Ivermectin under scrutiny: a systematic review and meta-analysis of efficacy and possible sources of controversies in COVID-19 patients

{ 'DOI': '10.1186/s12985-022-01829-8', 'ISSN': ['1743-422X'], 'URL': 'http://dx.doi.org/10.1186/s12985-022-01829-8', 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>We conducted a systematic review and meta-analysis to evaluate the ' 'efficacy of ivermectin for COVID-19 patients based on current peer-reviewed RCTs and to ' 'address disputes over the existing evidence.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>MEDLINE (Pubmed), Scopus, Web of Science, Cochrane library, Google ' 'scholar and Clinicaltrials.gov were searched for RCTs assessing the efficacy of Ivermectin up ' 'to 20 February 2022. A systematic review and meta-analysis of studies was performed based on ' 'the PRISMA 2020 statement criteria.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>19 and 17 studies were included in this systematic review and ' 'meta-analysis, respectively. There was no significant difference in progression to severe ' 'disease (log OR −\u20090.27 [95% CI −\u20090.61 to 0.08], I2\u2009=\u200942.29%), negative ' 'RT-PCR (log OR 0.25 [95% CI −\u20090.18–0.68], I2\u2009=\u200958.73%), recovery (log OR 0.11 ' '[95% CI −\u20090.22–0.45], I2\u2009=\u200913.84%), duration of hospitalization (SMD −\u2009' '0.40 [95% CI −\u20090.85–0.06], I2\u2009=\u200988.90%), time to negative RT-PCR (SMD −\u2009' '0.36 [95% CI −\u20090.89–0.17], I2\u2009=\u200946.2%), and viral load (SMD -0.17 [95% CI ' '-0.45 to 0.12], I^2\u2009=\u20090%). It is worth noting that, based on low-certainty ' 'evidence, ivermectin may possibly reduce mortality (log OR −\u20090.67 [95% CI −\u20091.20 to ' '−\u20090.13], I2\u2009=\u200928.96%). However, studies with a higher risk of bias were more ' 'likely to indicate positive effects on the efficacy of this drug, according to our subgroup ' 'analyses based on study quality.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusion</jats:title>\n' ' <jats:p>Ivermectin did not have any significant effect on outcomes of ' 'COVID-19 patients and as WHO recommends, use of ivermectin should be limited to clinical ' 'trials.</jats:p>\n' ' </jats:sec>', 'alternative-id': ['1829'], 'article-number': '102', 'assertion': [ { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'Received', 'name': 'received', 'order': 1, 'value': '24 March 2022'}, { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'Accepted', 'name': 'accepted', 'order': 2, 'value': '2 June 2022'}, { 'group': {'label': 'Article History', 'name': 'ArticleHistory'}, 'label': 'First Online', 'name': 'first_online', 'order': 3, 'value': '13 June 2022'}, {'group': {'label': 'Declarations', 'name': 'EthicsHeading'}, 'name': 'Ethics', 'order': 1}, { 'group': {'label': 'Ethics approval and consent to participate', 'name': 'EthicsHeading'}, 'name': 'Ethics', 'order': 2, 'value': 'Not applicable.'}, { 'group': {'label': 'Consent for publication', 'name': 'EthicsHeading'}, 'name': 'Ethics', 'order': 3, 'value': 'Not applicable.'}, { 'group': {'label': 'Competing interests', 'name': 'EthicsHeading'}, 'name': 'Ethics', 'order': 4, 'value': 'The authors declare that they have no Competing interests.'}], 'author': [ {'affiliation': [], 'family': 'Shafiee', 'given': 'Arman', 'sequence': 'first'}, { 'affiliation': [], 'family': 'Teymouri Athar', 'given': 'Mohammad Mobin', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Kohandel Gargari', 'given': 'Omid', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Jafarabady', 'given': 'Kyana', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Siahvoshi', 'given': 'Sepehr', 'sequence': 'additional'}, { 'affiliation': [], 'family': 'Mozhgani', 'given': 'Sayed-Hamidreza', 'sequence': 'additional'}], 'container-title': 'Virology Journal', 'container-title-short': 'Virol J', 'content-domain': {'crossmark-restriction': False, 'domain': ['link.springer.com']}, 'created': {'date-parts': [[2022, 6, 13]], 'date-time': '2022-06-13T17:03:52Z', 'timestamp': 1655139832000}, 'deposited': { 'date-parts': [[2022, 11, 14]], 'date-time': '2022-11-14T01:07:58Z', 'timestamp': 1668388078000}, 'indexed': {'date-parts': [[2022, 12, 7]], 'date-time': '2022-12-07T11:27:41Z', 'timestamp': 1670412461615}, 'is-referenced-by-count': 5, 'issue': '1', 'issued': {'date-parts': [[2022, 6, 13]]}, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2022, 12]]}}, 'language': 'en', 'license': [ { 'URL': 'https://creativecommons.org/licenses/by/4.0', 'content-version': 'tdm', 'delay-in-days': 0, 'start': { 'date-parts': [[2022, 6, 13]], 'date-time': '2022-06-13T00:00:00Z', 'timestamp': 1655078400000}}, { 'URL': 'https://creativecommons.org/licenses/by/4.0', 'content-version': 'vor', 'delay-in-days': 0, 'start': { 'date-parts': [[2022, 6, 13]], 'date-time': '2022-06-13T00:00:00Z', 'timestamp': 1655078400000}}], 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12985-022-01829-8.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s12985-022-01829-8/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12985-022-01829-8.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '297', 'original-title': [], 'prefix': '10.1186', 'published': {'date-parts': [[2022, 6, 13]]}, 'published-online': {'date-parts': [[2022, 6, 13]]}, 'publisher': 'Springer Science and Business Media LLC', 'reference': [ { 'DOI': '10.1002/jmv.25678', 'author': 'H Lu', 'doi-asserted-by': 'publisher', 'first-page': '401', 'journal-title': 'J Med Virol', 'key': '1829_CR1', 'unstructured': 'Lu H, Stratton CW, Tang Y-W. 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