meta|Evidence - COVID-19
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ivermectin (n=36) vs. placebo (n=37)
randomized controlled trial some concerns about risk of bias
ivermectine
Single dose :12 mg in patients weighing less than 80 kg and 18 mg in those above 80 kg
Placebo
COVID 19 hospitalized
Patients with 1) positive RT-PCR for SARS-CoV-2 by nasal and oropharyngeal swabbing, 2) Pneumonia, diagnosed by X-ray or high-resolution chest CTscan, with a pattern suggesting involvement due to coronavirus, 3) Recently established hypoxemic respiratory failure or acute clinical deterioration of pre-existing lung or heartdisease. Patients were excluded if they required high oxygen volumes (face mask > 10 L/ min), if they had predictors of a poor response to high-flow oxygen nasal prong therapy or if they required mechanical ventilation.
Double-blind.
Single center, Mexico.
3 arms : hydroxychloroquine, ivermectin, or placebo.study interrupted early only 108 patients included out of 200 patients anticipated
ivermectin plus doxycycline (n=70) vs. standard of care (n=70)
randomized controlled trial some concerns about risk of bias
ivermectin doxycycline
200ug/kg PO of Ivermectin per day for 2-3 days along with 100mg PO doxycycline twice per day for 5-10 days
standard of care
COVID 19 hospitalized
single blind
2 centres, Iraq
recovery of COVID-19 patients was based on the disappearance of symptoms, clearance of radiological chest x-ray or Ct-scans, and getting negative PCR results.
ivermectin (n=82) vs. control (n=82)
randomized controlled trial high risk of bias
ivermectin12mg once daily for 3 days
standard protocol of treatment alone for 14 days
COVID-19 mild to moderate
patients from ages 20 to 65 with mildly to moderately affected COVID-19 infection confirmed by pharyngeal swab PCR
open-label
two tertiary hospitals in Egypt
ivermectin (n=21) vs. lopinavir/ritonavir (n=20)
randomized controlled trial high risk of bias
Ivermectin 6mg (given every 84 hours) twice a week, or Ivermectin 12mg (given every 84 hours) for 2 weeks,
lopinavir / ritonavir daily for 2 weeks
COVID-19 mild to moderate
double-bind
proof of concept study
ivermectin (n=48) vs. placebo (n=24)
randomized controlled trial high risk of bias
ivermectin alone or in combination with doxycycline
oral ivermectin alone (12 mg once daily for 5 days) or in combination with doxycycline (12 mg ivermectin single dose and 200 mg stat doxycycline day-1 followed by 100 mg 12hrly for next 4 days)
placebo
COVID-19 mild to moderate
says as double blind
Dhaka, Bangladesh
ivermectin (n=57) vs. placebo (n=58)
randomized controlled trial some concerns about risk of bias
Ivermectin
ivermectin 12 mg on day 1 and day 2
Placebo
COVID-19 mild to moderate
All patients above the age of 18 admitted with a diagnosis of COVID -19 (on the basis of a positive RT PCR or Rapid Antigen Test report) at AIIMS, Patna, India with mild or moderate disease as defined by the ministry of health and family welfare guidelines and not meeting any of the exclusion criteria were considered eligible for the study. The exclusion criteria were: known allergy to or adverse drug reaction with Ivermectin; unwillingness or inability to provide consent to participate in the study; prior use of ivermectin during the course of this illness; pregnancy and lactation.
Double-blind.
Single center, tertiary care dedicated COVID-19 hospital in Bihar, India.
ivermectin (n=12) vs. placebo (n=12)
randomized controlled trial low risk of bias
ivermectin
400 mcg/kg, single dose
placebo
COVID-19 mild to moderate
double bliind
1 center, Spain
ivermectin (n=104) vs. placebo (n=52)
randomized controlled trial high risk of bias
Ivermectin 24mg and 12mg
Single oral administration of Ivermectin 12 mg (equivalent to 200 µg/kg) elixir or Ivermectin 24 mg (equivalent to 400 µg/kg) elixir. A 20 mL dose of final formulation consisted of ivermectin (12 or 24mg) in ethanol (40% v/v) sweetened with syrup base.
Placebo
3 arms: Ivermectin 24 mg (single dose), Ivermectin 12 mg (single dose), or placebo.
COVID-19 mild to moderate
Aged 18 years or above and diagnosed with non-severe COVID-19, i.e. room air saturation (SpO2) >90%, and with no hypotension or requirement of mechanical ventilation. Diagnosis of COVID-19 was based on a positive result on either SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) or the rapid antigen test.
Double-blind.
