Statistically significant lower risk is seen for mortality, ventilation, ICU admission, hospitalization, recovery, cases, and viral clearance. All remain significant for higher quality studies. 62 studies from 56 independent teams in 26 different countries show statistically significant improvements.
Meta analysis using the most serious outcome shows 61% [51‑70%] and 85% [77‑90%] lower risk for early treatment and prophylaxis, with similar results for higher quality studies,
primary outcomes, peer-reviewed studies, and for RCTs.
Results are very robust — in worst case exclusion sensitivity analysis 61 of 102 studies must be excluded to avoid finding statistically significant efficacy.
No treatment or intervention is 100% effective. All practical, effective, and safe means should be used based on risk/benefit analysis. Multiple treatments are typically used in combination, which may be significantly more effective. Pharmacokinetics show significant inter-individual variability Guzzo. Efficacy may vary depending on the manufacturer Williams.
Over 20 countries adopted ivermectin for COVID-19. The evidence base is much larger and has much lower conflict of interest than typically used to approve drugs.
All data to reproduce this paper and sources are in the appendix. Multiple other meta analyses show efficacy Bryant, Hariyanto, Kory, Lawrie, Nardelli.
