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Table 3. - Clinical studies assessing the efficacy of ivermectin in the prophylaxis and treatment of COVID-19.

Prophylaxis Trials Author, Country, source	Study design, size	Study subjects	Ivermectin dose	Dose frequency	Clinical outcomes reported
Prophylaxis trials
Shouman W, Egypt www.clinicaltrials.gov NCT04422561	RCT N = 340	Household members of pts with +COVID-19 PCR test	40–60 kg: 15 mg, 60–80 kg: 18 mg, and > 80 kg: 24 mg	Two doses, 72 hours apart	7.4% versus 58.4% developed COVID-19 symptoms, P < 0.001
Elgazzar A, Egypt ResearchSquare doi.org/10.21203/rs.3.rs-100956/v1	RCT N = 200	Health care and household contacts of pts with +COVID-19 PCR test	0.4 mg/kg	Two doses, day 1 and day 7	2% versus 10% tested positive for COVID-19 P < 0.05
Chala R, Argentina NCT04701710 Clinicaltrials.gov	RCT N = 234	Health care workers	12 mg	Every 7 d	3.4% versus 21.4%, P = 0.0001.
Carvallo H, Argentina Journal of Biochemical Research and Investigation doi.org/10.31546/2633–8653.1007	OCT N = 229	Healthy patients negative for COVID-19 PCR test	0.2 mg drops	1 drop 5 times a d x 28 d	0.0% versus 11.2% contracted COVID-19 P < 0.001
Alam MT, Bangladesh European J Med Hlth Sciences 10.24018/ejmed.2020.2.6.599	OCT N = 118	Health care workers	12 mg	Monthly	6.9% versus 73.3%, P < 0.05
Carvallo H, Argentina Journal of Biochemical Research and Investigation doi.org/10.31546/2633–8653.1007	OCT N = 1195	Health care workers	12 mg	Once weekly for up to 10 wk	0.0% of the 788 workers taking ivermectin versus 58% of the 407 controls contracted COVID-19.
Behera P, India medRxiv doi.org/10.1101/2020.10.29.20222661	OCT N = 186 case control pairs	Health care workers	0.3 mg/kg	Day 1 and day 4	2 doses reduced odds of contracting COVID-19 (OR 0.27 95% CI 0.16–0.53)
Bernigaud C, France Annales de Dermatologie et de Venereologi doi.org/10.1016/j.annder.2020.09.231	OCT N = 69 case control pairs	Nursing home residents	0.2 mg/kg	Once	10.1% versus 22.6% residents contracted COVID-19 0.0% versus 4.9% mortality
Hellwig M, USA J Antimicrobial Agents doi.org/10.1016/j.ijantimicag.2020.106,248	OCT N = 52 countries	Countries with and without IVM prophylaxis programs	Unknown	Variable	Significantly lower-case incidence of COVID-19 in African countries with IVM prophylaxis programs P < 0.001

Clinical trials–Outpatients					% Ivermectin versus % Controls
Prophylaxis Trials Author, Country, source	Study design, size	Study subjects	Ivermectin dose	Dose frequency	Clinical outcomes reported
Mahmud R, Bangladesh www.clinicaltrials.gov NCT0452383	DB-RCT N = 363	Outpatients and hospitalized	12 mg + doxycycline	Once, within 3 days of PCR+ test	Early improvement 60.7% versus 44.4%, P < 0.03, deterioration 8.7% versus 17.8%, P < 0.02
Chowdhury A, Bangladesh Research Square doi.org/10.21203/rs.3.rs-38896/v1	RCT N = 116	Outpatients	0.2 mg//kg + doxycycline	Once	Recovery time 5.9 versus 9.3 days (P = 0.07)
Ravikirti, India medRxiv doi.org/10.1101/2021.01.05.21249310	DB-RCT N = 115	Mild–moderate illness	12 mg	Daily for 2 d	No diff in day 6 PCR + 0% versus 6.9% mortality, P = 0.019
Babalola OE, Nigeria medRxiv doi.org/10.1101/2021.01.05.21249131	DB-RCT N = 62	Mild–moderate illness	6 mg and 12 mg	Every 48 hours × 2 wk	Time to viral clearance: 4.6 days high dose versus 6.0 days low dose versus 9.1 days control (P = 0.006)
Podder CS, Bangladesh IMC J Med Sci 2020;14(2)	RCT N = 62	Outpatients	0.2 mg/kg	Once	Recovery time 10.1 versus 11.5 days (NS), average time 5.3 versus 6.3 (NS)
Chaccour C. Spain Research Square doi.org/10.21203/rs.3.rs-116547/v1	DB-RCT N = 24	Outpatients	0.4 mg/kg	Once	No diff in PCR+ day 7, lower viral load d 4 and 7, (P < 0.05), 76 versus 158 pts. d of anosmia (P < 0.05), 68 versus 98 pts. d of cough (P < 0.05)
Morgenstern J, Dominican Republic medRxiv doi.org/10.1101/2020.10.29.20222505	Case series N = 3099	Outpatients and hospitalized	Outpatients: 0.4 mg/kg hospital patients: 0.3 mg/kg	Outpatients:0.3 mg/kg × 1 dose Inpatients: 0.3 mg/kg, days 1,2,6, and 7	Mortality = 0.03% in 2688 outpatients, 1% in 300 non-ICU hospital patients, and 30.6% in 111 ICU patients
Carvallo H, Argentina medRxiv doi.org/10.1101/2020.09.10.20191619	Case series N = 167	Outpatients and hospitalized	24 mg = mild, 36 mg = moderate, and 48 mg = severe	Days 0 and 7	All 135 with mild illness survived, 1/32 (3.1% of hospitalized) patients died
Alam A, Banglades J of Bangladesh College Phys and Surg, 2020; 38:10-15 doi.org/10.3329/jbcps.v38i0.47512	Case series N = 100	Outpatients	0.2 mg/kg/kg + doxycycline	Once	All improved within 72 h
Espatia-Hernandez G, Mexico Biomedical Research www.biomedres.info/biomedi..-proof-of-concept-study-14435.html	Case series N = 28	Outpatients	6 mg	Days 1,2, 7, and 8	All pts recovered average recovery time 3.6 d

