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Supplementary Data — Ivermectin for COVID-19: real-time meta analysis of 76 studies
https://ivmmeta.com/
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Chowdhury (RCT) 81% 0.19 [0.01-3.96] 14mg viral+ 0/60 2/56 OT​1 CT​2 Improvement, RR [CI] Dose (4d) Treatment Control Espitia-Hernandez 97% 0.03 [0.01-0.10] 12mg viral+ 0/28 7/7 CT​2 Carvallo 85% 0.15 [0.02-1.28] 36mg death 1/32 3/14 CT​2 Mahmud (DB RCT) 27% 0.73 [0.60-0.90] 12mg recov. time 183 (n) 180 (n) CT​2 Szente Fonseca -14% 1.14 [0.75-1.66] 24mg hosp. 340 (n) 377 (n) Cadegiani 78% 0.22 [0.01-4.48] 42mg death 0/110 2/137 CT​2 Ahmed (DB RCT) 85% 0.15 [0.01-2.70] 48mg symptoms 0/17 3/19 Chaccour (DB RCT) 8% 0.92 [0.77-1.09] 28mg viral+ 12 (n) 12 (n) Ghauri 92% 0.08 [0.01-0.88] 48mg no recov. 0/37 7/53 Babalola (DB RCT) 49% 0.51 [0.29-0.88] 24mg viral time 20 (n) 20 (n) OT​1 Ravikirti (DB RCT) 89% 0.11 [0.01-2.05] 24mg death 0/55 4/57 Bukhari (RCT) 82% 0.18 [0.07-0.46] 12mg viral+ 4/41 25/45 Mohan (DB RCT) 24% 0.76 [0.53-1.09] 28mg viral+ 21/40 31/45 Biber (DB RCT) 45% 0.55 [0.27-0.97] 36mg viral+ 13/47 21/42 Elalfy 87% 0.13 [0.06-0.27] 36mg viral+ 7/62 44/51 CT​2 López-Me.. (DB RCT) 43% 0.57 [0.16-1.87] 84mg progression 4/200 7/198 Roy 6% 0.94 [0.52-1.93] n/a recov. time 14 (n) 15 (n) CT​2 Chahla (CLUS. RCT) 87% 0.13 [0.03-0.54] 24mg no disch. 2/110 20/144 Mourya 89% 0.11 [0.05-0.25] 48mg viral+ 5/50 47/50 Loue (QR) 70% 0.30 [0.04-2.20] 14mg death 1/10 5/15 Merino (QR) 74% 0.26 [0.11-0.57] 24mg hosp. population-based cohort Faisal (RCT) 68% 0.32 [0.14-0.72] 48mg no recov. 6/50 19/50 Aref (RCT) 63% 0.37 [0.22-0.61] n/a recov. time 57 (n) 57 (n) Krolewiecki (RCT) 66% 0.34 [0.10-1.16] 168mg decay rate 20 (n) 14 (n) Vallejos (DB RCT) 33% 0.67 [0.34-1.28] 24mg hosp. 14/250 21/251 Together.. (DB RCT) 9% 0.91 [0.69-1.19] 84mg hosp./ER 86/677 95/678 Buonfrate (DB RCT) 31% 0.69 [0.46-1.03] 336mg viral load 30 (n) 29 (n) Mayer 55% 0.45 [0.32-0.63] 151mg death 3,266 (n) 17,966 (n) Borody 93% 0.07 [0.04-0.13] 96mg hosp. 5/600 70/600 CT​2 SC​4 Abbas (DB RCT) 31% 0.69 [0.46-1.05] 84mg recov. time 99 (n) 103 (n) Tau​2 = 0.37, I​2 = 81.5%, p < 0.0001 Early treatment 63% 0.37 [0.28-0.49] 169/6,517 433/21,285 63% improvement Gorial 71% 0.29 [0.01-5.76] 14mg no recov. 0/16 2/71 Improvement, RR [CI] Dose (4d) Treatment Control Kishoria (RCT) -8% 1.08 [0.57-2.02] 12mg viral+ 11/19 7/13 Podder (RCT) 16% 0.84 [0.55-1.12] 14mg recov. time 32 (n) 30 (n) Khan 87% 0.13 [0.02-1.00] 12mg death 1/115 9/133 Chachar (RCT) 10% 0.90 [0.44-1.83] 36mg no recov. 