020.07.07.20145979] - DOI
    1. NCT04343092. Ivermectin adjuvant to hydroxychloroquin in COVID19 patients. clinicaltrials.gov/ct2/show/NCT04343092 (first received 4 November 2020).
Hashim 2020 {published data only}
    1. Hashim HA, Maulood MF, Rasheed AM, Fatak DF, Kabah KK, Abdulamir AS. Controlled randomized clinical trial on using Ivermectin with doxycycline for treating COVID-19 patients in Baghdad, Iraq. medrxiv.org/content/10.1101/2020.10.26.20219345v1 (first received 27 October 2020). [DOI: 10.1101/2020.10.26.20219345] - DOI
    1. NCT04591600. Effectiveness of ivermectin and doxycycline on COVID-19 patients. clinicaltrials.gov/ct2/show/NCT04591600 (first received 19 October 2020).
IRCT20180922041089N4 {published data only}
    1. IRCT20180922041089N4. Evaluation of the effect of oral Ivermectin on the outcome of patients with COVID-19 and compare it with the effect of conjunctional therapies in patients admitted to Ziaeian, Baharloo, Imam Khomeini in the spring and summer 2020. en.irct.ir/trial/50305 (first received 23 August 2020).
IRCT20200408046987N2 {published data only}
    1. IRCT20200408046987N2. Determination the therapeutic effect of Ivermectin and Sovodak on patients infected with COVID-19: a clinical trial. en.irct.ir/trial/51007 (first received 7 November 2020).
Kishoria 2020 {published data only}
    1. Kishoria N, Mathur SL, Parmar V, Kaur RJ, Agarwal H, Verma S. Ivermectin as adjuvant to hydroxychlorquine in patients resistant to standard treatment for SARS-CoV-2: results of an open-label randomized clinical study. Paripex — Indian Journal of Research 2020;9(8):4801859. [DOI: 10.36106/paripex/4801859] - DOI
Lima‐Morales 2021 {published data only}
    1. Lima-Morales R, Méndez-Hernández P, Flores YN, Osorno-Romero P, Sancho-Hernándezk CR, Cuecuecha-Rugerio E. Effectiveness of a multidrug therapy consisting of ivermectin, azithromycin, montelukast, and acetylsalicylic acid to prevent hospitalization and death among ambulatory COVID-19 cases in Tlaxcala, Mexico. International Journal of Infectious Diseases 2021;105:598-605. [DOI: 10.1016/j.ijid.2021.02.014] - DOI - PMC - PubMed
Mahmud 2021 {published data only}
    1. Mahmud R, Rahman M, Alam I, Ahmed KG, Humayon Kabir AK, Jakaria Been Sayeed SK, et al. Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial. Journal of International Medical Research 2021;49(5):1-14. [DOI: 10.1177/03000605211013550] - DOI - PMC - PubMed
    1. NCT04523831. Clinical trial of ivermectin plus doxycycline for the treatment of confirmed Covid-19 infection. clinicaltrials.gov/ct2/show/results/NCT04523831 (first received 24 August 2020).
Morgenstern 2020 {published data only}
    1. Morgenstern J, Redondo JN, De León A, Canela JM, Torres N, Tavares J, et al. The use of compassionate Ivermectin in the management of symptomatic outpatients and hospitalized patients with clinical diagnosis of COVID-19 at the Medical Center Bournigal and the Medical Center Punta Cana, Rescue Group, Dominican Republic, from May 1 to August 10, 2020. medrxiv.org/content/10.1101/2020.10.29.20222505v1 (first received 3 November 2020). [DOI: 10.1101/2020.10.29.20222505] - DOI
Mustaq 2021 {published data only}
    1. Mushtaq A, Zartash S, Javed M, Rana MA, Qayyum MA, Bibi T, et al. Ivermectin may not be a miraculous drug to improve PF ratio and virus clearance in COVID-19 patient. Pakistan Journal of Medical and Health Sciences 2021;15(5):999-1001. [DOI: 10.53350/pjmhs21155999] - DOI
NCT04345419 {published data only}
    1. NCT04345419. Remdesivir efficacy in coronavirus disease. clinicaltrials.gov/ct2/show/NCT04345419 (first received 14 April 2020).
NCT04360356 {published data only}
    1. NCT04360356. Ivermectin and nitazoxanide combination therapy for COVID-19. clinicaltrials.gov/ct2/show/NCT04360356 (first received 24 April 2020).
NCT04373824 {published data only}
    1. NCT04373824. Max ivermectin-COVID-19 study versus standard of care treatment for COVID-19 cases. A pilot study. clinicaltrials.gov/ct2/show/NCT04373824 (first received 4 May 2020).
NCT04374279 {published data only}
    1. NCT04374279. Trial to promote recovery from COVID-19 with ivermectin or endocrine therapy. clinicaltrials.gov/ct2/show/NCT04374279 (first received 5 May 2020).
NCT04382846 {published data only}
    1. NCT04382846. Novel regimens in COVID-19 treatment. clinicaltrials.gov/ct2/show/NCT04382846 (first received 11 May 2020).
NCT04392427 {published data only}
    1. NCT04392427. New antiviral drugs for treatment of COVID-19. clinicaltrials.gov/ct2/show/NCT04392427 (first received 18 May 2020).
NCT04435587 {published data only}
    1. NCT04435587. Ivermectin vs combined hydroxychloroquine and antiretroviral drugs (ART) among asymptomatic COVID-19 infection (IDRA-COVID19). clinicaltrials.gov/ct2/show/NCT04435587 (first received 17 June 2020).
NCT04447235 {published data only}
    1. NCT04447235. Early treatment with ivermectin and losartan for cancer patients with COVID-19 Infection. clinicaltrials.gov/ct2/show/NCT04447235 (first received 25 June 2020).
NCT04482686 {published data only}
    1. NCT04482686. Trial of combination therapy to treat COVID-19 infection. clinicaltrials.gov/ct2/show/NCT04482686 (first received 22 July 2020).
NCT04530474 {published data only}
    1. NCT04530474. Outpatient use of ivermectin in COVID-19. clinicaltrials.gov/ct2/show/NCT04530474 (first received 28 August 2020).
NCT04551755 {published data only}
    1. NCT04551755. Safety and efficacy of ivermectin and doxycycline in treatment of Covid-19. clinicaltrials.gov/ct2/show/NCT04551755 (first received 16 September 2020).
NCT04703608 {published data only}
    1. NCT04703608. Prevention and treatment for COVID -19 (severe acute respiratory syndrome coronavirus 2 SARS-CoV-2) associated severe pneumonia in the Gambia (PaTS-COVID). clinicaltrials.gov/ct2/show/NCT04703608 (first received 11 January 2021).
NCT04723459 {published data only}
    1. NCT04723459. Efficacy of nano-ivermectin impregnated masks in prevention of Covid-19 among healthy contacts and medical staff. clinicaltrials.gov/ct2/show/NCT04723459 (first received 25 January 2021).
NCT04768179 {published data only}
    1. NCT04768179. Safety & efficacy of low dose aspirin/ivermectin combination therapy for treatment of Covid-19 patients (IVCOM). clinicaltrials.gov/ct2/show/NCT04768179 (first received 24 February 2021).
NCT04937569 {published data only}
    1. NCT04937569. Ivermectin versus standard treatment in mild COVID-19. clinicaltrials.gov/ct2/show/NCT04937569 (first received 24 June 2021).
NCT04951362 {published data only}
    1. NCT04951362. Role of ivermectin nanosuspension as nasal spray in treatment of persistant post covid19 anosmia. clinicaltrials.gov/ct2/show/NCT04951362 (first received 6 July 2021).