Clinical trials–Hospitalized patients					% Ivermectin versus % Controls
Prophylaxis Trials Author, Country, source	Study design, size	Study subjects	Ivermectin dose	Dose frequency	Clinical outcomes reported
Elgazzar A, Egypt ResearchSquare doi.org/10.21203/rs.3.rs-100956/v1	OL-RCT N = 400	Hospitalized patients	0.4 mg/kg	Daily for 4 days	Moderately ill: worsened 1% versus 22%, P<0.001. Severely ill: worsened 4% versus 30% mortality 2% versus 20% both with P < 0.001
Niaee S. M, Research Square doi.org/10.21203/rs.3.rs-109670/v1	DB-RCT N = 180	Hospitalized patients	0.2, 0.3, and 0.4 mg/kg (3 dosing strategies)	Once versus Days 1,3,5	Mortality 3.3% versus 18.3%. OR 0.18, (0.06–0.55, P < 0.05)
Hashim H, Iraq medRxiv doi.org/10.1101/2020.10.26.20219345	SB-RCT N=140	2/3 outpatients and 1/3 hospital pts	0.2 mg/kg + doxycycline	Daily for 2–3 d	Recovery time 6.3 versus 13.6 days (P<0.001), 0% versus 27.3% mortality in severely ill (P = 0.052)
Spoorthi S, India AIAM, 2020; 7(10):177-182	PCT N = 100	Hospitalized patients	0.2 mg/kg+ doxycycline	Once	Shorter hospital LOS, 3.7 versus 4.7 days, P = 0.03, faster resolution of symptoms, 6.7 versus 7.9 days, P = 0.01
Ahmed S. Dhaka, Bangladesh International journal of Infectious disease doi.org/10.1016/j.ijid.2020.11.191	DB-RCT N = 72	Hospitalized patients	12 mg	Daily for 5 d	Faster viral clearance 9.7 versus 12.7 days, P = 0.02
Chachar AZK, Pakistan Int J Sciences doi.org/10.18483/ijSci.2378	DB-RCT N = 50	Hospitalized patients-mild	12 mg	Two doses day 1 and one dose day 2	64% versus 60% asymptomatic by day 7
Portman-Baracco A, Brazil Arch Bronconeumol. 2020 doi.org/10.1016/j.arbres.2020.06.011	OCT N = 1408	Hospitalized patients	0.15 mg/kg	Once	Overall mortality 1.4% versus 8.5%, HR 0.2, 95% CI 0.12–0.37, P < 0.0001
Rajter JC, Florida Chest 2020 doi.org/10.1016/j.chest.2020.10.009	OCT N=280	Hospitalized patients	0.2 mg/kg + azithromycin	Day 1 and day 7 if needed	Overall mortality 15.0% versus 25.2%, P = 0.03, severe illness mortality 38.8% versus 80.7%, P = 0.001
Khan X, Bangladesh Arch Bronconeumol. 2020 doi.org/10.1016/j.arbres.2020.08.007	OCT N = 248	Hospitalized patients	12 mg	Once on admission	Mortality 0.9% versus 6.8%, P < 0.05, LOS 9 versus 15 days, P < 0.001
Gorial FI, Iraq medRxiv doi.org/10.1101/2020.07.07.20145979	OCT N = 87	Hospitalized patients	0.2 mg/kg + HCQ and azithromycin	Once on admission	LOS 7.6 versus 13.2 days, P < 0.001, 0/15 versus 2/71 died
Budiraja S. India medRxiv doi.org/10.1101/2020.11.16.20232223	OCT N = 1000 IVM=34	Hospitalized patients	n/a	n/a	100% IVM pts recovered 11.1% mortality in non-IVM-treated pts

DB-RCT, double-blinded randomized controlled trial; HCQ, hydroxychloroquine; IVM, ivermectin; LOS, length of stay; NS, nonstatistically significant, P > .05; OCT, observational controlled trial; OL, open label; PCR, polymerase chain reaction; RCT, randomized controlled trial; SB-RCT, single blinded randomized controlled trial.