9/25 10/25 Soto-Becerra -39% 1.39 [0.88-2.22] 14mg death 47/203 401/2,630 Rajter (PSM) 67% 0.33 [0.12-0.84] 14mg death 26/173 27/107 Hashim (SB RCT) 92% 0.08 [0.00-1.44] 28mg death 0/59 6/70 CT​2 Camprubí -25% 1.25 [0.43-3.63] 14mg viral+ 5/13 4/13 Spoorthi 21% 0.79 [0.64-0.98] n/a recov. time 50 (n) 50 (n) CT​2 Budhiraja 99% 0.01 [0.00-0.15] n/a death 0/34 103/942 Okumuş (DB RCT) 16% 0.84 [0.55-1.30] 56mg no improv. 16/30 19/30 Shahbazn.. (DB RCT) 19% 0.81 [0.67-0.97] 14mg recov. time 35 (n) 34 (n) Lima-Morales 78% 0.22 [0.12-0.41] 12mg death 15/481 52/287 CT​2 Gonzalez (DB RCT) -20% 1.20 [0.77-1.87] 12mg hosp. time 36 (n) 37 (n) Pott-Junior (RCT) -11% 1.11 [0.21-5.93] 14mg viral+ 10/27 1/3 Huvemek (DB RCT) 32% 0.68 [0.38-1.23] 84mg no improv. 13/50 19/50 Ahsan 50% 0.50 [0.28-0.90] 21mg death 17/110 17/55 CT​2 Abd-Elsalam (RCT) 25% 0.75 [0.17-3.06] 36mg death 3/82 4/82 Hazan 93% 0.07 [0.00-1.02] 24mg hosp. 0/24 synthetic CT​2 SC​4 Elavarasi 20% 0.80 [0.61-1.06] n/a death 48/283 311/1,475 Rezk 80% 0.20 [0.01-4.13] 72mg death 0/160 2/160 Malaysia M.. (RCT) -23% 1.23 [0.85-1.72] 112mg progression 51/241 43/249 Ozer 75% 0.25 [0.06-1.13] 28mg death 2/60 8/60 Ferreira -5% 1.05 [0.32-3.43] n/a death 3/21 11/81 Jamir -53% 1.53 [0.88-2.67] n/a death 32/76 69/190 Baguma 97% 0.03 [0.00-11.7] n/a death 7 (n) 474 (n) Mustafa 64% 0.36 [0.12-1.14] varies death 3/73 42/371 Shimizu 48% 0.52 [0.29-0.93] 14mg ventilation 39 (n) 49 (n) Zubair -9% 1.09 [0.33-3.64] 12mg death 5/90 5/98 Tau​2 = 0.15, I​2 = 69.6%, p = 0.0019 Late treatment 28% 0.72 [0.59-0.89] 317/2,664 1,172/7,869 28% improvement Shouman (RCT) 91% 0.09 [0.03-0.23] 36mg symp. case 15/203 59/101 Improvement, RR [CI] Dose (1m) Treatment Control Carvallo 96% 0.04 [0.00-0.63] 14mg cases 0/131 11/98 CT​2 Behera 54% 0.46 [0.29-0.71] 42mg cases 41/117 145/255 Carvallo 100% 0.00 [0.00-0.02] 48mg cases 0/788 237/407 CT​2 Hellwig (ECO.) 78% 0.22 [0.06-0.76] 14mg cases ecological Bernigaud 99% 0.01 [0.00-0.10] 84mg death 0/69 150/3,062 Alam 91% 0.09 [0.04-0.25] 12mg cases 4/58 44/60 IVERCOR PREP 73% 0.27 [0.15-0.48] 48mg cases 13/389 61/486 MD​3 Chahla (RCT) 84% 0.16 [0.04-0.46] 48mg cases 4/117 25/117 CT​2 Behera 83% 0.17 [0.12-0.23] 42mg cases 45/2,199 133/1,147 Tanioka (ECO.) 88% 0.12 [0.03-0.46] 14mg death ecological Seet (CLUS. RCT) 6% 0.94 [0.61-1.19] 12mg cases 398/617 433/619 OT​1 Morgenstern (PSM) 74% 0.26 [0.10-0.71] 56mg cases 5/271 18/271 Mondal 88% 0.12 [0.01-0.55] n/a symp. case 128 (n) 1,342 (n) Samajdar 80% 