Niaee 2021 {published data only}
    1. IRCT20200408046987N1. Dose-finding study of Ivermectin treatment on patients infected with Covid-19: a clinical trial. en.irct.ir/trial/47012 (first received 27 April 2020).
    1. Niaee MS, Gheibi N, Namdar P, Allami A, Zolghadr L, Javadi A, et al. Ivermectin as an adjunct treatment for hospitalized adult COVID-19 patients: a randomized multi-center clinical trial (preprint). researchsquare.com/article/rs-109670/v1 (first received 24 November 2020). [DOI: 10.21203/rs.3.rs-109670/v1] - DOI
    1. Niaee MS, Namdar P, Allami A, Zolghadr L, Javadi A, Karampour A, et al. Ivermectin as an adjunct treatment for hospitalized adult COVID-19 patients: a randomized multi-center clinical trial. Asian Pacific Journal of Tropical Medicine 2021;14:66-73. [DOI: 10.4103/1995-7645.318304] - DOI
Okumuş 2021 {published data only}
    1. NCT04646109. Ivermectin for severe COVID-19 management. clinicaltrials.gov/ct2/show/NCT04646109 (first received 27 November 2020).
    1. Okumuş N, Demirtürk N, Çetinkaya RA, Güner R, Avcı IY, Orhan S, et al. Evaluation of the effectiveness and safety of adding ivermectin to treatment in severe COVID-19 patients. BMC Infectious Diseases 2021;21:411. [DOI: 10.1186/s12879-021-06104-9] - DOI - PMC - PubMed
    1. Okumuş N, Demirtürk N, Çetinkaya RA, Güner R, Avcı IY, Orhan S, et al. Evaluation of the effectiveness and safety of adding ivermectin to treatment in severe COVID-19 patients. researchsquare.com/article/rs-224203/v1 (first received 24 February 2021). [DOI: 10.21203/rs.3.rs-224203/v1] - DOI - PMC - PubMed
Ozer 2021 {published data only}
    1. Ozer M, Goksu SY, Conception R, Ulker E, Balderas RM, Mahdi M, et al. Effectiveness and safety of Ivermectin in COVID-19 patients: a prospective study at a safety-net hospital. Journal of Medical Virology 2021 Nov 23 [Epub ahead of print]. [DOI: 10.1002/jmv.27469] - DOI - PMC - PubMed
Podder 2020 {published data only}
    1. Podder CS, Chowdhury N, Sina MI, Haque WM. Outcome of ivermectin treated mild to moderate COVID-19 cases: a single-centre, open-label, randomised controlled study. IMC Journal of Medical Science 2020;14(2):11-8. [DOI: ]
Rajter 2021 {published data only}
    1. Rajter JC, Sherman MS, Fatteh N, Vogel F, Sacks J, Rajter JJ. ICON (Ivermectin in COvid Nineteen) study: use of ivermectin is associated with lower mortality in hospitalized patients with COVID19. medrxiv.org/content/10.1101/2020.06.06.20124461v2 (first received 10 June 2020). [DOI: 10.1101/2020.06.06.20124461] - DOI
    1. Rajter JC, Sherman MS, Fatteh N, Vogel F, Sacks J, Rajter JJ. Use of ivermectin is associated with lower mortality in hospitalized patients with coronavirus disease 2019: the ivermectin in COVID nineteen study. Chest 2021;159(1):85-92. [DOI: 10.1016/j.chest.2020.10.009] - DOI - PMC - PubMed
Samaha 2021 {published data only}
    1. ChiCTR2000033627. In vivo use of ivermectin (IVR) for treatment for corona virus infected patients: a randomized controlled trial. chictr.org.cn/showprojen.aspx?proj=54707 (first received 7 June 2020).
    1. Samaha AA, Mouawia H, Fawaz M, Hassan H, Salami A, Bazzal AA, et al. Effects of a single dose of ivermectin on viral and clinical outcomes in asymptomatic SARS-CoV-2 infected subjects: a pilot clinical trial in Lebanon. Viruses 2021;13(6):989. [DOI: 10.3390/v13060989] - DOI - PMC - PubMed
    1. Samaha AA, Mouawia H, Fawaz M, Hassan H, Salami A, Bazzal AA, et al. Retraction: Samaha et al. Effects of a single dose of ivermectin on viral and clinical outcomes in asymptomatic SARS-CoV-2 infected subjects: a pilot clinical trial in Lebanon. Viruses 2021;13:2154. [DOI: 10.3390/v13112154] - DOI - PMC - PubMed
Seet 2021 {published data only}
    1. NCT04446104. A preventive treatment for migrant workers at high-risk of COVID-19. clinicaltrials.gov/ct2/show/NCT04446104 (first received 24 June 2020).
    1. Seet RC, Lin Quek AM, Qin Ooi DS, Sengupta S, Lashminarasappa SR, Yang Koo C. Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial. International Journal of Infectious Diseases 2021;106:314-22. [DOI: 10.1016/j.ijid.2021.04.035] - DOI - PMC - PubMed
Shahbaznejad 2021 {published data only}
    1. IRCT20111224008507N3. Effectiveness of ivermectin in the treatment of coronavirus infection in patients admitted to educational hospitals of Mazandaran in 2020. en.irct.ir/trial/49174 (first received 27 June 2020).
    1. Shahbaznejad L, Davoudi A, Eslami G, Markowitz JS, Navaeifar MR, Hosseinzadeh F, et al. Effects of ivermectin in patients with COVID-19: a multicenter, double-blind, randomized, controlled clinical trial. Clinical Therapeutics 6 May 2021 [Epub ahead of print]. [DOI: 10.1016/j.clinthera.2021.04.007] - DOI - PMC - PubMed
Shah Bukhari 2021 {published data only}
    1. NCT04392713. Efficacy of ivermectin in COVID-19. clinicaltrials.gov/ct2/show/NCT04392713 (first received 19 May 2020).
    1. Shah Bukhari KH, Asghar A, Perveen N, Hayat A, Mangat SA, Butt KR, et al. Efficacy of ivermectin in COVID-19 patients with mild to moderate disease. medrxiv.org/content/early/2021/02/05/2021.02.02.21250840 (first received 5 February 2021). [DOI: 10.1101/2021.02.02.21250840] - DOI
Shouman 2021 {published data only}
    1. NCT04422561. Prophylactic ivermectin in COVID-19 contacts. clinicaltrials.gov/ct2/show/NCT04422561 (first received 9 June 2020).
    1. Shoumann WM, Hegazy AA, Nafae RM, Ragab MI, Samra SR, Ibrahim DA, et al. Use of ivermectin as a potential chemoprophylaxis for COVID-19 in Egypt: a randomized clinical trial. Journal of Clinical and Diagnostic Research 2021;15(2):27-32. [DOI: 10.7860/JCDR/2021/46795.14529] - DOI
Spoorthi 2020 {published data only}
    1. Spoorthi V, Sasank S. Utility of ivermectin and doxycycline combination for the treatment of SARS-CoV-2. International Archives of Integrated Medicine 2020;7(10):177-82. [iaimjournal.com/wp-content/uploads/2020/10/iaim_2020_0710_23.pdf]

References to studies awaiting assessment

2020‐001971‐33/ES {published data only}
    1. 2020-001971-33/ES. Pragmatic study "CORIVER": ivermectin as antiviral treatment for patients infected by SARS-COV2 (COVID19). clinicaltrialsregister.eu/ctr-search/trial/2020-001971-33/ES (first received 22 July 2020).
