THE THERAPEUTIC POTENTIAL OF IVERMECTIN FOR COVID-19: A SYSTEMATIC
REVIEW OF MECHANISMS AND EVIDENCE
Abstract
Introduction: Ivermectin is a commonly used antihelminthic agent with
over 35 years of established safety data in humans. Recent data
demonstrates antiviral activity in vitro against SARS-CoV-2, in addition
to a range of viruses. In vitro and animal models also provide evidence
of immunomodulatory action. These additional modes of action are
supported by in silico modelling, which propose a number of viral and
host targets that would mediate these effects. Objectives: The aim of
this study is to systematically review the published and preprint
clinical literature and study results that assessed the potential role
of ivermectin as a COVID-19 therapeutic and prophylactic agent. Methods:
We conducted a comprehensive review of PubMed, medRxiv,
ClinicalTrials.gov, Global Coronavirus COVID-19 Clinical Trial Tracker,
World Health Organization International Clinical Trials Registry
Platform, EU Clinical Trials Register, ANZ clinical trials registry, and
references from relevant articles. PRISMA guidelines for systematic
reviews were employed. Results: Search keywords- “COVID-19 (and
synonyms) AND ivermectin”- generated 86 articles on PubMed, 48 on
medRvix and 37 on clinicaltrials.gov at the time of writing. Twelve of
these were listed as completed clinical trials and of these, 8 were
included as investigators had released results. Positive mortality
benefit, reduced time to clinical recovery, reduced incidence of disease
progression and decreased duration of hospital admission were reported
in patients across all stages of clinical severity. Limitations: Due to
the time-critical nature of the COVID-19 pandemic our review included
preprint data, which must be interpreted with caution while it awaits
peer review.