0.20 [0.11-0.38] n/a cases 12/164 29/81 Kerr (PSM) 70% 0.30 [0.19-0.46] 56mg death 25/3,034 79/3,034 Tau​2 = 1.05, I​2 = 95.3%, p < 0.0001 Prophylaxis 84% 0.16 [0.09-0.29] 562/8,285 1,424/11,080 84% improvement All studies 59% 0.41 [0.34-0.49] 1,048/17,466 3,029/40,234 59% improvement All 76 ivermectin COVID-19 primary outcome results ivmmeta.com Jan 26, 2022 Tau​2 = 0.38, I​2 = 87.5%, p < 0.0001 Effect extraction pre-specified, see appendix 1 OT: ivermectin vs. other treatment3 MD: minimal detail available currently 2 CT: study uses combined treatment4 SC: study uses synthetic control arm Favors ivermectin Favors control
Figure S1. Random effects meta-analysis for primary outcomes (as defined before the trial started).
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Chowdhury (RCT) 81% 0.19 [0.01-3.96] 14mg hosp. 0/60 2/56 OT​1 CT​2 Improvement, RR [CI] Dose (4d) Treatment Control Espitia-Hernandez 70% 0.30 [0.16-0.55] 12mg recov. time 28 (n) 7 (n) CT​2 Mahmud (DB RCT) 86% 0.14 [0.01-2.75] 12mg death 0/183 3/183 CT​2 Ahmed (DB RCT) 85% 0.15 [0.01-2.70] 48mg symptoms 0/17 3/19 Chaccour (DB RCT) 96% 0.04 [0.00-1.01] 28mg symptoms 12 (n) 12 (n) Ghauri 92% 0.08 [0.01-0.88] 48mg no recov. 0/37 7/53 Babalola (DB RCT) 64% 0.36 [0.10-1.27] 24mg viral+ 40 (n) 20 (n) OT​1 Ravikirti (DB RCT) 89% 0.11 [0.01-2.05] 24mg death 0/55 4/57 Mohan (DB RCT) 62% 0.38 [0.08-1.75] 28mg no recov. 2/40 6/45 Elalfy 87% 0.13 [0.06-0.27] 36mg viral+ 7/62 44/51 CT​2 Mourya 89% 0.11 [0.05-0.25] 48mg viral+ 5/50 47/50 Loue (QR) 70% 0.30 [0.04-2.20] 14mg death 1/10 5/15 Faisal (RCT) 68% 0.32 [0.14-0.72] 48mg no recov. 6/50 19/50 Aref (RCT) 63% 0.37 [0.22-0.61] n/a recov. time 57 (n) 57 (n) Krolewiecki (RCT) -152% 2.52 [0.11-58.1] 168mg ventilation 1/27 0/14 Vallejos (DB RCT) -33% 1.33 [0.30-5.72] 24mg death 4/250 3/251 Tau​2 = 0.11, I​2 = 25.4%, p < 0.0001 Early treatment 74% 0.26 [0.18-0.37] 26/978 143/940 74% improvement Podder (RCT) 16% 0.84 [0.55-1.12] 14mg recov. time 32 (n) 30 (n) Improvement, RR [CI] Dose (4d) Treatment Control Chachar (RCT) 10% 0.90 [0.44-1.83] 36mg no recov. 9/25 10/25 Rajter (PSM) 46% 0.54 [0.27-0.99] 14mg death 13/98 24/98 Hashim (SB RCT) 92% 0.08 [0.00-1.44] 28mg death 0/59 6/70 CT​2 Camprubí 40% 0.60 [0.18-2.01] 14mg ventilation 3/13 5/13 Spoorthi 21% 0.79 [0.64-0.98] n/a recov. time 50 (n) 50 (n) CT​2 Okumuş (DB RCT) 33% 0.67 [0.27-1.64] 56mg death 6/30 9/30 Shahbazn.. (DB RCT) -197% 2.97 [0.13-70.5] 14mg death 1/35 0/34 Lima-Morales 78% 0.22 [0.12-0.41] 12mg death 15/481 52/287 CT​2 Pott-Junior (RCT) 85% 0.15 [0.01-1.93] 14mg ventilation 1/27 1/4 Abd-Elsalam (RCT) 25% 0.75 [0.17-3.06] 36mg death 3/82 4/82 Rezk 80% 0.20 [0.01-4.13] 72mg death 0/160 2/160 Ozer 75% 0.25 [0.06-1.13] 28mg death 2/60 8/60 Jamir -53% 1.53 [0.88-2.67] n/a death 32/76 69/190 Shimizu 100% 0.00 [0.00-0.01] 14mg death 0/39 8/49 Tau​2 = 0.40, I​2 = 74.3%, p = 0.0046 Late treatment 47% 0.53 [0.34-0.82] 85/1,267 198/1,182 47% improvement Shouman (RCT) 91% 0.09 [0.03-0.23] 36mg symp. case 15/203 59/101 Improvement, RR [CI] Dose (1m) Treatment Control Behera 54% 0.46 [0.29-0.71] 42mg cases 41/117 145/255 Bernigaud 99% 0.01 [0.00-0.10] 84mg death 0/69 150/3,062 Alam 91% 0.09 [0.04-0.25] 12mg cases 4/58 44/60 Chahla (RCT) 95% 0.05 [0.00-0.80] 48mg m/s case 0/117 10/117 CT​2 Behera 83% 0.17 [0.12-0.23] 42mg cases 45/2,199 133/1,147 Seet (CLUS. RCT) 50% 0.50 [0.33-0.76] 12mg symp. case 32/617 64/619 OT​1 Morgenstern (PSM) 80% 0.20 [0.01-4.15] 56mg hosp. 0/271 2/271 Mondal 88% 0.12 [0.01-0.55] n/a symp. case 128 (n) 1,342 (n) Kerr (PSM) 70% 0.30 [0.19-0.46] 56mg death 25/3,034 79/3,034 Tau​2 = 0.47, I​2 = 86.0%, p < 0.0001 Prophylaxis 82% 0.18 [0.11-0.32] 162/6,813 686/10,008 82% improvement All studies 70% 0.30 [0.22-0.41] 273/9,058 1,027/12,130 70% improvement 41 ivermectin COVID-19 peer reviewed trials after exclusions ivmmeta.com Jan 26, 2022 Tau​2 = 0.55, I​2 = 81.5%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) 1 OT: ivermectin vs. other treatment2 CT: study uses combined treatment Favors ivermectin Favors control
Figure S2. Random effects meta-analysis for peer-reviewed studies after exclusions. Effect extraction is pre-specified, using the most serious outcome reported, see the appendix for details.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Chowdhury (RCT) 81% 0.19 [0.01-3.96] 14mg hosp. 0/60 2/56 OT​1 CT​2 Improvement, RR [CI] Dose (4d) Treatment Control Mahmud (DB RCT) 86% 0.14 [0.01-2.75] 12mg death 0/183 3/183 CT​2 Ahmed (DB RCT) 85% 0.15 [0.01-2.70] 48mg symptoms 0/17 3/19 Chaccour (DB RCT) 96% 0.04 [0.00-1.01] 28mg symptoms 12 (n) 12 (n) Babalola (DB RCT) 64% 0.36 [0.10-1.27] 24mg viral+ 40 (n) 20 (n) OT​1 Ravikirti (DB RCT) 89% 0.11 [0.01-2.05] 24mg death 0/55 4/57 Bukhari (RCT) 82% 0.18 [0.07-0.46] 12mg viral+ 4/41 25/45 Mohan (DB RCT) 62% 0.38 [0.08-1.75] 28mg no recov. 2/40 6/45 Biber (DB RCT) 70% 0.30 [0.03-2.76] 36mg hosp. 1/47 3/42 Chahla (CLUS. RCT) 87% 0.13 [0.03-0.54] 24mg no disch. 2/110 20/144 Faisal (RCT) 68% 0.32 [0.14-0.72] 48mg no recov. 