Supplementary Data — Ivermectin reduces COVID-19 risk: real-time meta-analysis of 106 studies (c19ivm ivmmeta)

@CovidAnalysis, Aug 31, 2026, Version 257V257 (V1 2020)
c19early.org
October 2026

Ivermectin COVID-19 primary outcome results

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (4d)Relative Risk
Chowdhury (RCT)81%0.19 · 0.01–3.96viral+0/602/5614mgOT1 CT2 Espitia-Hernandez97%0.03 · 0.01–0.10viral+0/287/712mgCT2 Carvallo85%0.15 · 0.02–1.28death1/323/1436mgCT2 Mahmud (DB RCT)27%0.73 · 0.60–0.90recov. time183 (n)180 (n)12mgCT2 Szente Fonseca−14%1.14 · 0.75–1.66hosp.340 (n)377 (n)24mg Cadegiani78%0.22 · 0.01–4.48death0/1102/13742mgCT2 Ahmed (DB RCT)85%0.15 · 0.01–2.70symptoms0/173/1948mg Chaccour (DB RCT)8%0.92 · 0.77–1.09viral+12 (n)12 (n)28mgSAINT Ghauri92%0.08 · 0.01–0.88no recov.0/377/5348mg Babalola (DB RCT)49%0.51 · 0.29–0.88viral time20 (n)20 (n)24mgOT1 Bukhari (RCT)82%0.18 · 0.07–0.46viral+4/4125/4512mg Mohan (DB RCT)24%0.76 · 0.53–1.09viral+21/4031/4528mgRIVET-COV Biber (DB RCT)39%0.61 · 0.29–1.07viral+13/4721/4236mg Elalfy87%0.13 · 0.06–0.27viral+7/6244/5136mgCT2 López-Me.. (DB RCT)43%0.57 · 0.16–1.87progression4/2007/19884mg Chahla (CLUS. RCT)87%0.13 · 0.03–0.54no disch.2/11020/14424mg Mourya89%0.11 · 0.05–0.25viral+5/5047/5048mg Loue (QR)70%0.30 · 0.04–2.20death1/105/1514mg Merino (QR)74%0.26 · 0.11–0.57hosp.77,381 (all patients)24mgcensored, see notes CS5 Faisal (RCT)68%0.32 · 0.14–0.72no recov.6/5019/5048mg Aref (RCT)63%0.37 · 0.22–0.61recov. time57 (n)57 (n)n/a Krolewiecki (RCT)66%0.34 · 0.10–1.16decay rate20 (n)12 (n)168mg Vallejos (DB RCT)33%0.67 · 0.34–1.28hosp.14/25021/25124mg Reis (DB RCT)10%0.90 · 0.70–1.16hosp./ER100/679111/67984mgTOGETHERimpossible data, see notes Buonfrate (DB RCT)20%0.80 · 0.36–1.76viral load28 (n)29 (n)336mgCOVER Mayer55%0.45 · 0.32–0.63death3,266 (n)17,966 (n)151mg Borody93%0.07 · 0.04–0.13hosp.5/60070/60096mgMD3 CT2 SC4 Abbas (DB RCT)36%0.64 · 0.43–0.96no recov.26/9942/10384mg de Jesús Ascenci..59%0.41 · 0.36–0.47death/hosp.7,898 (n)20,150 (n)12mgCT2 Manomai.. (DB RCT)5%0.95 · 0.62–1.45viral+19/3620/3648mg de la Ro.. (DB RCT)−187%2.87 · 0.12–67.49misc.1/300/2636mg Rezai (DB RCT)−5%1.05 · 0.07–16.68death1/2681/28184mg Mirahma.. (DB RCT)46%0.54 · 0.21–1.42hosp.6/13111/13024mg Schilling (RCT)−9%1.09 · 0.88–1.27viral rate45 (n)45 (n)168mgPLATCOV Bramante (DB RCT)−4%1.04 · 0.81–1.31progression105/40796/39190mgCOVID-OUTOT1 Mikamo (DB RCT)−4%1.04 · 0.90–1.21no improv.502 (n)527 (n)63mgIVERMILCO Siripongbo.. (RCT)6%0.94 · 0.65–1.35viral+30 (n)30 (n)168mgFINCOVCT2 Wijewic.. (DB RCT)51%0.49 · 0.26–0.93viral load80 (n)81 (n)96mg Mouawia (RCT)56%0.44 · 0.14–1.37hosp.4/639/6312mg
Early treatment54%0.46 · 0.37–0.58345/15,938624/42,97254% lower risk
Tau² = 0.30, I² = 86.1%, p < 0.0001
Gorial71%0.29 · 0.01–5.76no recov.0/162/7114mg Kishoria (RCT)−8%1.08 · 0.57–2.02viral+11/197/1312mg Podder (RCT)16%0.84 · 0.55–1.12recov. time32 (n)30 (n)14mg Khan87%0.13 · 0.02–1.00death1/1159/13312mg Chachar (RCT)10%0.90 · 0.44–1.83no recov.9/2510/2536mg Soto-Becerra−39%1.39 · 0.88–2.22death47/203401/2,63014mg Rajter (PSM)67%0.33 · 0.12–0.84death26/17327/10714mg Hashim (SB RCT)92%0.08 · 0.00–1.44death0/596/7028mgCT2 Camprubí−25%1.25 · 0.43–3.63viral+5/134/1314mg Spoorthi21%0.79 · 0.64–0.98recov. time50 (n)50 (n)n/aCT2 Budhiraja99%0.01 · 0.00–0.15death0/34103/942n/a Ravikirti (DB RCT)89%0.11 · 0.01–2.05death0/554/5724mg Okumuş (DB RCT)16%0.84 · 0.55–1.30no improv.16/3019/3056mg Shahbazn.. (DB RCT)19%0.81 · 0.67–0.97recov. time35 (n)34 (n)14mg Lima-Morales78%0.22 · 0.12–0.41death15/48152/28712mgCT2 Beltran .. (DB RCT)−20%1.20 · 0.77–1.87hosp. time36 (n)37 (n)12mg Pott-Junior (RCT)−11%1.11 · 0.21–5.93viral+10/271/314mgcensored, see notes Huvemek (DB RCT)32%0.68 · 0.38–1.23no improv.13/5019/5084mg Ahsan50%0.50 · 0.28–0.90death17/11017/5521mgCT2 Abd-Elsalam (RCT)25%0.75 · 0.17–3.06death3/824/8236mg Hazan93%0.07 · 0.00–1.02hosp.0/24synthetic24mgsee notes CT2 SC4 Elavarasi20%0.80 · 0.61–1.06death48/283311/1,475n/a Rezk80%0.20 · 0.01–4.13death0/1602/16072mg Lim (RCT)69%0.31 · 0.09–1.11death3/24110/249112mgI-TECH Ozer75%0.25 · 0.06–1.13death2/608/6028mg Ferreira−5%1.05 · 0.32–3.43death3/2111/81n/a Jamir (ICU)−53%1.53 · 0.88–2.67death32/7669/190n/aICU patients Mustafa64%0.36 · 0.12–1.14death3/7342/371varies Shimizu48%0.52 · 0.29–0.93ventilation39 (n)49 (n)14mg Zubair−9%1.09 · 0.33–3.64death5/905/9812mg Thairu (PSM)88%0.12 · 0.01–2.14death0/214/2656mg Efimenko (PSM)69%0.31 · 0.20–0.48death1,072 (n)40,536 (n)n/aself-censored, see notes OT1 Soto−41%1.41 · 1.16–1.76death280/484374/934n/a Ravikirti3%0.97 · 0.74–1.24death53/171254/794varies George (RCT)30%0.70 · 0.25–1.93death5/358/3924mg Naggie (DB RCT)2%0.98 · 0.89–1.09recovery708 (n)724 (n)168mgACTIV-6 Rezai (DB RCT)31%0.69 · 0.35–1.39death13/31118/29884mg Qadeer58%0.42 · 0.31–0.56viral+35/10584/10548mg Aref (RCT)74%0.26 · 0.12–0.55recov. time49 (n)47 (n)n/aLONG COVID Ochoa-Ja.. (DB RCT)−37%1.37 · 0.53–3.57ICU8/376/3828mg Sarojvisut (RCT)−2%1.02 · 0.06–16.15death1/1571/160112mg Munir48%0.52 · 0.22–1.21death92 (n)908 (n)n/a Llenas-García23%0.77 · 0.35–1.69progression96 (n)96 (n)14mg Wada (DB RCT)−4%1.04 · 0.76–1.43viral+106 (n)106 (n)14mg Osati32%0.68 · 0.45–0.92death448 (n)849 (n)n/a Hayward (RCT)−1%1.01 · 0.61–1.68death/hosp.34/2,15727/1,80673mgPRINCIPLE Varnaseri (DB RCT)82%0.18 · 0.04–0.78ventilation2/5511/5584mg Hashmi (RCT)26%0.74 · 0.38–1.47death81 (n)69 (n)56mgREMAP-CAPICU patients
Late treatment32%0.68 · 0.58–0.80700/8,8971,930/55,04232% lower risk
Tau² = 0.16, I² = 80.2%, p < 0.0001
Shouman (RCT)91%0.09 · 0.03–0.23symp. case15/20359/10136mg Carvallo96%0.04 · 0.00–0.63cases0/13111/9814mgsee notes CT2 Behera54%0.46 · 0.29–0.71cases41/117145/25542mg Carvallo100%0.00 · 0.00–0.02cases0/788237/40748mgsee notes CT2 Hellwig (ECO.)78%0.22 · 0.06–0.76casesecological14mg Bernigaud99%0.01 · 0.00–0.10death0/69150/3,06284mg Alam91%0.09 · 0.04–0.25cases4/5844/6012mg IVERCOR PREP73%0.27 · 0.15–0.48cases13/38961/48648mgMD3 Chahla (RCT)84%0.16 · 0.04–0.46cases4/11725/11748mgCT2 Behera83%0.17 · 0.12–0.23cases45/2,199133/1,14742mg Tanioka (ECO.)88%0.12 · 0.03–0.46deathecological14mg Seet (CLUS. RCT)6%0.94 · 0.61–1.19cases398/617433/61912mgOT1 Morgenstern (PSM)74%0.26 · 0.10–0.71cases5/27118/27156mg Mondal88%0.12 · 0.01–0.55symp. case128 (n)1,342 (n)n/a Samajdar80%0.20 · 0.11–0.38cases12/16429/81n/a Kerr (PSM)70%0.30 · 0.19–0.46death25/3,03479/3,03456mg Desort-H.. (DB RCT)72%0.28 · 0.20–0.41cases30/200105/199203mgSAIVE Wagstaff (DB RCT)55%0.45 · 0.22–1.00DAFS36 (n)32 (n)
Prophylaxis82%0.18 · 0.11–0.31592/8,5211,529/11,31182% lower risk
Tau² = 0.94, I² = 95.0%, p < 0.0001
All studies52%0.48 · 0.42–0.551,637/33,3564,083/109K52% lower risk
Tau² = 0.29, I² = 89.0%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
3 MD: minimal detail available currently
4 SC: study uses synthetic control arm
5 CS: censored, see details
Rotate screen for more detailsIncrease width for more details
← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S1. Random-effects meta-analysis for primary outcomes (as defined before the trial started).
c19early.org
October 2026