2020‐002091‐12/BG {published data only}
    1. 2020-002091-12/BG. Multicenter, randomized, double-blind, placebo-controlled study investigating efficacy, safety and tolerability of ivermectin HUVE-19 in patients with proven SARS-CoV-2 infection (COVID-19) and manifested clinical symptoms. clinicaltrialsregister.eu/ctr-search/trial/2020-002091-12/BG (first received 5 May 2020).
2020‐005015‐40/SK {published data only}
    1. 2020-005015-40/SK. Ivermectin to prevent SARS-CoV-2 (COVID-19) hospitalisation in subjects over 50. clinicaltrialsregister.eu/ctr-search/trial/2020-005015-40/SK (first received 25 March 2021).
Aref 2021 {published data only}
    1. Aref ZF, Bazeed SEES, Hassan MH, Hassan AS, Rashad A, Hassan RG, et al. Clinical, biochemical and molecular evaluations of ivermectin mucoadhesive nanosuspension nasal spray in reducing upper respiratory symptoms of mild COVID-19. International Journal of Nanomedicine 2021;16:4063—4072. [DOI: 10.2147/IJN.S313093] - DOI - PMC - PubMed
    1. NCT04716569. Evaluation of ivermectin mucoadhesive nanosuspension as nasal spray in management of early Covid-19. clinicaltrials.gov/ct2/show/NCT04716569 (first received 20 January 2020).
CTRI/2020/04/024948 {published data only}
    1. CTRI/2020/04/024948. A clinical trial to study the effects of hydroxychloroquine, ciclesonide and ivermectin in treatment of moderate COVID-19 illness. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=43364 (first received 30 April 2020).
CTRI/2020/06/025960 {published data only}
    1. CTRI/2020/06/025960. To study effect of ivermectin drug in patients infected with SARS-CoV-2 virus. ctri.nic.in/Clinicaltrials/showallp.php?mid1=44373&EncHid=&userName=CTRI... (first received 18 June 2020).
Hosseini 2021 {published data only}
    1. Hosseini FS, Malektojari A, Ghazizadeh S, Hassaniazad M, Davoodian P, Dadvand H, et al. The efficacy and safety of ivermectin in patients with mild and moderate COVID-19: a structured summary of a study protocol for a randomized controlled trial. Trials 2021;22(1):4. [DOI: 10.1186/s13063-020-04988-7] - DOI - PMC - PubMed
    1. IRCT20200506047323N6. The efficacy and safety of Ivermectin in patients with COVID-19: a randomized clinical trial. en.irct.ir/trial/49501 (first received 17 November 2020).
IRCT20111224008507N4 {published data only}
    1. IRCT20111224008507N4. Double-blind placebo-controlled clinical trial of evaluating the effectiveness of ivermectin in treatment of outpatients with COVID-19 in 2021. irct.ir/trial/53949 (first received 31 January 2021).
IRCT20180612040068N1 {published data only}
    1. IRCT20180612040068N1. To study the effect of Metronidazole and Ivermectin in the recovery of the infected patients with COVID-19 compared with protocol treatment: triple-blind randomized clinical trial. irct.ir/trial/54625 (first received 19 April 2021).
IRCT20190602043787N3 {published data only}
    1. IRCT20190602043787N3. Evaluation of the effect of ivermectin in hospitalized patients with COVID-19 in Imam Reza Hospital in Mashhad. en.irct.ir/trial/49180 (first received 20 July 2020).
IRCT20190624043993N2 {published data only}
    1. IRCT20190624043993N2. Evaluation effects of the standard regimen along with ivermectin on treatment of corona virus type 2 pneumonia. irct.ir/trial/49280 (first received 12 July 2020).
IRCT20200329046892N3 {published data only}
    1. IRCT20200329046892N3. Study of ivermectin effectiveness in treatment process, survival and cure rate of COVID-19 patients: a randomized clinical trial. irct.ir/trial/55216 (first received 29 March 2021) .
IRCT20200404046937N4 {published data only}
    1. IRCT20200404046937N4. Evaluating the efficacy and safety of Ivermectin in the treatment of COVID-19 patients: a double-blind randomized controlled trial, phase II. en.irct.ir/trial/49935 (first received 6 August 2020).
IRCT20200408046987N3 {published data only}
    1. IRCT20200408046987N3. Evaluation of prophylaxis induced by ivermectin in populations exposed to COVID-19 patients. www.irct.ir/trial/51999 (first received 6 December 2020).
IRCT20200422047168N2 {published data only}
    1. IRCT20200422047168N2. Clinical trial study of the therapeutic effect of ivermectin, besides kaletra and chloroquine in patients with coronavirus disease 2019 (COVID-19). en.irct.ir/trial/48444 (first received 30 May 2020).
IRCT20210213050344N1 {published data only}
    1. IRCT20210213050344N1. Investigation of the effectiveness of ivermectin on outpatient treatment of Covid-19 patients, Shiraz City, Southern Iran, 2020: A Randomized Controlled Trial Study (RCT). irct.ir/trial/54710 (first received 4 June 2021).
ISRCTN90437126 {published data only}
    1. ISRCTN90437126. Study on the effects of using ivermectin to prevent COVID-19 in an adult population in Brazil. www.isrctn.com/ISRCTN90437126 (first received 11 November 2020).
NCT04351347 {published data only}
    1. NCT04351347. The efficacy of ivermectin in larger doses in COVID-19 treatment. clinicaltrials.gov/ct2/show/NCT04351347 (first received 17 April 2020).
NCT04374019 {published data only}
    1. NCT04374019. Novel agents for treatment of high-risk COVID-19 positive patients. clinicaltrials.gov/ct2/show/NCT04374019 (first received 5 May 2020).
NCT04407130 {published data only}
    1. NCT04407130. Efficacy and safety of ivermectin and doxycycline in combination or IVE alone in patients with COVID-19 infection. clinicaltrials.gov/ct2/show/NCT04407130 (first received 29 May 2020).
NCT04407507 {published data only}
    1. NCT04407507. Efficacy, safety and tolerability of ivermectin in subjects infected with SARS-CoV-2 with or without symptoms. clinicaltrials.gov/ct2/show/NCT04407507 (first received 29 May 2020).
NCT04602507 {published data only}
    1. NCT04602507. Ivermectin in adults with severe COVID-19. clinicaltrials.gov/ct2/show/NCT04602507 (first received 26 October 2020).
NCT04673214 {published data only}
    1. NCT04673214. Evaluation of prognostic modification in COVID-19 patients in early intervention treatment, a randomized clinical trial. clinicaltrials.gov/ct2/show/NCT04673214 (first received 17 December 2020).
NCT04746365 {published data only}
    1. NCT04746365. Ivermectin Role In Covid-19 Clinical Trial (IRICT). clinicaltrials.gov/ct2/show/NCT04746365 (first received 9 February 2021).
NCT04891250 {published data only}
    1. NCT04891250. The Zambia Ivermectin Trial for the treatment and prevention of COVID-19 (ZIT). clinicaltrials.gov/ct2/show/NCT04891250 (first received 18 May 2021).
NCT04894721 {published data only}
    1. NCT04894721. Prophylaxis for COVID-19: ivermectin in close contacts of COVID-19 cases (IVERNEX-TUC). clinicaltrials.gov/ct2/show/NCT04894721 (first received 20 May 2021).
NCT05076253 {published data only}
    1. NCT05076253. Efficacy of Ivermectin in COVID-19. clinicaltrials.gov/ct2/show/NCT05076253 (first received 13 Octoboer 2021).
PACTR202102588777597 {published data only}
    1. PACTR202102588777597. Ivermectin Treatment Trial (ITT). pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/re... (first received 12 February 2021).