Single center, India.
ivermectin (n=50) vs. standard of care (n=50)
randomized controlled trial high risk of bias
ivermectin (single dose of 12 milligrams)
standard of care
COVID-19 mild to moderate
open-label
one hospital in Lahore, Pakistan
ivermectin (n=30) vs. standard of care (n=15)
randomized controlled trial some concerns about risk of bias
Ivermectin
Standard of care plus oral ivermectin at 0.6 mg/kg/day for 5 days.
Standard of care
All patients in both groups received standard of care.
COVID-19 mild to moderate
Eligibility criteria included COVID-19 symptoms onset ≤ 5 days at recruitment, absence of use of drugs with potentialactivity against SARS-CoV-2 and available in Argentina during the trial (hydroxychloroquine, chloroquine, lopinavir and azithromycin); and those drugs were not permitted during the first week of the trial.
Open-label.
4 hospitals in the metropolitan area of Buenos Aires, Argentina.
ivermectin (n=241) vs. standard of care (n=249)
randomized controlled trial some concerns about risk of bias
oral ivermectin, 0.4 mg/kg body weight daily for 5 days, plus standard of care
standard of care alone
symptomatic therapy and monitoring for signs of early deterioration based on clinical findings, laboratory test results, and chest imaging.
COVID-19 mild to moderate
open-label
Malaysia
ivermectin (n=25) vs. standard of care (n=25)
randomized controlled trial high risk of bias
ivermectin
12mg stat and then 12 mg after 12 hours and 12mg after 24 hours
standard of care
COVID-19 mild to moderate
open label
1 center, Pakistan
ivermectin (n=35) vs. standard of care (n=38)
randomized controlled trial some concerns about risk of bias
Ivermectin
Single dose of 0.2 mg/kg
Standard of care
Standard drugs of the national protocol are used.
All patients in both groups received supportive medical treatment for COVID-19 according to the national protocols of Iran at the time of this study (hydroxychloroquine and/or lopinavir/ritonavir).
COVID-19 mild to moderate
The diagnostic criteria for COVID-19 included any of the following: (1) positive result on COVID-19 reverse-transcription polymerase chain reaction; (2) clinical symptoms of COVID-19, with a history of contact with a patient with COVID-19; and/or (3) abnormalities on chest computed tomography (CT) compatible with COVID19 (ground-glass opacity, halo sign, reversed halo sign, and patchy infiltration).
Double-blind.
2 centers in Mazandaran, Iran.
Clinical improvement after baseline was defined as resolving a patient’s baseline status on persistent and continuous cough (persistent cough for >1 hour, or ≥3 coughing episodes in 24 hours, that interferes with activities of daily living and the ability to work) and tachypnea in addition to increasing oxygen saturation to >94%.
ivermectin plus doxycycline (n=200) vs. standard of care (n=200)
randomized controlled trial some concerns about risk of bias
Ivermectin and Doxycycline
Ivermectin 6 mg, 2 tab stat and Doxycycline 100 mg twice daily for 5 days
standard of care
COVID-19 mild to moderate
double blind
1 center, Bangladesh
ivermectin (n=53) vs. chloroquine (n=115)
randomized controlled trial some concerns about risk of bias
Ivermectin
14 mg once at day 0 1 placebo tablet at day 0, and once daily from day 1 to day 2, 1 placebo tablet daily from day 3 to 4, total dose 42 mg
Hydroxychloroquine or Chloroquine
HCQ : 400 mg twice on day 0, and once daily from day 1 to day 4, total dose 2.4 gCQ : 450 mg, twice on day 0, and once daily from day 1 to day 4, total dose 2.7 g
3 arms: chloroquine, hydroxychloroquine, ivermectin.
COVID-19 severe or critically
Double-blind.
Single center, Brasil.
Phase II.
ivermectin (n=30) vs. standard of care (n=30)
randomized controlled trial high risk of bias
ivermectin soc
Ivermectin (Enteral solution at 200 microgr/kg/day (9mg between 36-50 kg, 12mg between 51-65 kg, 15mg between 66-79 kg and 200 microgram/kg in > 80 kg) for 5 days
Soc
Favipiravir (2x1600mg loading dose followed by 2x600mg maintenance dose, po, total 5 days); Hydroxychloroquine (2x400mg loading dose followed by 2x200mg, po, 5 days);Azithromycin (500mg first day loading dose, followed by 250mg/day, po, total 5 days)
COVID-19 severe or critically
single blind
4 centres, Turkey
described as crossover assignment and several inconsistencies in the description of endpoints in clinicalTrials.gov
results up-dated with pre-print
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