Ivermectin COVID-19 peer reviewed studies after exclusions

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (4d)Relative Risk
Chowdhury (RCT)81%0.19 · 0.01–3.96hosp.0/602/5614mgOT1 CT2 Espitia-Hernandez70%0.30 · 0.16–0.55recov. time28 (n)7 (n)12mgCT2 Mahmud (DB RCT)86%0.14 · 0.01–2.75death0/1833/18312mgCT2 Ahmed (DB RCT)85%0.15 · 0.01–2.70symptoms0/173/1948mg Chaccour (DB RCT)96%0.04 · 0.00–1.01symptoms12 (n)12 (n)28mgSAINT Ghauri92%0.08 · 0.01–0.88no recov.0/377/5348mg Babalola (DB RCT)64%0.36 · 0.10–1.27viral+40 (n)20 (n)24mgOT1 Mohan (DB RCT)62%0.38 · 0.08–1.75no recov.2/406/4528mgRIVET-COV Biber (DB RCT)70%0.30 · 0.03–2.76hosp.1/473/4236mg Elalfy87%0.13 · 0.06–0.27viral+7/6244/5136mgCT2 Chahla (CLUS. RCT)87%0.13 · 0.03–0.54no disch.2/11020/14424mg Mourya89%0.11 · 0.05–0.25viral+5/5047/5048mg Loue (QR)70%0.30 · 0.04–2.20death1/105/1514mg Faisal (RCT)68%0.32 · 0.14–0.72no recov.6/5019/5048mg Aref (RCT)63%0.37 · 0.22–0.61recov. time57 (n)57 (n)n/a Krolewiecki (RCT)−152%2.52 · 0.11–58.11ventilation1/270/14168mg Vallejos (DB RCT)−33%1.33 · 0.30–5.72death4/2503/25124mg Mayer55%0.45 · 0.32–0.63death3,266 (n)17,966 (n)151mg de Jesús Ascenci..59%0.41 · 0.36–0.47death/hosp.7,898 (n)20,150 (n)12mgCT2 Manomai.. (DB RCT)43%0.57 · 0.20–1.46no recov.3/366/3648mg Mirahma.. (DB RCT)67%0.33 · 0.03–3.14ventilation1/1313/13024mg Bramante (DB RCT)−197%2.97 · 0.12–72.71death1/4080/39690mgCOVID-OUTOT1 Wijewic.. (DB RCT)−196%2.96 · 0.12–71.99death1/1270/12296mg Mouawia (RCT)56%0.44 · 0.14–1.37hosp.4/639/6312mg
Early treatment67%0.33 · 0.26–0.4239/13,009180/39,93267% lower risk
Tau² = 0.07, I² = 34.7%, p < 0.0001
Podder (RCT)16%0.84 · 0.55–1.12recov. time32 (n)30 (n)14mg Khan87%0.13 · 0.02–1.00death1/1159/13312mg Rajter (PSM)46%0.54 · 0.27–0.99death13/9824/9814mg Hashim (SB RCT)92%0.08 · 0.00–1.44death0/596/7028mgCT2 Camprubí40%0.60 · 0.18–2.01ventilation3/135/1314mg Spoorthi21%0.79 · 0.64–0.98recov. time50 (n)50 (n)n/aCT2 Ravikirti (DB RCT)89%0.11 · 0.01–2.05death0/554/5724mg Okumuş (DB RCT)33%0.67 · 0.27–1.64death6/309/3056mg Shahbazn.. (DB RCT)−197%2.97 · 0.13–70.51death1/350/3414mg Lima-Morales78%0.22 · 0.12–0.41death15/48152/28712mgCT2 Pott-Junior (RCT)85%0.15 · 0.01–1.93ventilation1/271/414mgcensored, see notes Abd-Elsalam (RCT)25%0.75 · 0.17–3.06death3/824/8236mg Rezk80%0.20 · 0.01–4.13death0/1602/16072mg Lim (RCT)69%0.31 · 0.09–1.11death3/24110/249112mgI-TECH Ozer75%0.25 · 0.06–1.13death2/608/6028mg Jamir (ICU)−53%1.53 · 0.88–2.67death32/7669/190n/aICU patients Efimenko (PSM)69%0.31 · 0.20–0.48death1,072 (n)40,536 (n)n/aself-censored, see notes OT1 George (RCT)30%0.70 · 0.25–1.93death5/358/3924mg Naggie (DB RCT)−202%3.02 · 0.12–74.08death1/7080/724168mgACTIV-6 Aref (RCT)74%0.26 · 0.12–0.55recov. time49 (n)47 (n)n/aLONG COVID Ochoa-Ja.. (DB RCT)57%0.43 · 0.07–2.50death2/374/3828mg Munir48%0.52 · 0.22–1.21death92 (n)908 (n)n/a Llenas-García17%0.83 · 0.38–1.84death10/9612/9614mg Wada (DB RCT)19%0.81 · 0.44–1.38progression19/10623/10614mg Hayward (RCT)−1%1.01 · 0.61–1.68death/hosp.34/2,15727/1,80673mgPRINCIPLE Varnaseri (DB RCT)82%0.18 · 0.04–0.78ventilation2/5511/5584mg
Late treatment50%0.50 · 0.36–0.67153/6,021288/45,90250% lower risk
Tau² = 0.32, I² = 69.1%, p < 0.0001
Shouman (RCT)91%0.09 · 0.03–0.23symp. case15/20359/10136mg Behera54%0.46 · 0.29–0.71cases41/117145/25542mg Bernigaud99%0.01 · 0.00–0.10death0/69150/3,06284mg Alam91%0.09 · 0.04–0.25cases4/5844/6012mg Chahla (RCT)95%0.05 · 0.00–0.80m/s case0/11710/11748mgCT2 Behera83%0.17 · 0.12–0.23cases45/2,199133/1,14742mg Seet (CLUS. RCT)50%0.50 · 0.33–0.76symp. case32/61764/61912mgOT1 Morgenstern (PSM)80%0.20 · 0.01–4.15hosp.0/2712/27156mg Mondal88%0.12 · 0.01–0.55symp. case128 (n)1,342 (n)n/a Kerr (PSM)70%0.30 · 0.19–0.46death25/3,03479/3,03456mg Wagstaff (DB RCT)55%0.45 · 0.22–1.00DAFS36 (n)32 (n)
Prophylaxis79%0.21 · 0.12–0.34162/6,849686/10,04079% lower risk
Tau² = 0.44, I² = 84.9%, p < 0.0001
All studies64%0.36 · 0.29–0.44354/25,8791,154/95,87464% lower risk
Tau² = 0.31, I² = 75.4%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
Rotate screen for more detailsIncrease width for more details
← Ivermectin
reduces riskIvermectin
increases risk →
Fig. 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. Analysis validating pooled outcomes for COVID-19 can be found below.
c19early.org
October 2026