References to ongoing studies

2020‐001994‐66/ES {published data only}
    1. 2020-001994-66/ES. Study of the efficacy of ivermectin in the treatment and prevention of COVID-19. clinicaltrialsregister.eu/ctr-search/trial/2020-001994-66/ES (first received 7 May 2020).
2021‐000166‐15/HU {published data only}
    1. 2021-000166-15/HU. A randomized, double-blind, placebo-controlled study to assess the safety and efficacy of ivermectin in asymptomatic and mild severity COVID-19 patients. clinicaltrialsregister.eu/ctr-search/trial/2021-000166-15/HU (first received 25 January 2021).
2021‐002024‐21/CZ {published data only}
    1. 2021-002024-21/CZ. Randomized placebo controlled clinical trial evaluating the safety and efficacy of ivermectin in hospitalized patients with Covid-19 disease. clinicaltrialsregister.eu/ctr-search/trial/2021-002024-21/CZ (first received 28 April 2021).
ACTRN12620000982910 {published data only}
    1. ACTRN12620000982910. A randomized double-blind placebo-controlled trial of oral ivermectin for outpatient treatment of those at high risk for hospitalization due to COVID-19. anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000982910 (first received 14 September 2020).
ACTRN12621001535864 {published data only}
    1. ACTRN12621001535864. Ivermectin to prevent Coronavirus. anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382688&isReview=true (first received 20 October 2021).
Ashraf 2021 {published data only}
    1. Ashraf S, Ashraf S, Farooq I, Ashraf S, Ashraf M, Imran MA, et al. Anti-COVID property of subcutaneous ivermectin in synergy with zinc among midlife moderately symptomatic patients: a structured summary of a study protocol for a randomised controlled trial. Trials 2021;22:591. [DOI: 10.1186/s13063-021-05487-z] - DOI - PMC - PubMed
    1. NCT04472585. Efficacy of subcutaneous ivermectin with or without zinc in COVID-19 patients (SIZI-COVID-PK). clinicaltrials.gov/ct2/show/NCT04472585 (first received 15 July 2020).
CTRI/2020/05/025068 {published data only}
    1. CTRI/2020/05/025068. A phase IIB open label randomized controlled trial to evaluate the efficacy and safety of ivermectin in reducing viral loads in patients with hematological disorders who are admitted with COVID 19 infection. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=43449 (first received 7 May 2020).
CTRI/2020/05/025224 {published data only}
    1. CTRI/2020/05/025224. Study to efficacy of ivermectin in patients of COVID-19. ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=43728&EncHid=&modid=... (first received 18 May 2020).
Garcia 2021 {published data only}
    1. Garcia PJ, Hurtado HM, Ugarte-Gil C, Leon P, Malaga G, Chaccour C, et al. Randomized clinical trial to compare the efficacy of ivermectin versus placebo to negativize nasopharyngeal PCR in patients with early COVID-19 in Peru (SAINT-Peru): a structured summary of a study protocol for randomized controlled trial. Trials 2021;22(1):262. [DOI: 10.1186/s13063-021-05236-2] [PMID: ] - DOI - PMC - PubMed
    1. Garica PJ, Huratdo HM, Urgae-Gil C, Leon P, Malaga G, Chaccour C, et al. Randomized clinical trial to compare the efficacy of ivermectin versus placebo to negativize nasopharyngeal PCR in patients with early COVID-19 in Peru (SAINT-Peru): a structured summary of a study protocol for randomized controlled trial. researchsquare.com/article/rs-345747/v1 (first received 23 May 2021). [DOI: 10.21203/rs.3.rs-345747/v1] - DOI - PMC - PubMed
    1. NCT04635943. Randomized phase IIA clinical trial to evaluate the efficacy of ivermectin to obtain negative PCR results in patients with early phase COVID-19 (SAINT-PERU). clinicaltrials.gov/ct2/show/NCT04635943 (first received 19 November 2020).
    1. PER-034-20. Randomized phase IIa clinical trial to compare the efficacy of ivermectin versus placebo to obtain negative PCR results in patients with early phase Covid-19. www.ins.gob.pe/ensayosclinicos/rpec/recuperarECPBNuevoEN.asp?numec=034-20 (first received 17 July 2020).
IRCT20111224008507N5 {published data only}
    1. IRCT20111224008507N5. Double-blind placebo-controlled clinical trial of evaluating the effectiveness of ivermectin in treatment of patients admitted with COVID-19 in 2021. en.irct.ir/trial/54402 (first received 22 February 2021).
IRCT20190417043295N2 {published data only}
    1. IRCT20190417043295N2. Evaluation of the effect of adding ivermectin to standard therapies on the outcome of intubated Covid-19 patients under ventilator. en.irct.ir/trial/57603 (first received 20 September 2021).
ISRCTN86534580 {published data only}
    1. ISRCTN86534580. PRINCIPLE: A clinical trial evaluating treatments for suspected and confirmed COVID-19 for recovery at home. isrctn.com/ISRCTN86534580 (first received 12 May 2021). [DOI: 10.1186/ISRCTN86534580] - DOI
NCT04425707 {published data only}
    1. NCT04425707. Ivermectin in treatment of COVID 19 patients. clinicaltrials.gov/ct2/show/NCT04425707 (first received 11 June 2020).
NCT04445311 {published data only}
    1. NCT04445311. Ivermectin in treatment of COVID-19. clinicaltrials.gov/ct2/show/NCT04445311 (first received 24 June 2020).
NCT04510194 {published data only}
    1. NCT04510194. COVID-OUT: Early Outpatient Treatment for SARS-CoV-2 Infection (COVID-19). clinicaltrials.gov/ct2/show/NCT04510194 (first received 12 August 2020).
NCT04510233 {published data only}
    1. NCT04510233. Ivermectin nasal spray for COVID19 patients. clinicaltrials.gov/ct2/show/NCT04510233 (first received 12 August 2020).
NCT04527211 {published data only}
    1. NCT04527211. Effectiveness and safety of ivermectin for the prevention of Covid-19 infection in Colombian health personnel (IveprofCovid19). clinicaltrials.gov/ct2/show/NCT04527211 (first received 26 August 2020).
NCT04703205 {published data only}
    1. NCT04703205. Study in Covid-19 patients with ivermectin (CORVETTE-01). clinicaltrials.gov/ct2/show/NCT04703205 (first received 11 January 2021).
    1. jRCT2031200120. Double-blind study in Covid-19 patients with ivermectin. jrct.niph.go.jp/en-latest-detail/jRCT2031200120 (first received 16 September 2020).
NCT04712279 {published data only}
    1. NCT04712279. The (HD)IVACOV Trial (The High-Dose IVermectin Against COVID-19 Trial). clinicaltrials.gov/ct2/show/NCT04712279 (first received 15 January 2021).
NCT04729140 {published data only}
    1. NCT04729140. An outpatient clinical trial using ivermectin and doxycycline in COVID-19 positive patients at high risk to prevent COVID-19 related hospitalization. clinicaltrials.gov/ct2/show/NCT04729140 (first received 28 January 2021).
NCT04834115 {published data only}
    1. NCT04834115. Efficacy of ivermectin in outpatients with non-severe COVID-19. clinicaltrials.gov/ct2/show/NCT04834115 (first received 6 April 2021).
NCT04836299 {published data only}
    1. NCT04836299. Clinical trial to "study the efficacy and therapeutic safety of ivermectin (SAINTBO). clinicaltrials.gov/ct2/show/NCT04836299 (first received 8 April 2021).
