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Supplementary Data — Ivermectin for COVID-19: real-time meta analysis of 67 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 98% 0.02 [0.00-0.20] 48mg symptoms 37 (n) 53 (n) 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) 61% 0.39 [0.13-1.23] 84mg progression 4/200 10/198 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 [0.44-1.07] 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 Tau​2 = 0.42; I​2 = 82.4% Early treatment 65% 0.35 [0.26-0.47] 169/6,418 429/21,182 65% 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 [0.00-1.04] 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 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 Tau​2 = 0.15; I​2 = 73.8% Late treatment 29% 0.71 [0.57-0.89] 274/2,198 1,043/6,446 29% 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 Tau​2 = 1.13; I​2 = 95.4% Prophylaxis 85% 0.15 [0.08-0.28] 537/5,251 1,345/8,046 85% improvement All studies 62% 0.38 [0.32-0.46] 980/13,867 2,817/35,674 62% improvement All 67 ivermectin COVID-19 primary outcome results ivmmeta.com Dec 1, 2021 1 OT: ivermectin vs. other treatment2 CT: study uses combined treatment3 MD: minimal detail available currently4 SC: study uses synthetic control armTau​2 = 0.39; I​2 = 88.6%; Z = 9.84 Effect extraction pre-specified, see appendix 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 98% 0.02 [0.00-0.20] 48mg symptoms 37 (n) 53 (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 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 = 0.16; I​2 = 33.4% Early treatment 75% 0.25 [0.17-0.37] 26/978 136/940 75% 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 Ozer 75% 0.25 [0.06-1.13] 28mg death 2/60 8/60 Tau​2 = 0.17; I​2 = 56.0% Late treatment 44% 0.56 [0.39-0.81] 53/992 119/783 44% 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) Tau​2 = 0.58; I​2 = 87.6% Prophylaxis 84% 0.16 [0.09-0.31] 137/3,779 607/6,974 84% improvement All studies 70% 0.30 [0.22-0.41] 216/5,749 862/8,697 70% improvement 37 ivermectin COVID-19 peer reviewed trials after exclusions ivmmeta.com Dec 1, 2021 1 OT: ivermectin vs. other treatment2 CT: study uses combined treatmentTau​2 = 0.49; I​2 = 79.7%; Z = 7.63 Effect extraction pre-specified, see appendix 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 Buonfrate (DB RCT) -600% 7.00 [0.39-126] 336mg hosp. 4/58 0/29 Tau​2 = 0.06; I​2 = 11.3% Early treatment 68% 0.32 [0.22-0.47] 24/1,047 88/1,024 68% 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 Gonzalez (DB RCT) 14% 0.86 [0.29-2.56] 12mg death 5/36 6/37 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% Late treatment 25% 0.75 [0.56-1.02] 38/376 55/362 25% 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% Prophylaxis 84% 0.16 [0.04-0.75] 47/937 133/837 84% improvement All studies 60% 0.40 [0.27-0.58] 109/2,360 276/2,223 60% improvement 27 ivermectin COVID-19 Randomized Controlled Trials after exclusions ivmmeta.com Dec 1, 2021 1 OT: ivermectin vs. other treatment2 CT: study uses combined treatmentTau​2 = 0.48; I​2 = 65.8%; Z = 4.70 Effect extraction pre-specified, see appendix 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% 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 Gonzalez (DB RCT) 14% 0.86 [0.29-2.56] 12mg 5/36 6/37 Abd-Elsalam (RCT) 25% 0.75 [0.17-3.06] 36mg 3/82 4/82 Ozer 75% 0.25 [0.06-1.13] 28mg 2/60 8/60 Tau​2 = 0.36; I​2 = 50.8% Late treatment 63% 0.37 [0.21-0.65] 46/1,046 223/1,844 63% improvement Bernigaud 99% 0.01 [0.00-0.10] 84mg 0/69 150/3,062 Improvement, RR [CI] Dose (1m) Treatment Control Tau​2 = 0.00; I​2 = 0.0% Prophylaxis 99% 0.01 [0.00-0.10] 0/69 150/3,062 99% improvement All studies 64% 0.36 [0.23-0.56] 51/4,879 388/23,378 64% improvement 17 ivermectin COVID-19 mortality results after exclusions ivmmeta.com Dec 1, 2021 1 CT: study uses combined treatmentTau​2 = 0.31; I​2 = 51.9%; Z = 4.49 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% 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 Tau​2 = 0.00; I​2 = 0.0% Late treatment 45% 0.55 [0.33-0.91] 24/749 34/578 45% improvement All studies 41% 0.59 [0.37-0.94] 30/1,081 42/900 41% improvement 10 ivermectin COVID-19 mechanical ventilation results after exclusions ivmmeta.com Dec 1, 2021 1 CT: study uses combined treatmentTau​2 = 0.00; I​2 = 0.0%; Z = 2.22 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) 14% 0.86 [0.28-2.67] 24mg 5/55 6/57 Improvement, RR [CI] Dose (4d) Treatment Control Mayer 66% 0.34 [0.22-0.51] 151mg 3,266 (n) 17,966 (n) Tau​2 = 0.24; I​2 = 56.4% Early treatment 53% 0.47 [0.20-1.10] 5/3,321 6/18,023 53% improvement Khan 89% 0.11 [0.01-0.80] 12mg 1/115 11/133 Improvement, RR [CI] Dose (4d) Treatment Control Camprubí 33% 0.67 [0.13-3.35] 14mg 2/13 3/13 Pott-Junior (RCT) 85% 0.15 [0.01-1.93] 14mg 1/27 1/4 Ozer 49% 0.51 [0.09-2.50] 28mg 6/60 3/60 Tau​2 = 0.00; I​2 = 0.0% Late treatment 64% 0.36 [0.15-0.86] 10/215 18/210 64% improvement All studies 62% 0.38 [0.26-0.54] 15/3,536 24/18,233 62% improvement 6 ivermectin COVID-19 ICU results after exclusions ivmmeta.com Dec 1, 2021 Tau​2 = 0.00; I​2 = 0.1%; Z = 5.31 Favors ivermectin Favors control
Figure S6. Random effects meta-analysis for ICU admission after exclusions.
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 Biber (DB RCT) 70% 0.30 [0.03-2.76] 36mg hosp. 1/47 3/42 Merino (QR) 74% 0.26 [0.11-0.57] 24mg hosp. population-based cohort Vallejos (DB RCT) 33% 0.67 [0.34-1.28] 24mg hosp.