Ivermectin COVID-19 Randomized Controlled Trials after exclusions

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (4d)Relative Risk
Chowdhury (RCT)81%0.19 · 0.01–3.96hosp.0/602/5614mgOT1 CT2 Mahmud (DB RCT)86%0.14 · 0.01–2.75death0/1833/18312mgCT2 Ahmed (DB RCT)85%0.15 · 0.01–2.70symptoms0/173/1948mg Chaccour (DB RCT)96%0.04 · 0.00–1.01symptoms12 (n)12 (n)28mgSAINT Babalola (DB RCT)64%0.36 · 0.10–1.27viral+40 (n)20 (n)24mgOT1 Bukhari (RCT)82%0.18 · 0.07–0.46viral+4/4125/4512mg Mohan (DB RCT)62%0.38 · 0.08–1.75no recov.2/406/4528mgRIVET-COV Biber (DB RCT)70%0.30 · 0.03–2.76hosp.1/473/4236mg Chahla (CLUS. RCT)87%0.13 · 0.03–0.54no disch.2/11020/14424mg Faisal (RCT)68%0.32 · 0.14–0.72no recov.6/5019/5048mg Aref (RCT)63%0.37 · 0.22–0.61recov. time57 (n)57 (n)n/a Krolewiecki (RCT)−152%2.52 · 0.11–58.11ventilation1/270/14168mg Vallejos (DB RCT)−33%1.33 · 0.30–5.72death4/2503/25124mg Manomai.. (DB RCT)43%0.57 · 0.20–1.46no recov.3/366/3648mg Mirahma.. (DB RCT)67%0.33 · 0.03–3.14ventilation1/1313/13024mg Bramante (DB RCT)−197%2.97 · 0.12–72.71death1/4080/39690mgCOVID-OUTOT1 Wijewic.. (DB RCT)−196%2.96 · 0.12–71.99death1/1270/12296mg Mouawia (RCT)56%0.44 · 0.14–1.37hosp.4/639/6312mg
Early treatment64%0.36 · 0.27–0.4830/1,699102/1,68564% lower risk
Tau² = 0.00, I² = 0.0%, p < 0.0001
Podder (RCT)16%0.84 · 0.55–1.12recov. time32 (n)30 (n)14mg Hashim (SB RCT)92%0.08 · 0.00–1.44death0/596/7028mgCT2 Ravikirti (DB RCT)89%0.11 · 0.01–2.05death0/554/5724mg Okumuş (DB RCT)33%0.67 · 0.27–1.64death6/309/3056mg Shahbazn.. (DB RCT)−197%2.97 · 0.13–70.51death1/350/3414mg Pott-Junior (RCT)85%0.15 · 0.01–1.93ventilation1/271/414mgcensored, see notes Huvemek (DB RCT)32%0.68 · 0.38–1.23no improv.13/5019/5084mg Abd-Elsalam (RCT)25%0.75 · 0.17–3.06death3/824/8236mg Lim (RCT)69%0.31 · 0.09–1.11death3/24110/249112mgI-TECH George (RCT)30%0.70 · 0.25–1.93death5/358/3924mg Naggie (DB RCT)−202%3.02 · 0.12–74.08death1/7080/724168mgACTIV-6 Aref (RCT)74%0.26 · 0.12–0.55recov. time49 (n)47 (n)n/aLONG COVID Ochoa-Ja.. (DB RCT)57%0.43 · 0.07–2.50death2/374/3828mg Wada (DB RCT)19%0.81 · 0.44–1.38progression19/10623/10614mg Hayward (RCT)−1%1.01 · 0.61–1.68death/hosp.34/2,15727/1,80673mgPRINCIPLE Varnaseri (DB RCT)82%0.18 · 0.04–0.78ventilation2/5511/5584mg
Late treatment39%0.61 · 0.45–0.8290/3,758126/3,42139% lower risk
Tau² = 0.09, I² = 28.6%, p = 0.0013
Shouman (RCT)91%0.09 · 0.03–0.23symp. case15/20359/10136mg Chahla (RCT)95%0.05 · 0.00–0.80m/s case0/11710/11748mgCT2 Seet (CLUS. RCT)50%0.50 · 0.33–0.76symp. case32/61764/61912mgOT1 Desort-H.. (DB RCT)96%0.04 · 0.02–0.11high v. load4/20099/199203mgSAIVE Wagstaff (DB RCT)55%0.45 · 0.22–1.00DAFS36 (n)32 (n)
Prophylaxis85%0.15 · 0.05–0.4651/1,173232/1,06885% lower risk
Tau² = 1.23, I² = 90.9%, p = 0.0008
All studies62%0.38 · 0.28–0.52171/6,630460/6,17462% lower risk
Tau² = 0.48, I² = 66.9%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
Rotate screen for more detailsIncrease width for more details
← Ivermectin
reduces riskIvermectin
increases risk →
Fig. 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. Analysis validating pooled outcomes for COVID-19 can be found below.
c19early.org
October 2026

Ivermectin COVID-19 mortality results after exclusions

StudyImprovementRR · 95% CITreatmentControlDose (4d)Relative Risk
Mahmud (DB RCT)86%0.14 · 0.01–2.750/1833/18312mgCT2 Loue (QR)70%0.30 · 0.04–2.201/105/1514mg Vallejos (DB RCT)−33%1.33 · 0.30–5.724/2503/25124mg Mayer55%0.45 · 0.32–0.633,266 (n)17,966 (n)151mg Bramante (DB RCT)−197%2.97 · 0.12–72.711/4080/39690mgCOVID-OUTOT1 Wijewic.. (DB RCT)−196%2.96 · 0.12–71.991/1270/12296mg
Early treatment49%0.51 · 0.32–0.827/4,24411/18,93349% lower risk
Tau² = 0.05, I² = 6.2%, p = 0.0054
Gorial71%0.29 · 0.01–5.760/162/7114mg Khan87%0.13 · 0.02–1.001/1159/13312mg Rajter (PSM)46%0.54 · 0.27–0.9913/9824/9814mg Hashim (SB RCT)92%0.08 · 0.00–1.440/596/7028mgCT2 Budhiraja99%0.01 · 0.00–0.150/34103/942n/a Ravikirti (DB RCT)89%0.11 · 0.01–2.050/554/5724mg Okumuş (DB RCT)33%0.67 · 0.27–1.646/309/3056mg Shahbazn.. (DB RCT)−197%2.97 · 0.13–70.511/350/3414mg Lima-Morales78%0.22 · 0.12–0.4115/48152/28712mgCT2 Abd-Elsalam (RCT)25%0.75 · 0.17–3.063/824/8236mg Rezk80%0.20 · 0.01–4.130/1602/16072mg Lim (RCT)69%0.31 · 0.09–1.113/24110/249112mgI-TECH Ozer75%0.25 · 0.06–1.132/608/6028mg Jamir (ICU)−53%1.53 · 0.88–2.6732/7669/190n/aICU patients Efimenko (PSM)69%0.31 · 0.20–0.481,072 (n)40,536 (n)n/aself-censored, see notes OT1 George (RCT)30%0.70 · 0.25–1.935/358/3924mg Naggie (DB RCT)−202%3.02 · 0.12–74.081/7080/724168mgACTIV-6 Ochoa-Ja.. (DB RCT)57%0.43 · 0.07–2.502/374/3828mg Munir48%0.52 · 0.22–1.2192 (n)908 (n)n/a Llenas-García17%0.83 · 0.38–1.8410/9612/9614mg Osati32%0.68 · 0.45–0.92448 (n)849 (n)n/a
Late treatment59%0.41 · 0.27–0.6294/4,030326/45,65359% lower risk
Tau² = 0.46, I² = 69.0%, p < 0.0001
Bernigaud99%0.01 · 0.00–0.100/69150/3,06284mg Kerr (PSM)70%0.30 · 0.19–0.4625/3,03479/3,03456mg
Prophylaxis94%0.06 · 0.00–2.3625/3,103229/6,09694% lower risk
Tau² = 6.33, I² = 86.1%, p = 0.13
All studies59%0.41 · 0.30–0.58126/11,377566/70,68259% lower risk
Tau² = 0.37, I² = 66.8%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
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← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S4. Random-effects meta-analysis for mortality after exclusions.
c19early.org
October 2026