NCT04885530 {published data only}
    1. NCT04885530. ACTIV-6: COVID-19 study of repurposed medications. clinicaltrials.gov/ct2/show/NCT04885530 (first received 13 May 2021).
NCT04886362 {published data only}
    1. NCT04886362. Ivermectina Colombia (IVERCOL). clinicaltrials.gov/ct2/show/NCT04886362 (first received 14 May 2021).
NCT04944082 {published data only}
    1. NCT04944082. Remdesivir-Ivermectin Combination Therapy in Severe Covid-19. clinicaltrials.gov/ct2/show/NCT04944082.
NCT05040724 {published data only}
    1. NCT05040724. Evaluation of the Impact of the Administration of Single Dose of Ivermectin in the Early Phase of COVID-19 (IVERCoV). clinicaltrials.gov/ct2/show/NCT05040724 (first received 10 September 2021).
NCT05041907 {published data only}
    1. NCT05041907. Finding treatments for COVID-19: a trial of antiviral pharmacodynamics in early symptomatic COVID-19 (PLATCOV). clinicaltrials.gov/ct2/show/NCT05041907 (first received 13 September 2021).
NCT05060666 {published data only}
    1. 2021-002445-15/DE. Prophylaxis of COVID-19 disease with ivermectin in COVID-19 contact persons. clinicaltrialsregister.eu/ctr-search/trial/2021-002445-15/DE (first received 2 August 2021).
    1. NCT05060666. Prophylaxis of COVID-19 disease with ivermectin in COVID-19 contact persons. clinicaltrials.gov/ct2/show/study/NCT05060666 (first received 29 September 2021).
NCT05155527 {published data only}
    1. NCT05155527. A double-blind randomized controlled trial of Ivermectin with Favipiravir in mild-to-moderate COVID-19 patients (IFCOV). clinicaltrials.gov/ct2/show/NCT05155527 (first received 13 December 2021).
PACTR202102848675636 {published data only}
    1. PACTR202102848675636. Double blind, community-based, randomized controlled trial on the use of ivermectin as post exposure chemo-prophylaxis for COVID-19 among high risk individuals in Lagos (IVERPEPCOV) COVID-19. pesquisa.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/re... (first received 11 February 2021).
SLCTR/2021/020 {published data only}
    1. SLCTR/2021/020. Efficacy and safety of oral ivermectin in the treatment of COVID-19 patients: a randomized double-blind controlled clinical trial. slctr.lk/trials/slctr-2021-020 (first received 19 July 2021).

Additional references

Agarwal 2020
    1. Agarwal A, Rochwerg B, Siemieniuk RA, Agoritsas T, Lamontagne F, Askie L, et al. A living WHO guideline on drugs for covid-19. BMJ (www.bmj.com/content/370/bmj.m3379) 2020;370:(last updated 6 December 2021). [DOI: 10.1136/bmj.m3379] - DOI - PubMed
Ansems 2021
    1. Ansems K, Grundeis F, Dahms K, Mikolajewska A, Thieme V, Piechotta V, et al. Remdesivir for the treatment of COVID‐19. Cochrane Database of Systematic Reviews 2021, Issue 8. Art. No: CD014962. [DOI: 10.1002/14651858.CD014962] - DOI - PMC - PubMed
Ashour 2019
    1. Ashour DS. Ivermectin: from theory to clinical application. International Journal of Antimicrobial Agents 2019;54(2):134-42. [DOI: 10.1016/j.ijantimicag.2019.05.003] - DOI - PubMed
Balshem 2011
    1. Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines – 3: rating the quality of evidence. Journal of Clinical Epidemiology 2011;64(4):401-6. [PMID: ] - PubMed
BBC NEWS
    1. Schraer R, Goodman J. Ivermectin: How false science created a Covid 'miracle' drug. www.bbc.com/news/health-58170809 (accessed 6 October 2021).
BIRD 2021
    1. British Ivermectin Recommendation Development panel. The BIRD recommendation on the use of ivermectin for Covid-19. francesoir.fr/sites/francesoir/files/media-icons/bird-proceedings-02-03-... (accessed prior to 19 July 2021).
Bryant 2021a
    1. Bryant A, Lawrie T, Dowswell T, Fordham E, Mitchell S, Hill S, et al. Ivermectin for prevention and treatment of COVID-19 infection: a systematic review, meta-analysis, and trial sequential analysis to inform clinical guidelines. American Journal of Therapeutics 2021;28(4):e434–e60. [DOI: 10.1097/MJT.0000000000001402] - DOI - PMC - PubMed
Bryant 2021b
    1. Bryant A, Lawrie T, Fordham E. Ivermectin for prevention and treatment of COVID-19 infection: a systematic review, meta-analysis, and trial sequential analysis to inform clinical guidelines. American Journal of Therapeutics, 28, e434-e460, July 2021. American Journal of Therapeutics 2021;28(5):e573-6. [DOI: 10.1097/MJT.0000000000001442] - DOI - PMC - PubMed
Caly 2020
    1. Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral Research 2020;178:e1047874. [DOI: 10.1016/j.antiviral.2020.104787] - DOI - PMC - PubMed
Campbell 1983
    1. Campbell WC, Fisher MH, Stapley EO, Albers-Schoenberg G, Jacob TA. Ivermectin: a potent new antiparasitic agent. Science 1983;221(4613):823-8. [DOI: 10.1126/science.6308762] - DOI - PubMed
Cochrane LSR
    1. Cochrane LSR. Guidance for the production and publication of Cochrane living systematic reviews: Cochrane Reviews in living mode. Available from community.cochrane.org/review-production/production-resources/living-sys... (accessed 22 March 2021).
Cochrane policy ‐ managing problematic studies
    1. Cochrane Database of Systematic Reviews: editorial policies. Cochrane policy on managing potentially problematic studies. www.cochranelibrary.com/cdsr/editorial-policies#problematic-studies (assessed 4 April 2022).
COMET 2020
    1. Core outcome set developers’ response to COVID-19. www.comet-initiative.org/Studies/Details/1538 (accessed 13 June 2021).
CONSORT 2010 Statement
    1. Schulz KF, Altman DG, Moher D, for the CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Medicine 2010;8:18. [DOI: 10.1186/1741-7015-8-18] - DOI - PMC - PubMed
COVID Guidelines India 2021
    1. Covid Management Guidelines India Group. COVID Management Guidelines India. indiacovidguidelines.org/ivermectin/ (accessed 26 January 2022).
COVID‐NMA Working Group
    1. COVID-NMA working group. The COVID-NMA initiative: a living mapping and living systematic review of Covid-19 trials. covid-nma.com (accessed prior to 16 December 2021).
Data extraction template
    1. Cochrane Pregnancy and Childbirth Group. pcg_data_extraction_form_v_2.2_-_13_july_2021_1.docx. pregnancy.cochrane.org/author-resources-new-reviews (assessed 9 December 2021).
Deeks 2020
    1. Deeks JJ, Higgins JP, Altman DG. Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.1 (updated September 2020). Cochrane. Available from training.cochrane.org/handbook/archive/v6.1.
Deng 2020
    1. Deng G, Yin M, Chen X, Zeng F. Clinical determinants for fatality of 44,672 patients with COVID-19. Critical Care 2020;24:e179. [DOI: 10.1186/s13054-020-02902-w] - DOI - PMC - PubMed
Dong 2020
    1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infectious Diseases 2020;20(5):533-4. [DOI: 10.1016/S1473-3099(20)30120-1] - DOI - PMC - PubMed
Dourmishev 2005
    1. Dourmishev AL, Dourmishev LA, Schwartz RA. Ivermectin: pharmacology and application in dermatology. International Journal of Dermatology 2005;44(12):981-8. [DOI: 10.1111/j.1365-4632.2004.02253.x] - DOI - PubMed
Drugs.com 2023
    1. Ivermectin side effects. Last updated on 28 Aug 2023. drugs.com/sfx/ivermectin-side-effects.html#serious-side-effects (accessed 20 February 2024).
