H202101604 Response.pdf

133 Molesworth Street
PO Box 5013
Wellington 6140
New Zealand
T+64 4 496 2000

17 March 2021

Adrian O’Flynn

By email:  [FYI request #14723 email]

Ref:
H202101604

Dear Adrian O’Flynn

Response to your request for official information

Thank you for your request under the Official Information Act 1982 (the Act) to the Ministry of
Health (the Ministry) on 19 February 2021 regarding the use of ivermectin as a treatment for
COVID-19.

Your questions and my responses are as follows.

Does the Ministry of Health stand by it's comments on 8 April 2020? If yes, why?

Thank you for your inquiry. Your point is well taken that it is important to keep up to date on the
current evidence of therapies used for the treatment of COVID-19. However, the Ministry’s
statement on 8 April 2020 (www.health.govt.nz/news-media/news-items/caution-about-
laboratory-covid-19-report) is still in-line with the current evidence.

Evidence from high-quality randomised controlled trials is required to demonstrate the benefits
and to assess the safety of therapies so it can be approved for a specific indication. To date,
there are only a few small randomised clinical trials evaluating ivermectin as a therapy for
COVID-19. The results are mixed with most studies showing no benefit. Generally, the quality of
clinical evidence is low as the majority are preprint, non-peer-reviewed trials with small sample
sizes.

Who in the Ministry of Health reviews the scientific studies on the efficacy of Ivermectin in
the treatment of Covid-19? This could be part of a general body that looks at possible
treatments for Covid-19. If there is no body, then why does the Ministry of Health not have
such a body?

The Science and Technical Advisory team in the COVID-19 Health System Response
Directorate is constantly looking for and reviewing the evidence regarding effective therapies for
COVID-19, including the use of ivermectin. It should be noted that Medsafe is the regulatory
body responsible for recommendations on therapies in New Zealand, not the Ministry.

If there is a person/body, which studies has the person/body responsible for reviewing the
efficacy of Ivermectin in the treatment of Covid-19 considered or reviewed on the efficacy
of Ivermectin in the treatment of Covid-19 since the 8 April 2020? Please provide the list
of studies and/or scientific papers that the person/body has reviewed.

The Science and Technical Advisory team have reviewed the evidence for the treatment of
COVID-19 with ivermectin therapy. A copy of this review is attached as Appendix 1 to this letter.
Neither the National Institutes of Health (NIH) in the United States nor the World Health
Organization (WHO) recommend ivermectin for the treatment of COVID-19. You may be
interested in several ongoing reviews that can be found at:
•  The NIH: www.covid19treatmentguidelines.nih.gov/antiviral-therapy/
•  The NIH National Library of Medicine (PubMed): https://pubmed.ncbi.nlm.nih.gov/
•  The WHO: www.who.int/publications/i/item/therapeutics-and-covid-19-living-guideline
•  The British Medical Journal ‘Drug treatments for covid-19: living systematic review and
network meta-analysis, BMJ 2020; 370’: www.doi.org/10.1136/bmj.m2980
•  The United States Centers for Disease Control and Prevention:
www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html

Has the person/body responsible for reviewing the efficacy of Ivermectin in the treatment
of Covid-19 considered the research undertaken by: Frontline COVID-19 Critical Care
Alliance; Dr. Andrew Hill of Liverpool University, and his meta-analysis on the efficacy of
Ivermectin in the treatment of Covid-19; Dr. Tess Lawrie, Director of The Evidence-Based
Medicine Consultancy Ltd, and her meta-analysis on the efficacy of Ivermectin in the
treatment of Covid-19?

These pieces of work have been reviewed.

If the person/body responsible for reviewing the efficacy of Ivermectin in the treatment of
Covid-19 has considered the studies and meta-analyses why does this person/body not
consider Ivermectin an effective treatment in Covid-19? If the person/body responsible for
reviewing the efficacy of Ivermectin in the treatment of Covid-19 has not considered the
studies and meta-analyses will that person consider the studies and meta-analyses. If no,
why? If yes, when will a statement either confirming or changing the Ministry of Health's
position be issued?

Much of this evidence is based on observational data, which is prone to confounding and other
biases, therefore it cannot be used as the basis for guidance for therapies. Some of the
evidence is not peer-reviewed and is only available on social media channels or in preprint. This
research includes some randomised clinical trial data, but those studies have mixed results, are
often small studies and overall provide a low level of clinical evidence.

You may be interested in a response from Medsafe regarding ivermectin which is available at:
www.health.govt.nz/system/files/documents/information-release/h202100482_15_feb_2021.pdf.

I trust this information fulfils your request. Under section 28(3) of the Act you have the right to
ask the Ombudsman to review any decisions made under this request. The Ombudsman may
be contacted by email at: [email address] or by calling 0800 802 602.

Page 2 of 3

Please note that this response, with your personal details removed, may be published on the
Ministry website at: www.health.govt.nz/about-ministry/information-releases/responses-official-
information-act-requests.