Ivermectin COVID-19 mechanical ventilation results after exclusions

StudyImprovementRR · 95% CITreatmentControlDose (4d)Relative Risk
Krolewiecki (RCT)−152%2.52 · 0.11–58.111/270/14168mg Vallejos (DB RCT)−33%1.33 · 0.30–5.724/2503/25124mg Mirahma.. (DB RCT)67%0.33 · 0.03–3.141/1313/13024mg
Early treatment−1%1.01 · 0.32–3.196/4086/3951% higher risk
Tau² = 0.00, I² = 0.0%, p = 0.99
Rajter (PSM)64%0.36 · 0.12–1.104/9811/9814mg Camprubí40%0.60 · 0.18–2.013/135/1314mg Ravikirti (DB RCT)79%0.21 · 0.03–1.721/555/5724mg Shahbazn.. (DB RCT)−94%1.94 · 0.18–20.452/351/3414mg Lima-Morales52%0.48 · 0.20–1.188/43411/28712mgCT1 Pott-Junior (RCT)85%0.15 · 0.01–1.931/271/414mgcensored, see notes Abd-Elsalam (RCT)0%1.00 · 0.21–4.813/823/8236mg Lim (RCT)59%0.41 · 0.13–1.304/24110/249112mgI-TECH Ozer (PSM)13%0.87 · 0.11–5.583/602/6028mg Shimizu48%0.52 · 0.29–0.9339 (n)49 (n)14mg Ochoa-Ja.. (DB RCT)−34%1.34 · 0.42–4.237/375/3828mg Hayward (RCT)−151%2.51 · 0.26–24.153/2,1491/1,80173mgPRINCIPLE Varnaseri (DB RCT)82%0.18 · 0.04–0.782/5511/5584mg
Late treatment48%0.52 · 0.37–0.7341/3,32566/2,82748% lower risk
Tau² = 0.00, I² = 0.0%, p = 0.00016
All studies45%0.55 · 0.40–0.7647/3,73372/3,22245% lower risk
Tau² = 0.00, I² = 0.0%, p = 0.0002800.511.52+
1 CT: study uses combined treatment
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← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S5. Random-effects meta-analysis for mechanical ventilation after exclusions.
c19early.org
October 2026

Ivermectin COVID-19 ICU results after exclusions

StudyImprovementRR · 95% CITreatmentControlDose (4d)Relative Risk
Mayer66%0.34 · 0.22–0.513,266 (n)17,966 (n)151mg
Early treatment66%0.34 · 0.22–0.523,266 (n)17,966 (n)66% lower risk
Tau² = 0.00, I² = 0.0%, p < 0.0001
Khan89%0.11 · 0.01–0.801/11511/13312mg Camprubí33%0.67 · 0.13–3.352/133/1314mg Ravikirti (DB RCT)14%0.86 · 0.28–2.675/556/5724mg Pott-Junior (RCT)85%0.15 · 0.01–1.931/271/414mgcensored, see notes Lim (RCT)22%0.78 · 0.27–2.206/2418/249112mgI-TECH Ozer (PSM)49%0.51 · 0.09–2.506/603/6028mg Shimizu43%0.57 · 0.32–1.0239 (n)49 (n)14mg Ochoa-Ja.. (DB RCT)−37%1.37 · 0.53–3.578/376/3828mg Llenas-García−4%1.04 · 0.51–2.1196 (n)96 (n)14mg Hayward (RCT)−319%4.19 · 0.49–35.845/2,1491/1,80173mgPRINCIPLE Varnaseri (DB RCT)83%0.17 · 0.05–0.533/5518/5584mg
Late treatment39%0.61 · 0.38–0.9637/2,88757/2,55539% lower risk
Tau² = 0.18, I² = 32.5%, p = 0.034
All studies46%0.54 · 0.36–0.8337/6,15357/20,52146% lower risk
Tau² = 0.19, I² = 42.4%, p = 0.004500.511.52+
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reduces riskIvermectin
increases risk →
Fig. S6. Random-effects meta-analysis for ICU admission after exclusions.
c19early.org
October 2026

Ivermectin COVID-19 hospitalization results after exclusions

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (4d)Relative Risk
Chowdhury (RCT)81%0.19 · 0.01–3.96hosp.0/602/5614mgOT1 CT2 Biber (DB RCT)70%0.30 · 0.03–2.76hosp.1/473/4236mg Merino (QR)74%0.26 · 0.11–0.57hosp.77,381 (all patients)24mgcensored, see notes CS3 Vallejos (DB RCT)33%0.67 · 0.34–1.28hosp.14/25021/25124mg Mirahma.. (DB RCT)46%0.54 · 0.21–1.42hosp.6/13111/13024mg Bramante (DB RCT)61%0.39 · 0.08–2.00hosp.2/2065/20290mgCOVID-OUTOT1 Mouawia (RCT)56%0.44 · 0.14–1.37hosp.4/639/6312mg
Early treatment55%0.45 · 0.30–0.6727/75751/74455% lower risk
Tau² = 0.00, I² = 0.0%, p < 0.0001
Gorial42%0.58 · 0.45–0.75hosp. time16 (n)71 (n)14mg Khan40%0.60 · 0.44–0.81hosp. time115 (n)133 (n)12mg Spoorthi16%0.84 · 0.74–0.96hosp. time50 (n)50 (n)n/aCT2 Shahbazn.. (DB RCT)15%0.85 · 0.74–0.97hosp. time35 (n)34 (n)14mg Lima-Morales67%0.33 · 0.22–0.47hosp.44/48189/28712mgCT2 Abd-Elsalam (RCT)20%0.80 · 0.63–1.03hosp. time82 (n)82 (n)36mg Lim (RCT)−5%1.05 · 0.94–1.19hosp. time241 (n)249 (n)112mgI-TECH Ozer (PSM)−9%1.09 · 0.99–1.22hosp. time60 (n)60 (n)28mg Naggie (DB RCT)−5%1.05 · 0.43–2.58hosp.10/8179/774168mgACTIV-6 Varnaseri (DB RCT)33%0.67 · 0.52–0.85hosp. time55 (n)55 (n)84mg
Late treatment25%0.75 · 0.63–0.9054/1,95298/1,79525% lower risk
Tau² = 0.07, I² = 89.3%, p = 0.0018
Morgenstern (PSM)80%0.20 · 0.01–4.15hosp.0/2712/27156mg Kerr (PSM)67%0.33 · 0.23–0.46hosp.44/3,03499/3,03456mg
Prophylaxis67%0.33 · 0.23–0.4644/3,305101/3,30567% lower risk
Tau² = 0.00, I² = 0.0%, p < 0.0001
All studies35%0.65 · 0.54–0.78125/6,014250/5,84435% lower risk
Tau² = 0.09, I² = 86.1%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
3 CS: censored, see details
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← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S7. Random-effects meta-analysis for hospitalization after exclusions.
c19early.org
October 2026