EMA 2021
    1. European Medicines Agency. EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials. ema.europa.eu/en/news/ema-advises-against-use-ivermectin-prevention-trea... (accessed 26 January 2022).
FDA 2020
    1. US Food and Drug Administration. Product safety information: COVID-19 and ivermectin intended for animals. fda.gov/animal-veterinary/product-safety-information/faq-covid-19-and-iv... (accessed 26 January 2022).
FDA 2021
    1. US Food and Drug Administration. Why you should not use ivermectin to treat or prevent COVID-19. fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-tre... (accessed 26 January 2022).
Garegnani 2021
    1. Garegnani LI, Madrid E, Meza N. Misleading clinical evidence and systematic reviews on ivermectin for COVID-19. BMJ Evidence Based Medicine 2021 Apr 22 [Epub ahead of print]. [DOI: 10.1136/bmjebm-2021-111678] [PMID: ] - DOI - PubMed
German AWMF Guideline 2021a
    1. Kluge S, Janssens U, Welte T, Weber-Carstens S, Schälte G, Spinner CD, et al. S3-Guideline – recommendations on Inpatient Treatment of Patients With COVID-19 [S3-Leitlinie - Empfehlungen zur stationären Therapie von Patienten mit COVID-19]. awmf.org/uploads/tx_szleitlinien/113-001LGl_S3_Empfehlungen-zur-stationa... (accessed 26 January 2022).
German AWMF Guideline 2021b
    1. Blankenfeld H, Kaduszkiewicz H, Kochen MM, Pömsl J, Scherer M, Baum E, et al. SARS-CoV-2/Covid-19-Informationen & Praxishilfen für niedergelassene Hausärztinnen und Hausärzte. awmf.org/uploads/tx_szleitlinien/053-054l_S2e_SARS-CoV-2-Covid-19-Inform... (assessed 18 January 2022).
Ghosn 2021
    1. Ghosn L, Chaimani A, Evrenoglou T, Davidson M, Graña C, Schmucker C, et al. Interleukin‐6 blocking agents for treating COVID‐19: a living systematic review. Cochrane Database of Systematic Reviews 2021, Issue 3. Art. No: CD013881. [DOI: 10.1002/14651858.CD013881] - DOI - PMC - PubMed
Goetz 2016
    1. Goetz V, Magar L, Dornfeld D, Giese S, Pohlmann A, Hoeper D, et al. Influenza A viruses escape from MxA restriction at the expense of efficient nuclear vRNP import. Scientific Reports 2016;6:e23138. [DOI: 10.1038/srep23138] - DOI - PMC - PubMed
González‐Canga 2008
    1. González-Canga A, Sahagún-Prieto AM, Diez-Liébana MJ, Fernández-Martínez N, Sierra-Vega M, García-Vieitez JJ. The pharmacokinetics and interactions of ivermectin in humans. Journal of the American Association of Pharmaceutical Scientists 2008;10:42-6. [DOI: 10.1208/s12248-007-9000-9] - DOI - PMC - PubMed
Grey 2020
    1. Grey A, Bolland MJ, Avenell A, Klein AA, Gunsalus CK. Check for publication integrity before misconduct. Nature 2020;577(7789):167-9. [DOI: 10.1038/d41586-019-03959-6] - DOI - PubMed
Herrmann 2020
    1. Herrmann J, Adam EH, Notz Q, Helmer P, Sonntagbauer M, Ungemach-Papenberg P, et al. COVID-19 induced acute respiratory distress syndrome – a multicenter observational study. Frontiers in Medicine 2020;7:599533. [PMID: ] - PMC - PubMed
Higgins 2020a
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.1 (updated September 2020). Cochrane, 2020. Available from training.cochrane.org/handbook/archive/v6.1.
Higgins 2020b
    1. Higgins JP, Eldridge S, Li T. Chapter 23: Including variants on randomized trials. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.1 (updated September 2020). Cochrane, 2020. Available from training.cochrane.org/handbook/archive/v6.1.
Higgins 2020c
    1. Higgins JP, Savović J, Page MJ, Elbers RG, Sterne JA. Chapter 8: Assessing risk of bias in a randomized trial. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.1 (updated September 2020). Cochrane, 2020. Available from training.cochrane.org/handbook/archive/v6.1.
Higgins 2020d
    1. Higgins JP, Li T, Deeks JJ (editors). Chapter 6: Choosing effect measures and computing estimates of effect. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.1 (updated September 2020). Cochrane, 2020. Available from training.cochrane.org/handbook/archive/v6.1.
Higgins 2021
    1. Higgins JP, Lasserson T, Chandler J, Tovey D, Thomas J, Flemyng E, et al. Methodological Expectations of Cochrane Intervention Reviews. Cochrane: London, Version February 2021. Available from www.community.cochrane.org/mecir-manual/ (accessed prior to 19 July 2021).
Hill 2021a
    1. Hill A, Garratt A, Levi J, Falconer J, Ellis L, McCann K, et al. Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection. Open Forum Infectious Diseases 2021;8(11):ofab358. [DOI: 10.1093/ofid/ofab358] - DOI - PMC - PubMed
Hill 2021b
    1. Hill A, Garratt A, Levi J, Falconer J, Ellis L, McCann K, et al. Retraction: Expression of Concern: “Meta-analysis of Randomized Trials of Ivermectin to Treat SARS-CoV-2 Infection”. Open Forum Infectious Diseases 2021;8(8):ofab394. [DOI: 10.1093/ofid/ofab394] - DOI - PMC - PubMed
Huang 2020
    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497-506. [DOI: 10.1016/S0140-6736(20)30183-5] - DOI - PMC - PubMed
IDSA 2021
    1. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden L, Cheng VC, et al. Infectious Diseases Society of America guidelines on the treatment and management of patients with COVID-19, version 4.3.0. idsociety.org/practice-guideline/covid-19-guideline-treatment-and-manage... (accessed 26 January 2022).
Implementation guidance ‐ problematic studies
    1. Cochrane Editorial and Publishing Policy Resource. Policy for managing potentially problematic studies: implementation guidance. documentation.cochrane.org/display/EPPR/Policy+for+managing+potentially+... (assessed 4 April 2022).
