Crying wolf in time of Corona: the strange case of ivermectin and hydroxychloroquine. Is the fear of failure withholding potential life-saving treatment from clinical use?

Nardelli et al., Signa Vitae, doi:10.22514/sv.2021.043, Mar 2021

Ivermectin for COVID-19

4th treatment shown to reduce risk in August 2020, now with p < 0.0000000001 from 106 studies, recognized in 24 countries.

No treatment is 100% effective.
Protocols combine treatments.

Meta analysis of RCT mortality results showing RR 0.19, p < 0.00001.
7 meta-analyses show significant improvements with ivermectin for mortality1-6, hospitalization7, recovery3, and cases3.
Currently there are 106 ivermectin for COVID-19 studies, showing 47% lower mortality [34‑58%], 35% lower ventilation [17‑50%], 40% lower ICU admission [12‑58%], 34% lower hospitalization [21‑44%], and 79% fewer cases [69‑86%].
OutcomeImprovementEffect · pTreatmentControl
risk of death 79.5% lower · RR 0.21 · p < 0.001*** 79.5% lowerRR 0.21p < 0.001*** 14 of 703 (2.0%) 57 of 620 (9.2%) treatment 14 of 703 (2.0%), control 57 of 620 (9.2%)NNT 14odds ratio converted to relative risk

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates. *** p < 0.001

Nardelli et al., 11 Mar 2021, peer-reviewed, 8 authors.
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