Ivermectin COVID-19 recovery results after exclusions

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (4d)Relative Risk
Chowdhury (RCT)46%0.54 · 0.40–0.73no recov.27/6047/5614mgOT1 CT2 Espitia-Hernandez70%0.30 · 0.16–0.55recov. time28 (n)7 (n)12mgCT2 Mahmud (DB RCT)94%0.06 · 0.04–0.09no recov.72/183100/18012mgCT2 Ghauri92%0.08 · 0.01–0.88no recov.0/377/5348mg Babalola (DB RCT)41%0.59 · 0.33–1.05∆Spo238 (n)18 (n)24mgOT1 Mohan (DB RCT)62%0.38 · 0.08–1.75no recov.2/406/4528mgRIVET-COV Chahla (CLUS. RCT)87%0.13 · 0.03–0.54no disch.2/11020/14424mg Faisal (RCT)68%0.32 · 0.14–0.72no recov.6/5019/5048mg Aref (RCT)63%0.37 · 0.22–0.61recov. time57 (n)57 (n)n/a Manomai.. (DB RCT)43%0.57 · 0.20–1.46no recov.3/366/3648mg Mirahma.. (DB RCT)39%0.61 · 0.26–1.42no recov.8/13113/13024mg Mouawia (RCT)31%0.69 · 0.53–0.90no recov.63 (n)63 (n)12mg
Early treatment67%0.33 · 0.19–0.57120/833218/83967% lower risk
Tau² = 0.71, I² = 90.1%, p < 0.0001
Gorial71%0.29 · 0.01–5.76no recov.0/162/7114mg Podder (RCT)16%0.84 · 0.55–1.12recov. time32 (n)30 (n)14mg Khan87%0.13 · 0.02–1.00no recov.1/1159/13312mg Hashim (SB RCT)41%0.59 · 0.46–0.77recov. time70 (n)70 (n)28mgCT2 Spoorthi21%0.79 · 0.64–0.98recov. time50 (n)50 (n)n/aCT2 Ravikirti (DB RCT)89%0.11 · 0.01–2.05no disch.0/554/5724mg Shahbazn.. (DB RCT)32%0.68 · 0.47–1.00recov. time35 (n)34 (n)14mg Lima-Morales59%0.41 · 0.30–0.55no recov.75/481118/28712mgCT2 Rezk33%0.67 · 0.35–1.27no recov.14/14520/13872mg Lim (RCT)−2%1.02 · 0.85–1.23no recov.116/241116/247112mgI-TECH George (RCT)19%0.81 · 0.52–1.27recov. time35 (n)39 (n)24mg Naggie (DB RCT)2%0.98 · 0.89–1.09recovery708 (n)724 (n)168mgACTIV-6 Aref (RCT)74%0.26 · 0.12–0.55recov. time49 (n)47 (n)n/aLONG COVID Wada (DB RCT)60%0.40 · 0.13–1.24no recov.4/10710/10714mg Hayward (RCT)16%0.84 · 0.78–0.92no recov.2,157 (n)1,806 (n)73mgPRINCIPLE Varnaseri (DB RCT)28%0.72 · 0.66–0.78recov. time55 (n)55 (n)84mg
Late treatment29%0.71 · 0.62–0.82210/4,351279/3,89529% lower risk
Tau² = 0.04, I² = 81.2%, p < 0.0001
Wagstaff (DB RCT)55%0.45 · 0.22–1.00DAFS36 (n)32 (n)
Prophylaxis55%0.45 · 0.22–0.9536 (n)32 (n)55% lower risk
Tau² = 0.00, I² = 0.0%, p = 0.036
All studies48%0.52 · 0.44–0.62330/5,220497/4,76648% lower risk
Tau² = 0.14, I² = 89.8%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
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← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S8. Random-effects meta-analysis for recovery results only after exclusions.
c19early.org
October 2026

Ivermectin COVID-19 case results after exclusions

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (1m)Relative Risk
Shouman (RCT)91%0.09 · 0.03–0.23symp. case15/20359/10136mg Behera54%0.46 · 0.29–0.71cases41/117145/25542mg Bernigaud55%0.45 · 0.22–0.91cases7/69692/3,06284mg Alam91%0.09 · 0.04–0.25cases4/5844/6012mg Chahla (RCT)84%0.16 · 0.04–0.46cases4/11725/11748mgCT2 Behera83%0.17 · 0.12–0.23cases45/2,199133/1,14742mg Seet (CLUS. RCT)50%0.50 · 0.33–0.76symp. case32/61764/61912mgOT1 Morgenstern (PSM)74%0.26 · 0.10–0.71cases5/27118/27156mg Mondal88%0.12 · 0.01–0.55symp. case128 (n)1,342 (n)n/a Kerr (PSM)44%0.56 · 0.53–0.58casespopulation-based cohort56mg Desort-H.. (DB RCT)96%0.04 · 0.02–0.11high v. load4/20099/199203mgSAIVE Wagstaff (DB RCT)47%0.53 · 0.29–0.91viral+ time36 (n)32 (n)
Prophylaxis76%0.24 · 0.15–0.36157/4,0151,279/7,20576% lower risk
Tau² = 0.44, I² = 92.6%, p < 0.0001
All studies76%0.24 · 0.15–0.36157/4,0151,279/7,20576% lower risk
Tau² = 0.44, I² = 92.6%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
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← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S9. Random-effects meta-analysis for COVID-19 case results after exclusions.
c19early.org
October 2026

Ivermectin COVID-19 viral clearance results after exclusions

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (4d)Relative Risk
Chowdhury (RCT)81%0.19 · 0.01–3.96viral+0/602/5614mgOT1 CT2 Espitia-Hernandez97%0.03 · 0.01–0.10viral+0/287/712mgCT2 Mahmud (DB RCT)39%0.61 · 0.44–0.83viral+14/18336/18012mgCT2 Ahmed (DB RCT)76%0.24 · 0.07–0.91viral+11/2220/2348mg Chaccour (DB RCT)95%0.05 · 0.00–0.67viral load12 (n)12 (n)28mgSAINT Babalola (DB RCT)64%0.36 · 0.10–1.27viral+40 (n)20 (n)24mgOT1 Bukhari (RCT)82%0.18 · 0.07–0.46viral+4/4125/4512mg Mohan (DB RCT)24%0.76 · 0.53–1.09viral+21/4031/4528mgRIVET-COV Biber (DB RCT)62%0.38 · 0.14–0.90viral+8/4717/4236mg Elalfy87%0.13 · 0.06–0.27viral+7/6244/5136mgCT2 Mourya89%0.11 · 0.05–0.25viral+5/5047/5048mg Aref (RCT)79%0.21 · 0.07–0.71viral+3/5714/57n/a Krolewiecki (RCT)66%0.34 · 0.10–1.16decay rate20 (n)12 (n)168mg Vallejos (DB RCT)−5%1.05 · 0.88–1.21viral+137/250131/25124mg Manomai.. (DB RCT)5%0.95 · 0.62–1.45viral+19/3620/3648mg Wijewic.. (DB RCT)51%0.49 · 0.26–0.93viral load80 (n)81 (n)96mg Mouawia (RCT)62%0.38 · 0.30–0.48viral load63 (n)63 (n)12mg
Early treatment67%0.33 · 0.22–0.49229/1,091394/1,03167% lower risk
Tau² = 0.46, I² = 88.4%, p < 0.0001
Khan73%0.27 · 0.12–0.58viral time115 (n)133 (n)12mg Camprubí−25%1.25 · 0.43–3.63viral+5/134/1314mg Ravikirti (DB RCT)−12%1.12 · 0.89–1.40viral+42/5539/5724mg Okumuş (DB RCT)80%0.20 · 0.05–0.81viral+2/165/856mg Pott-Junior (RCT)1%0.99 · 0.04–26.30viral+27 (n)3 (n)14mgcensored, see notes Rezk27%0.73 · 0.57–0.93viral time160 (n)160 (n)72mg Wada (DB RCT)−4%1.04 · 0.76–1.43viral+106 (n)106 (n)14mg
Late treatment22%0.78 · 0.56–1.1049/49248/48022% lower risk
Tau² = 0.11, I² = 72.0%, p = 0.15
All studies56%0.44 · 0.33–0.58278/1,583442/1,51156% lower risk
Tau² = 0.32, I² = 86.8%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
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← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S10. Random-effects meta-analysis for viral clearance after exclusions.
c19early.org
October 2026