IntHout 2016
    1. IntHout J, Ioannidis JP, Rovers MM, Goeman JJ. Plea for routinely presenting prediction intervals in meta-analysis. BMJ Open 2016;12(6):e010247. [DOI: 10.1136/bmjopen-2015-010247] [PMID: ] - DOI - PMC - PubMed
ivmmeta.com
    1. Ivermectin for COVID-19: real-time meta analysis of 60 studies. ivmmeta.com/ (accessed 26 January 2022).
Izcovich 2021
    1. Izcovich A, Peiris S, Ragusa M, Tortosa F, Rada G, Aldighieri S, et al. Bias as a source of inconsistency in ivermectin trials for COVID-19: a systematic review. Ivermectin's suggested benefits are mainly based on potentially biased results. Journal of Clinical Epidemiology 2021;144:43-55. [DOI: 10.1016/j.jclinepi.2021.12.018] - DOI - PMC - PubMed
Karagiannidis 2020
    1. Karagiannidis C, Mostert C, Hentschker C, Voshaar T, Malzahn J, Schillinger G, et al. Case characteristics, resource use, and outcomes of 10,021 patients with COVID-19 admitted to 920 German hospitals: an observational study. Lancet Respiratory Medicine 2020;9:853-62. [DOI: 10.1016/S2213-2600(20)30316-7] [PMID: ] - DOI - PMC - PubMed
Kobayashi 2020
    1. Kobayashi T, Jung S, Linton NM, Kinoshita R, Hayashi K, Miyama T, et al. Communicating the risk of death from novel coronavirus disease (COVID-19). Journal of Clinical Medicine 2020;9(2):580. [DOI: 10.3390/jcm9020580] - DOI - PMC - PubMed
Kory 2021
    1. Kory P, Meduri GU, Varon J, Iglesias J, Marik PE. Review of the emerging evidence demonstrating the efficacy of ivermectin in the prophylaxis and treatment of COVID-19. American Journal of Therapeutics 2021;28(3):e299-e318. [DOI: 10.1097/MJT.0000000000001377] - DOI - PMC - PubMed
Kreuzberger 2021
    1. Kreuzberger N, Hirsch C, Chai KL, Tomlinson E, Khosravi Z, Popp M, et al. SARS‐CoV‐2‐neutralising monoclonal antibodies for treatment of COVID‐19. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No: CD013825. [DOI: 10.1002/14651858.CD013825.pub2] - DOI - PMC - PubMed
Lefebvre 2020
    1. Lefebvre C, Glanville J, Briscoe S, Littlewood A, Marshall C, Metzendorf MI, et al. Chapter 4: Searching for and selecting studies. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.1 (updated September 2020). Cochrane, 2020. Available from training.cochrane.org/handbook/archive/v6.1.
MAGICapp [Computer program]
    1. MAGICapp. MAGIC, 2020. Available at magicevidence.org/magicapp/.
Marik 2021
    1. Marik PE, Kory P. Ivermectin, a reanalysis of the data. American Journal of Therapeutics 2021;28(5):e579-e80. [DOI: 10.1097/MJT.0000000000001443] - DOI - PMC - PubMed
Marshall 2020
    1. Marshall JC, Murthy S, Diaz J, Adhikari NK, Angus DC, Arabi YM, et al. A minimal common outcome measure set for COVID-19 clinical research. Lancet Infectious Diseases 2020;20(8):e192-7. [DOI: 10.1016/S1473-3099(20)30483-7] [PMID: ] - DOI - PMC - PubMed
Merck 2021
    1. Merck. Merck statement on ivermectin use during the COVID-19 pandemic. merck.com/news/merck-statement-on-ivermectin-use-during-the-covid-19-pan... (accessed 15 May 2021).
Merck 2022
    1. Merck. Stromectol. Revised May 2022. merck.com/product/usa/pi_circulars/s/stromectol/stromectol_pi.pdf (assessed 20 February 2024).
Meta [Computer program]
    1. Meta: general package for meta-analysis. cran.r-project.org/web/packages/meta, 2021. Available at cran.r-project.org/web/packages/meta/meta.pdf.
Mikolajewska 2021
    1. Mikolajewska A, Fischer A-L, Piechotta V, Mueller A, Metzendorf M-I, Becker M, et al. Colchicine for the treatment of COVID‐19. Cochrane Database of Systematic Reviews 2021, Issue 10. Art. No: CD015045. [DOI: 10.1002/14651858.CD015045] - DOI - PMC - PubMed
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, the PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Journal of Clinical Epidemiology 2009;62(10):1006-12. [DOI: 10.1016/j.jclinepi.2009.06.005] - DOI - PubMed
NIH 2021
    1. COVID-19 treatment guidelines panel. Coronavirus disease 2019 (COVID-19) treatment guidelines. www.covid19treatmentguidelines.nih.gov/ (accessed 26 January 2022).
Oran 2021
    1. Oran DP, Topol EJ. The proportion of SARS-CoV-2 infections that are asymptomatic: a systematic review. Annals of Internal Medicine 2021;174(5):655-62. [DOI: 10.7326/M20-6976] - DOI - PMC - PubMed
Panahi 2015
    1. Panahi Y, Poursaleh Z, Goldust M. The efficacy of topical and oral ivermectin in the treatment of human scabies. Annals of Parasitology 2015;61(1):11-6. [PMID: ] - PubMed
Parmar 1998
    1. Parmar MK, Torri V, Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Statistics in Medicine 1998;17(24):2815-34. [DOI: 10.1002/(sici)1097-0258(19981230)17:24<2815::aid-sim110>3.0.co;2-8] - DOI - PubMed
Patel 2020
    1. Patel A, Desai SS, Grainger DW, Mehra MR. Usefulness of Ivermectin in COVID-19 Illness. Available at www.isglobal.org/documents/10179/6022921/Patel+et+al.+2020+version+2.pdf... (accessed 26 January 2022).
Popp 2021c
    1. Popp M, Stegemann M, Riemer M, Metzendorf M-I, Romero CS, Mikolajewska A, et al. Antibiotics for the treatment of COVID‐19. Cochrane Database of Systematic Reviews 2021, Issue 10. Art. No: CD015025. [DOI: 10.1002/14651858.CD015025] - DOI - PMC - PubMed
Popp 2021d
    1. Popp M, Kranke P, Meybohm P, Metzendorf MI, Skoetz N, Stegemann MS, et al. Evidence on the efficacy of ivermectin for COVID-19: another story of apples and oranges. BMJ Evidence Based Medicine 2021 Aug 20 [Epub ahead of print]:111791. [DOI: 10.1136/bmjebm-2021-111791] - DOI - PMC - PubMed
Prescott 2020
    1. Prescott HC, Girard TD. Recovery from severe COVID-19. JAMA 2020;324(8):739-40. [DOI: 10.1001/jama.2020.14103] - DOI - PubMed
Retraction Watch Database (ivermectin)
    1. retractiondatabase.org. retractiondatabase.org/RetractionSearch.aspx#?ttl%3divermectin (accessed 26 January 2022).
RevMan Web 2020 [Computer program]
    1. Review Manager Web (RevMan Web). Version 2.3.0. Cochrane, 2020. Available at revman.cochrane.org.
Ritchie 2022
    1. Ritchie H, Mathieu E, Rodés-Guirao L, Appel C, Giattino C, Ortiz-Ospina E, et al. Coronavirus pandemic (COVID-19). ourworldindata.org/covid-vaccinations.
Rodríguez‐Mega 2020
    1. Rodríguez-Mega E. Latin America's embrace of an unproven COVID treatment is hindering drug trials. Nature 2020;586:481-2. [DOI: 10.1038/d41586-020-02958-2] - DOI - PubMed
Rothrock 2021
    1. Rothrock SG, Weber KD, Giordano PA, Barneck MD. Meta-Analyses do not establish improved mortality with ivermectin use in COVID-19. American Journal of Therapeutics 2021;29(1):87-e94. [DOI: 10.1097/MJT.0000000000001461] - DOI - PubMed
Schünemann 2020
    1. Schünemann HJ, Higgins JP, Vist GE, Glasziou P, Akl EA, Skoetz N, et al. Chapter 14: Completing ‘Summary of findings’ tables and grading the certainty of the evidence. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 6.1 (updated September 2020). Cochrane, 2020. Available from training.cochrane.org/handbook/archive/v6.1.