6/50 19/50 Aref (RCT) 63% 0.37 [0.22-0.61] n/a recov. time 57 (n) 57 (n) Krolewiecki (RCT) -152% 2.52 [0.11-58.1] 168mg ventilation 1/27 0/14 Vallejos (DB RCT) -33% 1.33 [0.30-5.72] 24mg death 4/250 3/251 Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Early treatment 69% 0.31 [0.23-0.44] 20/989 88/995 69% improvement Podder (RCT) 16% 0.84 [0.55-1.12] 14mg recov. time 32 (n) 30 (n) Improvement, RR [CI] Dose (4d) Treatment Control Chachar (RCT) 10% 0.90 [0.44-1.83] 36mg no recov. 9/25 10/25 Hashim (SB RCT) 92% 0.08 [0.00-1.44] 28mg death 0/59 6/70 CT​2 Okumuş (DB RCT) 33% 0.67 [0.27-1.64] 56mg death 6/30 9/30 Shahbazn.. (DB RCT) -197% 2.97 [0.13-70.5] 14mg death 1/35 0/34 Pott-Junior (RCT) 85% 0.15 [0.01-1.93] 14mg ventilation 1/27 1/4 Huvemek (DB RCT) 32% 0.68 [0.38-1.23] 84mg no improv. 13/50 19/50 Abd-Elsalam (RCT) 25% 0.75 [0.17-3.06] 36mg death 3/82 4/82 Tau​2 = 0.00, I​2 = 0.0%, p = 0.066 Late treatment 26% 0.74 [0.54-1.02] 33/340 49/325 26% improvement Shouman (RCT) 91% 0.09 [0.03-0.23] 36mg symp. case 15/203 59/101 Improvement, RR [CI] Dose (1m) Treatment Control Chahla (RCT) 95% 0.05 [0.00-0.80] 48mg m/s case 0/117 10/117 CT​2 Seet (CLUS. RCT) 50% 0.50 [0.33-0.76] 12mg symp. case 32/617 64/619 OT​1 Tau​2 = 1.43, I​2 = 93.0%, p = 0.02 Prophylaxis 84% 0.16 [0.04-0.75] 47/937 133/837 84% improvement All studies 63% 0.37 [0.25-0.54] 100/2,266 270/2,157 63% improvement 25 ivermectin COVID-19 Randomized Controlled Trials after exclusions ivmmeta.com Jan 26, 2022 Tau​2 = 0.46, I​2 = 65.9%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) 1 OT: ivermectin vs. other treatment2 CT: study uses combined treatment Favors ivermectin Favors control
Figure S3. Random effects meta-analysis for RCT studies after exclusions. Effect extraction is pre-specified, using the most serious outcome reported, see the appendix for details.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Mahmud (DB RCT) 86% 0.14 [0.01-2.75] 12mg 0/183 3/183 CT​1 Improvement, RR [CI] Dose (4d) Treatment Control Ravikirti (DB RCT) 89% 0.11 [0.01-2.05] 24mg 0/55 4/57 Loue (QR) 70% 0.30 [0.04-2.20] 14mg 1/10 5/15 Vallejos (DB RCT) -33% 1.33 [0.30-5.72] 24mg 4/250 3/251 Mayer 55% 0.45 [0.32-0.63] 151mg 3,266 (n) 17,966 (n) Tau​2 = 0.00, I​2 = 0.0%, p < 0.0001 Early treatment 55% 0.45 [0.33-0.62] 5/3,764 15/18,472 55% improvement Gorial 71% 0.29 [0.01-5.76] 14mg 0/16 2/71 Improvement, RR [CI] Dose (4d) Treatment Control Khan 87% 0.13 [0.02-1.00] 12mg 1/115 9/133 Rajter (PSM) 46% 0.54 [0.27-0.99] 14mg 13/98 24/98 Hashim (SB RCT) 92% 0.08 [0.00-1.44] 28mg 0/59 6/70 CT​1 