Ivermectin COVID-19 studies by strongyloides prevalence

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (4d)Relative Risk
Gorial71%0.29 · 0.01–5.76death0/162/7114mg Espitia-Hernandez70%0.30 · 0.16–0.55recov. time28 (n)7 (n)12mgCT2 Shouman (RCT)91%0.09 · 0.03–0.23symp. case15/20359/10136mg Carvallo85%0.15 · 0.02–1.28death1/323/1436mgCT2 Rajter (PSM)46%0.54 · 0.27–0.99death13/9824/9814mg Carvallo96%0.04 · 0.00–0.63cases0/13111/9814mgsee notes CT2 Hashim (SB RCT)92%0.08 · 0.00–1.44death0/596/7028mgCT2 Camprubí40%0.60 · 0.18–2.01ventilation3/135/1314mg Carvallo100%0.00 · 0.00–0.02cases0/788237/40748mgsee notes CT2 Bernigaud99%0.01 · 0.00–0.10death0/69150/3,06284mg Chaccour (DB RCT)96%0.04 · 0.00–1.01symptoms12 (n)12 (n)28mgSAINT Ghauri92%0.08 · 0.01–0.88no recov.0/377/5348mg IVERCOR PREP73%0.27 · 0.15–0.48cases13/38961/48648mgMD3 Chahla (RCT)95%0.05 · 0.00–0.80m/s case0/11710/11748mgCT2 Okumuş (DB RCT)33%0.67 · 0.27–1.64death6/309/3056mg Bukhari (RCT)82%0.18 · 0.07–0.46viral+4/4125/4512mg Shahbazn.. (DB RCT)−197%2.97 · 0.13–70.51death1/350/3414mg Lima-Morales78%0.22 · 0.12–0.41death15/48152/28712mgCT2 Biber (DB RCT)70%0.30 · 0.03–2.76hosp.1/473/4236mg Elalfy87%0.13 · 0.06–0.27viral+7/6244/5136mgCT2 Beltran .. (DB RCT)14%0.86 · 0.29–2.56death5/366/3712mg Huvemek (DB RCT)32%0.68 · 0.38–1.23no improv.13/5019/5084mg Chahla (CLUS. RCT)87%0.13 · 0.03–0.54no disch.2/11020/14424mg Seet (CLUS. RCT)50%0.50 · 0.33–0.76symp. case32/61764/61912mgOT1 Loue (QR)70%0.30 · 0.04–2.20death1/105/1514mg Ahsan50%0.50 · 0.28–0.90death17/11017/5521mgCT2 Merino (QR)74%0.26 · 0.11–0.57hosp.77,381 (all patients)24mgcensored, see notes CS5 Faisal (RCT)68%0.32 · 0.14–0.72no recov.6/5019/5048mg Abd-Elsalam (RCT)25%0.75 · 0.17–3.06death3/824/8236mg Aref (RCT)63%0.37 · 0.22–0.61recov. time57 (n)57 (n)n/a Krolewiecki (RCT)−152%2.52 · 0.11–58.11ventilation1/270/14168mg Vallejos (DB RCT)−33%1.33 · 0.30–5.72death4/2503/25124mg Hazan86%0.14 · 0.01–2.15death0/24synthetic24mgsee notes CT2 SC4 Buonfrate (DB RCT)−211%3.11 · 0.13–73.31hosp.1/280/31336mgCOVER Mayer55%0.45 · 0.32–0.63death3,266 (n)17,966 (n)151mg Borody92%0.08 · 0.01–0.79death0/6006/60096mgMD3 CT2 SC4 Rezk80%0.20 · 0.01–4.13death0/1602/16072mg Ozer75%0.25 · 0.06–1.13death2/608/6028mg Mustafa64%0.36 · 0.12–1.14death3/7342/371varies Abbas (DB RCT)−4%1.04 · 0.07–16.41death1/991/10384mg Zubair−9%1.09 · 0.33–3.64death5/905/9812mg de Jesús Ascenci..59%0.41 · 0.36–0.47death/hosp.7,898 (n)20,150 (n)12mgCT2 Efimenko (PSM)69%0.31 · 0.20–0.48death1,072 (n)40,536 (n)n/aself-censored, see notes OT1 de la Ro.. (DB RCT)−187%2.87 · 0.12–67.49misc.1/300/2636mg Naggie (DB RCT)−202%3.02 · 0.12–74.08death1/7080/724168mgACTIV-6 Rezai (DB RCT)31%0.69 · 0.35–1.39death13/31118/29884mg Rezai (DB RCT)−5%1.05 · 0.07–16.68death1/2681/28184mg Mirahma.. (DB RCT)67%0.33 · 0.03–3.14ventilation1/1313/13024mg Bramante (DB RCT)−197%2.97 · 0.12–72.71death1/4080/39690mgCOVID-OUTOT1 Qadeer58%0.42 · 0.31–0.56viral+35/10584/10548mg Aref (RCT)74%0.26 · 0.12–0.55recov. time49 (n)47 (n)n/aLONG COVID Mikamo (DB RCT)−205%3.05 · 0.12–74.69progression1/5020/52763mgIVERMILCO Desort-H.. (DB RCT)96%0.04 · 0.02–0.11high v. load4/20099/199203mgSAIVE Munir48%0.52 · 0.22–1.21death92 (n)908 (n)n/a Llenas-García17%0.83 · 0.38–1.84death10/9612/9614mg Wada (DB RCT)19%0.81 · 0.44–1.38progression19/10623/10614mg Hayward (RCT)−1%1.01 · 0.61–1.68death/hosp.34/2,15727/1,80673mgPRINCIPLE Varnaseri (DB RCT)82%0.18 · 0.04–0.78ventilation2/5511/5584mg Hashmi (RCT)26%0.74 · 0.38–1.47death81 (n)69 (n)56mgREMAP-CAPICU patients Wagstaff (DB RCT)55%0.45 · 0.22–1.00DAFS36 (n)32 (n) Mouawia (RCT)56%0.44 · 0.14–1.37hosp.4/639/6312mg
<8.1%65%0.35 · 0.29–0.43302/22,8551,216/92,41565% lower risk
Tau² = 0.27, I² = 68.0%, p < 0.0001
Chowdhury (RCT)81%0.19 · 0.01–3.96hosp.0/602/5614mgOT1 CT2 Kishoria (RCT)−8%1.08 · 0.57–2.02no disch.11/197/1312mg Podder (RCT)16%0.84 · 0.55–1.12recov. time32 (n)30 (n)14mg Khan87%0.13 · 0.02–1.00death1/1159/13312mg Chachar (RCT)10%0.90 · 0.44–1.83no recov.9/2510/2536mg Soto-Becerra17%0.83 · 0.71–0.97death92/2031,438/2,63014mg Mahmud (DB RCT)86%0.14 · 0.01–2.75death0/1833/18312mgCT2 Szente Fonseca−14%1.14 · 0.75–1.66hosp.340 (n)377 (n)24mg Behera54%0.46 · 0.29–0.71cases41/117145/25542mg Cadegiani78%0.22 · 0.01–4.48death0/1102/13742mgCT2 Spoorthi21%0.79 · 0.64–0.98recov. time50 (n)50 (n)n/aCT2 Budhiraja99%0.01 · 0.00–0.15death0/34103/942n/a Ahmed (DB RCT)85%0.15 · 0.01–2.70symptoms0/173/1948mg Alam91%0.09 · 0.04–0.25cases4/5844/6012mg Babalola (DB RCT)64%0.36 · 0.10–1.27viral+40 (n)20 (n)24mgOT1 Ravikirti (DB RCT)89%0.11 · 0.01–2.05death0/554/5724mg Mohan (DB RCT)62%0.38 · 0.08–1.75no recov.2/406/4528mgRIVET-COV Behera83%0.17 · 0.12–0.23cases45/2,199133/1,14742mg López-Me.. (DB RCT)67%0.33 · 0.01–8.11death0/2001/19884mg Pott-Junior (RCT)85%0.15 · 0.01–1.93ventilation1/271/414mgcensored, see notes Mourya89%0.11 · 0.05–0.25viral+5/5047/5048mg Morgenstern (PSM)80%0.20 · 0.01–4.15hosp.0/2712/27156mg Mondal88%0.12 · 0.01–0.55symp. case128 (n)1,342 (n)n/a Reis (DB RCT)12%0.88 · 0.49–1.55death21/67924/67984mgTOGETHERimpossible data, see notes Elavarasi20%0.80 · 0.61–1.06death48/283311/1,475n/a Lim (RCT)69%0.31 · 0.09–1.11death3/24110/249112mgI-TECH Samajdar80%0.20 · 0.11–0.38cases12/16429/81n/a Ferreira−5%1.05 · 0.32–3.43death3/2111/81n/a Kerr (PSM)70%0.30 · 0.19–0.46death25/3,03479/3,03456mg Jamir (ICU)−53%1.53 · 0.88–2.67death32/7669/190n/aICU patients Manomai.. (DB RCT)43%0.57 · 0.20–1.46no recov.3/366/3648mg Thairu (PSM)88%0.12 · 0.01–2.14death0/214/2656mg Soto−41%1.41 · 1.16–1.76death280/484374/934n/a Ravikirti3%0.97 · 0.74–1.24death53/171254/794varies George (RCT)30%0.70 · 0.25–1.93death5/358/3924mg Schilling (RCT)67%0.33 · 0.01–7.97hosp.0/451/45168mgPLATCOV Ochoa-Ja.. (DB RCT)57%0.43 · 0.07–2.50death2/374/3828mg Sarojvisut (RCT)−2%1.02 · 0.06–16.15death1/1571/160112mg Osati32%0.68 · 0.45–0.92death448 (n)849 (n)n/a Siripongbo.. (RCT)0%1.00 · 0.07–15.26progression1/301/30168mgFINCOVCT2 Wijewic.. (DB RCT)−196%2.96 · 0.12–71.99death1/1270/12296mg
≥8.1%50%0.50 · 0.38–0.65701/10,4623,146/16,90650% lower risk
Tau² = 0.39, I² = 87.5%, p < 0.0001
All studies60%0.40 · 0.33–0.481,003/33,3174,362/109K60% lower risk
Tau² = 0.46, I² = 85.7%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
3 MD: minimal detail available currently
4 SC: study uses synthetic control arm
5 CS: censored, see details
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← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S11. Random-effects meta-analysis for studies grouped by strongyloides prevalence. Data is by country and from Buonfrate. Effect extraction follows the same pre-specified protocol as detailed in the appendix.
c19early.org
October 2026