Yours sincerely

Gill Hall
Group Manager, COVID-19 Science and Insights
COVID-19 Health System Response
Page 3 of 3

link to page 15 link to page 15 link to page 15 link to page 15 link to page 15 Response to Request for Information
Key points
•  In order for a therapy to be approved for a specific indication, evidence from high-quality
randomized controlled trials are required to demonstrate benefit and begin to assess safety.
•  There are few, small randomized clinical trials evaluating ivermectin as a therapy for COVID-
19. Results are mixed, with most studies showing no benefit. Generally, the quality of
evidence is low: the majority are preprint, non-peer-reviewed trials, with small sample sizes.
•  There are two peer-reviewed clinical trial comparing ivermectin therapy to comparator, and  1982
both studies showed no mortality benefit for ivermectin[1, 2].
•  In addition, there are several observational studies of ivermectin. One recent systematic
review, retrieved 4 observational studies: 3 with comparator arms and one without a
Act
comparator group.[3] The review found a statistically significant effect on mortality and
symptoms, but the quality of evidence was very low.
•  There is no strong evidence to date of benefit for ivermectin as a therapy for COVID-19.
Objective
To summarize the evidence for the treatment of COVID-19 with ivermectin therapy
Background
Indications
Information
In New Zealand, ivermectin is approved for treating intestinal strongyloidiasis (anguillulosis),
microfilaraemia in patients with lymphatic filariasis caused by Wuchereria bancrofti, and human
scabies after prior treatment has failed.[4] Elsewhere, ivermectin is used for the treatment of
onchocerciasis (river blindness)
Safety
Official
In general, ivermectin has a good safety profile. Side effects are related to the microfilarial density
and most of them are mild and transient in nature.[4]
the
Mechanism of action (MOA)
Until recently, ivermectin was primarily an antiparasitic medicine. It works by binding to glutamate-
gated chloride ion channels to alter chloride channel function; and by acting as a gamma-
aminobutyric acid agonist in the parasite. This leads to parasite paralysis and death. In recent years,
under
ivermectin has shown antiviral activity against a broad range of viruses in vitro. Ivermectin’s MOA is
inhibition of replication. The antiviral activity is purportedly due to the inhibition of importin (IMP)
α/β Integrase which helps in the nuclear import and propagation of infection of RNA viruses. Based
on this, researchers have proposed evaluating ivermectin as an add on therapy for COVID-19
treatment.
Methodology
The following search strategy was used:
Released
Database: Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations,
Daily and Versions(R) <1946 to February 01, 2021>, adapted for Embase, Scopus, Cochrane, Europe
PMC for Preprints, Clinical Trials Databases

link to page 15 link to page 15 link to page 15 link to page 15 link to page 16 link to page 7 link to page 16 link to page 15 link to page 15 1  Ivermectin/ or Ivermectin.mp. or ivomec.mp. or Stromectol.mp. or Soolantra.mp. or
Sklice.mp. or Mectizan.mp.
2  (2019-ncov or ncov19 or ncov-19 or 2019-novel CoV or sars-cov2 or sars-cov-2 or sarscov2 or
sarscov-2 or Sars-coronavirus2 or Sars-coronavirus-2 or SARS-like coronavirus* or
coronavirus-19 or covid19 or covid-19 or covid 2019 or ((novel or new or nouveau) adj2 (CoV
on nCoV or covid or coronavirus* or corona virus or Pandemi*2)) or ((covid or covid19 or
covid-19) and pandemic*2) or (coronavirus* and pneumonia)).mp.
3  1 and 2
4  limit 3 to randomized controlled trial
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5  3 and (trial* or random* or control*).mp. [mp=title, abstract, original title, name of
substance word, subject heading word, floating sub-heading word, keyword heading word,
organism supplementary concept word, protocol supplementary concept word, rare disease
Act
supplementary concept word, unique identifier, synonyms]
6  4 or 5
In addition, ClinicalTrials.gov was reviewed for any trials comparing ivermectin to control, that
had reported results.

Evidence for effectiveness
Clinical trial evidence
Information
This review evaluates results from nine clinical trials. Three of the RCTs were peer-reviewed[1, 2, 5],
however they were too small to demonstrate significance clinical benefit. Two studies reported
statistically significant differences between the ivermectin treatment and control arms. However,
neither studies were peer-reviewed: one study the results were only available on
ClinicaTrials.gov[6]; the other study reported a mortality benefit for ivermectin, but mortality was
not a pre-specified outcome for the trial.[7]
Official
Studies where ivermectin was compared to another active comparator that was itself an
experimental therapy, rather than standard or care or placebo, were excluded. Studies evaluating
the
ivermectin as a prophylaxis were not included. No studies demonstrated a pre-specified mortality
benefit outcome. Results are summarized in Table 1.
•  Hashim, et al.[8] compared the combination of ivermectin+doxycycline with standard care
(SC). The did not find any statistically significant results. However, they reported in-hospital
under
mortality of 2.9% and 8.6% in the ivermectin+doxycycline combination therapy and SOC
groups, respectively. Disease progression was lower in the combination therapy group
compared to SC (4.3% vs. 10%, respectively).
•  Study NCT04523831[6] was an ivermectin+doxycycline combination study that evaluated
only mild or moderate COVID patients, and therefore mortality was not a prespecified
outcome. They reported a higher rate of clinical improvement within 7 days in the
ivermectin+doxycycline group compared to comparator (60.7% vs 44.4%, respectively). They
also found that fewer patients in the treatment arm than the SC arm took 12 days or more
Released
to improve (23% and 37.2%, respectively), and a lower rate of clinical deterioration (8.7% vs
17.85%, respectively). Results were statistically significant.
•  SAINT trial[5] was a small phase 2 trial of N=24 patients, with the primary objective of
assessing viral load in patients with mild and moderate COVID after one dose of ivermectin,
compared to placebo. They found no statistically significant differences between the groups.