Budhiraja 99% 0.01 [0.00-0.15] n/a 0/34 103/942 Okumuş (DB RCT) 33% 0.67 [0.27-1.64] 56mg 6/30 9/30 Shahbazn.. (DB RCT) -197% 2.97 [0.13-70.5] 14mg 1/35 0/34 Lima-Morales 78% 0.22 [0.12-0.41] 12mg 15/481 52/287 CT​1 Abd-Elsalam (RCT) 25% 0.75 [0.17-3.06] 36mg 3/82 4/82 Rezk 80% 0.20 [0.01-4.13] 72mg 0/160 2/160 Ozer 75% 0.25 [0.06-1.13] 28mg 2/60 8/60 Jamir -53% 1.53 [0.88-2.67] n/a 32/76 69/190 Baguma 97% 0.03 [0.00-11.7] n/a 7 (n) 474 (n) Shimizu 100% 0.00 [0.00-0.01] 14mg 0/39 8/49 Tau​2 = 1.19, I​2 = 77.5%, p = 0.00077 Late treatment 74% 0.26 [0.12-0.57] 73/1,292 296/2,680 74% improvement Bernigaud 99% 0.01 [0.00-0.10] 84mg 0/69 150/3,062 Improvement, RR [CI] Dose (1m) Treatment Control Kerr (PSM) 70% 0.30 [0.19-0.46] 56mg 25/3,034 79/3,034 Tau​2 = 6.33, I​2 = 86.1%, p = 0.13 Prophylaxis 94% 0.06 [0.00-2.36] 25/3,103 229/6,096 94% improvement All studies 70% 0.30 [0.18-0.50] 103/8,159 540/27,248 70% improvement 21 ivermectin COVID-19 mortality results after exclusions ivmmeta.com Jan 26, 2022 Tau​2 = 0.62, I​2 = 72.8%, p < 0.0001 1 CT: study uses combined treatment Favors ivermectin Favors control
Figure S4. Random effects meta-analysis for mortality after exclusions.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Ravikirti (DB RCT) 79% 0.21 [0.03-1.72] 24mg 1/55 5/57 Improvement, RR [CI] Dose (4d) Treatment Control Krolewiecki (RCT) -152% 2.52 [0.11-58.1] 168mg 1/27 0/14 Vallejos (DB RCT) -33% 1.33 [0.30-5.72] 24mg 4/250 3/251 Tau​2 = 0.31, I​2 = 20.8%, p = 0.79 Early treatment 18% 0.82 [0.22-3.13] 6/332 8/322 18% improvement Rajter (PSM) 64% 0.36 [0.12-1.10] 14mg 4/98 11/98 Improvement, RR [CI] Dose (4d) Treatment Control Camprubí 40% 0.60 [0.18-2.01] 14mg 3/13 5/13 Shahbazn.. (DB RCT) -94% 1.94 [0.18-20.4] 14mg 2/35 1/34 Lima-Morales 52% 0.48 [0.20-1.18] 12mg 8/434 11/287 CT​1 Pott-Junior (RCT) 85% 0.15 [0.01-1.93] 14mg 1/27 1/4 Abd-Elsalam (RCT) 0% 1.00 [0.21-4.81] 36mg 3/82 3/82 Ozer 13% 0.87 [0.11-5.58] 28mg 3/60 2/60 Shimizu 48% 0.52 [0.29-0.93] 14mg 39 (n) 49 (n) Tau​2 = 0.00, I​2 = 0.0%, p = 0.0015 Late treatment 46% 0.54 [0.36-0.79] 24/788 34/627 46% improvement All studies 44% 0.56 [0.39-0.81] 30/1,120 42/949 44% improvement 11 ivermectin COVID-19 mechanical ventilation results after exclusions ivmmeta.com Jan 26, 2022 Tau​2 = 0.00, I​2 = 0.0%, p = 0.0019 1 CT: study uses combined treatment Favors ivermectin Favors control
Figure S5. Random effects meta-analysis for mechanical ventilation after exclusions.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Ravikirti (DB RCT)