Ivermectin COVID-19 studies after SSC exclusions

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (4d)Relative Risk
Chowdhury (RCT)81%0.19 · 0.01–3.96hosp.0/602/5614mgOT1 CT2 Mahmud (DB RCT)86%0.14 · 0.01–2.75death0/1833/18312mgCT2 Ahmed (DB RCT)85%0.15 · 0.01–2.70symptoms0/173/1948mg Chaccour (DB RCT)96%0.04 · 0.00–1.01symptoms12 (n)12 (n)28mgSAINT Ghauri92%0.08 · 0.01–0.88no recov.0/377/5348mg Babalola (DB RCT)64%0.36 · 0.10–1.27viral+40 (n)20 (n)24mgOT1 Bukhari (RCT)82%0.18 · 0.07–0.46viral+4/4125/4512mg Mohan (DB RCT)62%0.38 · 0.08–1.75no recov.2/406/4528mgRIVET-COV López-Me.. (DB RCT)67%0.33 · 0.01–8.11death0/2001/19884mg Faisal (RCT)68%0.32 · 0.14–0.72no recov.6/5019/5048mg Aref (RCT)63%0.37 · 0.22–0.61recov. time57 (n)57 (n)n/a Krolewiecki (RCT)−152%2.52 · 0.11–58.11ventilation1/270/14168mg Vallejos (DB RCT)−33%1.33 · 0.30–5.72death4/2503/25124mg Reis (DB RCT)12%0.88 · 0.49–1.55death21/67924/67984mgTOGETHERimpossible data, see notes Buonfrate (DB RCT)−211%3.11 · 0.13–73.31hosp.1/280/31336mgCOVER Manomai.. (DB RCT)43%0.57 · 0.20–1.46no recov.3/366/3648mg de la Ro.. (DB RCT)−187%2.87 · 0.12–67.49misc.1/300/2636mg Rezai (DB RCT)−5%1.05 · 0.07–16.68death1/2681/28184mg Mirahma.. (DB RCT)67%0.33 · 0.03–3.14ventilation1/1313/13024mg Schilling (RCT)67%0.33 · 0.01–7.97hosp.0/451/45168mgPLATCOV Bramante (DB RCT)−197%2.97 · 0.12–72.71death1/4080/39690mgCOVID-OUTOT1 Mikamo (DB RCT)−205%3.05 · 0.12–74.69progression1/5020/52763mgIVERMILCO Siripongbo.. (RCT)0%1.00 · 0.07–15.26progression1/301/30168mgFINCOVCT2 Wijewic.. (DB RCT)−196%2.96 · 0.12–71.99death1/1270/12296mg Mouawia (RCT)56%0.44 · 0.14–1.37hosp.4/639/6312mg
Early treatment53%0.47 · 0.35–0.6353/3,361114/3,36953% lower risk
Tau² = 0.05, I² = 9.0%, p < 0.0001
Gorial71%0.29 · 0.01–5.76death0/162/7114mg Podder (RCT)16%0.84 · 0.55–1.12recov. time32 (n)30 (n)14mg Khan87%0.13 · 0.02–1.00death1/1159/13312mg Chachar (RCT)10%0.90 · 0.44–1.83no recov.9/2510/2536mg Soto-Becerra17%0.83 · 0.71–0.97death92/2031,438/2,63014mg Rajter (PSM)46%0.54 · 0.27–0.99death13/9824/9814mg Hashim (SB RCT)92%0.08 · 0.00–1.44death0/596/7028mgCT2 Camprubí40%0.60 · 0.18–2.01ventilation3/135/1314mg Spoorthi21%0.79 · 0.64–0.98recov. time50 (n)50 (n)n/aCT2 Budhiraja99%0.01 · 0.00–0.15death0/34103/942n/a Ravikirti (DB RCT)89%0.11 · 0.01–2.05death0/554/5724mg Okumuş (DB RCT)33%0.67 · 0.27–1.64death6/309/3056mg Shahbazn.. (DB RCT)−197%2.97 · 0.13–70.51death1/350/3414mg Lima-Morales78%0.22 · 0.12–0.41death15/48152/28712mgCT2 Beltran .. (DB RCT)14%0.86 · 0.29–2.56death5/366/3712mg Pott-Junior (RCT)85%0.15 · 0.01–1.93ventilation1/271/414mgcensored, see notes Huvemek (DB RCT)32%0.68 · 0.38–1.23no improv.13/5019/5084mg Abd-Elsalam (RCT)25%0.75 · 0.17–3.06death3/824/8236mg Elavarasi20%0.80 · 0.61–1.06death48/283311/1,475n/a Rezk80%0.20 · 0.01–4.13death0/1602/16072mg Lim (RCT)69%0.31 · 0.09–1.11death3/24110/249112mgI-TECH Ozer75%0.25 · 0.06–1.13death2/608/6028mg Jamir (ICU)−53%1.53 · 0.88–2.67death32/7669/190n/aICU patients George (RCT)30%0.70 · 0.25–1.93death5/358/3924mg Naggie (DB RCT)−202%3.02 · 0.12–74.08death1/7080/724168mgACTIV-6 Rezai (DB RCT)31%0.69 · 0.35–1.39death13/31118/29884mg Qadeer58%0.42 · 0.31–0.56viral+35/10584/10548mg Aref (RCT)74%0.26 · 0.12–0.55recov. time49 (n)47 (n)n/aLONG COVID Ochoa-Ja.. (DB RCT)57%0.43 · 0.07–2.50death2/374/3828mg Sarojvisut (RCT)−2%1.02 · 0.06–16.15death1/1571/160112mg Munir48%0.52 · 0.22–1.21death92 (n)908 (n)n/a Llenas-García17%0.83 · 0.38–1.84death10/9612/9614mg Wada (DB RCT)19%0.81 · 0.44–1.38progression19/10623/10614mg Osati32%0.68 · 0.45–0.92death448 (n)849 (n)n/a Hayward (RCT)−1%1.01 · 0.61–1.68death/hosp.34/2,15727/1,80673mgPRINCIPLE Varnaseri (DB RCT)82%0.18 · 0.04–0.78ventilation2/5511/5584mg Hashmi (RCT)26%0.74 · 0.38–1.47death81 (n)69 (n)56mgREMAP-CAPICU patients
Late treatment40%0.60 · 0.49–0.72369/6,6982,280/12,07740% lower risk
Tau² = 0.14, I² = 63.8%, p < 0.0001
Shouman (RCT)91%0.09 · 0.03–0.23symp. case15/20359/10136mg Behera54%0.46 · 0.29–0.71cases41/117145/25542mg Bernigaud99%0.01 · 0.00–0.10death0/69150/3,06284mg Alam91%0.09 · 0.04–0.25cases4/5844/6012mg Chahla (RCT)95%0.05 · 0.00–0.80m/s case0/11710/11748mgCT2 Behera83%0.17 · 0.12–0.23cases45/2,199133/1,14742mg Seet (CLUS. RCT)50%0.50 · 0.33–0.76symp. case32/61764/61912mgOT1 Morgenstern (PSM)80%0.20 · 0.01–4.15hosp.0/2712/27156mg Mondal88%0.12 · 0.01–0.55symp. case128 (n)1,342 (n)n/a Kerr (PSM)70%0.30 · 0.19–0.46death25/3,03479/3,03456mg Desort-H.. (DB RCT)96%0.04 · 0.02–0.11high v. load4/20099/199203mgSAIVE Wagstaff (DB RCT)55%0.45 · 0.22–1.00DAFS36 (n)32 (n)
Prophylaxis83%0.17 · 0.10–0.29166/7,049785/10,23983% lower risk
Tau² = 0.53, I² = 86.4%, p < 0.0001
All studies57%0.43 · 0.35–0.52588/17,1083,179/25,68557% lower risk
Tau² = 0.36, I² = 77.3%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
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← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S12. Random-effects meta-analysis with SSC exclusions. SSC has not reviewed late treatment and prophylaxis trials. SSC exclusions are from Nov 27, 2021.
c19early.org
October 2026