Singh 2021
    1. Singh B, Ryan H, Kredo T, Chaplin M, Fletcher T. Chloroquine or hydroxychloroquine for prevention and treatment of COVID-19. Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No: CD013587. [DOI: 10.1002/14651858.CD013587.pub2] - DOI - PMC - PubMed
Sterne 2019
    1. Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:l4898. [DOI: 10.1136/bmj.l4898] [PMID: ] - DOI - PubMed
Stroehlein 2021
    1. Stroehlein JK, Wallqvist J, Iannizzi C, Mikolajewska A, Metzendorf M-I, Benstoem C, et al. Vitamin D supplementation for the treatment of COVID‐19: a living systematic review. Cochrane Database of Systematic Reviews 2021, Issue 5. Art. No: CD015043. [DOI: 10.1002/14651858.CD015043] - DOI - PMC - PubMed
Supplementary File_Ivermectin_Research Integrity
    1. Weibel S, Popp M, Reis S. Supplementary File_Ivermectin_Research Integrity Assessment (Version 1). Zenodo 2022. [DOI: 10.5281/zenodo.6630618] - DOI
Supplementary File_Ivermectin_Risk of Bias
    1. Weibel S, Popp M, Reis S. Supplementary File_Ivermectin_Risk of Bias Excel Tool (Version 2). Zenodo 2022. [DOI: 10.5281/zenodo.6630574] - DOI
Tay 2013
    1. Tay MY, Fraser JE, Chan WK, Moreland NJ, Rathore AP, Wang C, et al. Nuclear localization of dengue virus (DENV) 1–4 non-structural protein 5; protection against all 4 DENV serotypes by the inhibitor Ivermectin. Antiviral Research 2013;99(3):301-6. [DOI: 10.1016/j.antiviral.2013.06.002] - DOI - PubMed
Temple 2021
    1. Temple C, Hoang R, Hendrickson RG. Toxic effects from ivermectin use associated with prevention and treatment of Covid-19. New England Journal of Medicine 2021;385(23):2197-8. [DOI: 10.1056/NEJMc2114907] - DOI - PMC - PubMed
The Guardian 2021a
    1. Davey M. Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns. Available at www.theguardian.com/science/2021/jul/16/huge-study-supporting-ivermectin... (accessed 15 July 2021).
The Guardian 2021b
    1. Robins-Early N. Desperation, misinformation: how the ivermectin craze spread across the world. Available at www.theguardian.com/world/2021/sep/24/ivermectin-covid-peru-misinformation (accessed 26 January 2022).
The Scientist 2021
    1. Offord C. Frontiers removes controversial ivermectin paper pre-publication. Available at www.the-scientist.com/news-opinion/frontiers-removes-controversial-iverm... (accessed 26 January 2022).
Tierney 2007
    1. Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials 2007;8:16. [DOI: 10.1186/1745-6215-8-16] - DOI - PMC - PubMed
Wagner 2021
    1. Wagner C, Griesel M, Mikolajewska A, Mueller A, Nothacker M, Kley K, et al. Systemic corticosteroids for the treatment of COVID‐19. Cochrane Database of Systematic Reviews 2021, Issue 8. Art. No: CD014963. [DOI: 10.1002/14651858.CD014963] - DOI - PMC - PubMed
Wagstaff 2012
    1. Wagstaff KM, Sivakumaran H, Heaton SM, Harrich D, Jans DA. Ivermectin is a specific inhibitor of importin α/β-mediated nuclear import able to inhibit replication of HIV-1 and dengue virus. Biochemical Journal 2012;443(3):851-6. [DOI: 10.1042/BJ20120150] - DOI - PMC - PubMed
Watson 2020
    1. Watson J, Whiting PF, Brush JE. Interpreting a Covid-19 test result. BMJ 2020;369:m1808. [DOI: 10.1136/bmj.m1808] - DOI - PubMed
Weibel 2022
    1. Weibel S, Popp M, Reis S, Skoetz N, Garner P, Sydenham E. Identifying and managing problematic trials: a Research Integrity Assessment (RIA) tool for randomized controlled trials in evidence synthesis. medrxiv.org/content/10.1101/2022.05.31.22275756v1 (first received 5 June 2022). [DOI: 10.1101/2022.05.31.22275756] - DOI - PMC - PubMed
WHO 2018
    1. International standards for clinical trial registries – Version 3.0. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. www.who.int/ictrp/International_Standards_for_Clinical_Trial_Registratio... assessed 14 December 2021.
WHO 2019
    1. World Health Organization. WHO model list of essential medicines, 21st list. www.who.int/medicines/publications/essentialmedicines/en (accessed 19 February 2021).
WHO 2020a
    1. World Health Organization. Report of the WHO–China Joint Mission on Coronavirus Disease 2019 (COVID-19). www.who.int/publications-detail/report-of-the-who-china-joint-mission-on... (accessed 3 June 2021).
WHO 2020b
    1. World Health Organization. Antigen-detection in the diagnosis of SARS-CoV-2 infection using rapid immunoassays: interim guidance, 11 September 2020. Available at apps.who.int/iris/handle/10665/334253.
WHO 2021a
    1. World Health Organization. Classification of Omicron (B.1.1.529): SARS-CoV-2 variant of concern. www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-s... (accessed 26 January 2022).
WHO 2021b
    1. World Health Organization. Therapeutics and COVID-19. Living guideline. who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2021.1 (accessed 26 January 2022).
WHO 2022a
    1. World Health Organization. WHO coronavirus disease (COVID-19) dashboard. covid19.who.int/ (accessed 27 January 2022).
WHO 2022b
    1. World Health Organization. Accelerating COVID-19 Vaccine Deployment. who.int/publications/m/item/accelerating-covid-19-vaccine-deployment (accessed 08 June 2022).
Williamson 2020
    1. Williamson E, Walker AJ, Bhaskaran KJ, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020;584:430-6. [DOI: 10.1038/s41586-020-2521-4] - DOI - PMC - PubMed
Wulan 2015
    1. Wulan WN, Heydet D, Walker EJ, Gahan ME, Ghildyal R. Nucleocytoplasmic transport of nucleocapsid proteins of enveloped RNA viruses. Frontiers in Microbiology 2015;6:e553. [DOI: 10.3389/fmicb.2015.00553] - DOI - PMC - PubMed
Yamasmith 2018
    1. Yamasmith E, Saleh-arong FA, Avirutnan P, Angkasekwinai N, Mairiang D, Wongsawat E, et al. Efficacy and safety of ivermectin against dengue infection: a phase III, randomized, double-blind, placebo-controlled trial. Internal Medicine and One Health. 34th Annual Meeting of the Royal College of Physicians of Thailand; 2018 April 26-28; Chonburi (THA) 2018.
Yang 2020
    1. Yang SN, Atkinson SC, Wang C, Lee A, Bogoyevitch MA, Borg NA, et al. The broad spectrum antiviral ivermectin _targets the host nuclear transport importin α/β1 heterodimer. Antiviral Research 2020;177:e104760. [DOI: 10.1016/j.antiviral.2020.104760] - DOI - PubMed

References to other published versions of this review

Popp 2021a
    1. Popp M, Stegemann M, Metzendorf MI, Kranke P, Meybohm P, Skoetz N, et al. Ivermectin for preventing and treating COVID-19. Cochrane Database of Systematic Reviews 2021, Issue 4. Art. No: CD015017. [DOI: 10.1002/14651858.CD015017] - DOI - PMC - PubMed
Popp 2021b
    1. Popp M, Stegemann M, Metzendorf MI, Kranke P, Meybohm P, Skoetz N, et al. Ivermectin for preventing and treating COVID-19. Cochrane Database of Systematic Reviews 2021, Issue 7. Art. No: CD015017. [DOI: 10.1002/14651858.CD015017.pub2] - DOI - PMC - PubMed
  NODES
admin 4
Association 1
COMMUNITY 3
Idea 1
idea 1
INTERN 18
Project 4
twitter 2