Ivermectin COVID-19 studies after GMK exclusions

StudyImprovementRR · 95% CIOutcomeTreatmentControlDose (4d)Relative Risk
Mahmud (DB RCT)86%0.14 · 0.01–2.75death0/1833/18312mgCT2 Szente Fonseca−14%1.14 · 0.75–1.66hosp.340 (n)377 (n)24mg Ahmed (DB RCT)85%0.15 · 0.01–2.70symptoms0/173/1948mg Chaccour (DB RCT)96%0.04 · 0.00–1.01symptoms12 (n)12 (n)28mgSAINT Bukhari (RCT)82%0.18 · 0.07–0.46viral+4/4125/4512mg Mohan (DB RCT)62%0.38 · 0.08–1.75no recov.2/406/4528mgRIVET-COV Biber (DB RCT)70%0.30 · 0.03–2.76hosp.1/473/4236mg López-Me.. (DB RCT)67%0.33 · 0.01–8.11death0/2001/19884mg Krolewiecki (RCT)−152%2.52 · 0.11–58.11ventilation1/270/14168mg Vallejos (DB RCT)−33%1.33 · 0.30–5.72death4/2503/25124mg Reis (DB RCT)12%0.88 · 0.49–1.55death21/67924/67984mgTOGETHERimpossible data, see notes Buonfrate (DB RCT)−211%3.11 · 0.13–73.31hosp.1/280/31336mgCOVER Mayer55%0.45 · 0.32–0.63death3,266 (n)17,966 (n)151mg Manomai.. (DB RCT)43%0.57 · 0.20–1.46no recov.3/366/3648mg de la Ro.. (DB RCT)−187%2.87 · 0.12–67.49misc.1/300/2636mg Rezai (DB RCT)−5%1.05 · 0.07–16.68death1/2681/28184mg Mirahma.. (DB RCT)67%0.33 · 0.03–3.14ventilation1/1313/13024mg Schilling (RCT)67%0.33 · 0.01–7.97hosp.0/451/45168mgPLATCOV Bramante (DB RCT)−197%2.97 · 0.12–72.71death1/4080/39690mgCOVID-OUTOT1 Mikamo (DB RCT)−205%3.05 · 0.12–74.69progression1/5020/52763mgIVERMILCO Siripongbo.. (RCT)0%1.00 · 0.07–15.26progression1/301/30168mgFINCOVCT2 Wijewic.. (DB RCT)−196%2.96 · 0.12–71.99death1/1270/12296mg Mouawia (RCT)56%0.44 · 0.14–1.37hosp.4/639/6312mg
Early treatment40%0.60 · 0.43–0.8448/6,77089/21,51840% lower risk
Tau² = 0.13, I² = 26.7%, p = 0.0034
Podder (RCT)16%0.84 · 0.55–1.12recov. time32 (n)30 (n)14mg Soto-Becerra17%0.83 · 0.71–0.97death92/2031,438/2,63014mg Hashim (SB RCT)92%0.08 · 0.00–1.44death0/596/7028mgCT2 Ravikirti (DB RCT)89%0.11 · 0.01–2.05death0/554/5724mg Shahbazn.. (DB RCT)−197%2.97 · 0.13–70.51death1/350/3414mg Lima-Morales78%0.22 · 0.12–0.41death15/48152/28712mgCT2 Beltran .. (DB RCT)14%0.86 · 0.29–2.56death5/366/3712mg Huvemek (DB RCT)32%0.68 · 0.38–1.23no improv.13/5019/5084mg Abd-Elsalam (RCT)25%0.75 · 0.17–3.06death3/824/8236mg Elavarasi20%0.80 · 0.61–1.06death48/283311/1,475n/a Rezk80%0.20 · 0.01–4.13death0/1602/16072mg Lim (RCT)69%0.31 · 0.09–1.11death3/24110/249112mgI-TECH Ozer75%0.25 · 0.06–1.13death2/608/6028mg Jamir (ICU)−53%1.53 · 0.88–2.67death32/7669/190n/aICU patients George (RCT)30%0.70 · 0.25–1.93death5/358/3924mg Naggie (DB RCT)−202%3.02 · 0.12–74.08death1/7080/724168mgACTIV-6 Rezai (DB RCT)31%0.69 · 0.35–1.39death13/31118/29884mg Qadeer58%0.42 · 0.31–0.56viral+35/10584/10548mg Aref (RCT)74%0.26 · 0.12–0.55recov. time49 (n)47 (n)n/aLONG COVID Ochoa-Ja.. (DB RCT)57%0.43 · 0.07–2.50death2/374/3828mg Sarojvisut (RCT)−2%1.02 · 0.06–16.15death1/1571/160112mg Munir48%0.52 · 0.22–1.21death92 (n)908 (n)n/a Llenas-García17%0.83 · 0.38–1.84death10/9612/9614mg Wada (DB RCT)19%0.81 · 0.44–1.38progression19/10623/10614mg Osati32%0.68 · 0.45–0.92death448 (n)849 (n)n/a Hayward (RCT)−1%1.01 · 0.61–1.68death/hosp.34/2,15727/1,80673mgPRINCIPLE Varnaseri (DB RCT)82%0.18 · 0.04–0.78ventilation2/5511/5584mg Hashmi (RCT)26%0.74 · 0.38–1.47death81 (n)69 (n)56mgREMAP-CAPICU patients
Late treatment40%0.60 · 0.48–0.75336/6,2902,117/10,71140% lower risk
Tau² = 0.17, I² = 67.5%, p < 0.0001
Seet (CLUS. RCT)50%0.50 · 0.33–0.76symp. case32/61764/61912mgOT1 Morgenstern (PSM)80%0.20 · 0.01–4.15hosp.0/2712/27156mg Kerr (PSM)70%0.30 · 0.19–0.46death25/3,03479/3,03456mg Desort-H.. (DB RCT)96%0.04 · 0.02–0.11high v. load4/20099/199203mgSAIVE Wagstaff (DB RCT)55%0.45 · 0.22–1.00DAFS36 (n)32 (n)
Prophylaxis75%0.25 · 0.12–0.5461/4,158244/4,15575% lower risk
Tau² = 0.52, I² = 82.4%, p = 0.00039
All studies46%0.54 · 0.44–0.65445/17,2182,450/36,38446% lower risk
Tau² = 0.22, I² = 65.8%, p < 0.000100.511.52+
1 OT: ivermectin vs. other treatment
2 CT: study uses combined treatment
Rotate screen for more detailsIncrease width for more details
← Ivermectin
reduces riskIvermectin
increases risk →
Fig. S13. Random-effects meta-analysis with GMK exclusions. Our main exclusion analyses already exclude all studies where the GMK team believes there are major data issues. This analysis corresponds with GMK's recommendation for meta-analysis as of Oct 26, 2021. GMK excludes most non-RCT studies, with the notable exception of several studies with major issues that report negative or relatively poor results — Szente Fonseca which is likely affected by multicollinearity among treatments, Elavarasi which reports unadjusted results with no group details and is subject to confounding by indication, and Soto-Becerra which has several major issues described in the details.
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Fig. S14. Comparison of results for RCTs versus observational studies. For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.