link to page 16 link to page 16 link to page 16 link to page 15 link to page 16 •  Shakhsi Niaee, et al.[9] reported a 6-arm trial with two comparator arms (SC, SC+placebo)
and 4 treatment arms with different regimens of ivermectin. All patients received
hydroxychloroquine 200mg/kg twice per day as part of SC. In-hospital mortality was 3.3%
and 18.3% in the ivermectin therapy arms (combined) and comparator arms (combined),
respectively, but the difference is not statistically significant. There was no evidence of
benefit for the other outcomes (duration of hospital admission and low O2, fever, and
tachypnea).
•  Podder, et al.[10] was an open-label RCT that reported no differences between the
ivermectin and comparator arms. Results are not peer-reviewed.
1982
•  Ravikirti, et al.[7] reported a mortality benefit for ivermectin (in-hospital mortality was 0%
(0/55) in the ivermectin group and 6.9% (4/58) in the placebo group. However, mortality was
not a pre-specified primary or secondary outcome. Results are not peer-reviewed.   Act
•  Both Charchar, et al. and Krolewiecki, et al. were small studies that did not report significant
differences in prespecified outcomes.[2, 11]

Information
Official
the
under
Released

link to page 16 link to page 15
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Table 1 Summary of randomised clinical trial data evaluating ivermectin against a control, as of 03 February 2021l
Trial name
Trial
Patients
Intervention
Outcome Measures/
Location
Comment
Act
Results
Hashim et a, 2020,
RCT,
Outpatient and
IVM+DOXY:
Mortality:
Alkarkh
Results were not
(preprint)[8]
combination
inpatient groups
2-3 days of 200 μg/kg
IVM+DOXY: 2.9% (2/70)
Health
significant, but
NCT04591600
therapy
with COVID-19
IVM + 5-10 days DOXY
SC: 8.6% (6/70)
Directorate-
ivermectin group

diagnosed using
+ standard care (SC), N=70
P=0.16
Baghdad,
tended to have greater
clinical, radiological

Iraq
benefit on mortality
and
Comparator: SC, N=70
Disease progression:
and disease
laboratory PCR

IVM+DOXY: 4.3% (3/70)
progression.
testing.
SC included 5dexamethasone
SC: 10% (7/70)
Results not peer-
6 mg/day or
P=0.19
reviewed
methylprednisolone 40mg
Information
twice per day, as needed
NCT04523831,
RCT, double-
Outpatient and
IVM+DOXY:
Mortality:
Dhaka
Study of patients at
[6]preliminary
blind,
inpatient groups
6-12 mg IVM + 5 days
IVM+DOXY: 0%
Medical
low risk for severe
results reported on
combination
with mild or
DOXY + SC, N=183
SC: 1.7%
College,
COVID.
ClinicalTrials.gov,
therapy
moderate disease

P-value not reported
Bangladesh
IVM+DOXY group had
Official
not peer-reviewed
patients, diagnosed
Comparator:

higher rate of for
using PCR
SC, N=180
Early clinical
clinical improvement
improvement <7 days
within 7 days and
IVM+DOXY: 60.7%
lower rate of disease
the
SC: 44.4%
progression
P<0.03
Results not peer-

reviewed
Clinical improvement
>12 days:
IVM+DOXY: 23%
under
SC: 37.2%
P<0.004

Clinical deterioration:
IVM+DOXY: 8.7%
Released

link to page 15 SC: 17.8%
1982
P<0.013
Act
Ahmed et al 2021.
RCT, double-
Inpatient with
IVM monotherapy:
Mortality: 0 events in
Dhaka,
No evidence for
International
blind, 3 arm
COVID-19
Oral ivermectin alone (12 mg
any arm
Bangladesh
mortality benefit.
Journal of
trial of
diagnosed with
once daily for

Study too small to
Information
Infectious
monotherapy,
physical exam and
5 days), N=22.
Remission of fever in 7
produce statistically
Diseases[1]
combination
PCR

days
significance.
therapy, and
IVM+DOXY:
IVM: 100%
Mixed results when
placebo.
oral ivermectin in
IVM+DOXY: 94.1%
comparing treatment
combination with doxycycline
Placebo: 84.2%
arms to comparator.
(12 mg

ivermectin single dose and
Remission of cough in 7
Peer-reviewed.
Official
200 mg doxycycline on day 1,
days
followed
IVM: 38.9%
by 100 mg every 12 h for the
IVM+DOXY: 36.8%
next 4 days), N=23
Placebo: 60%
the

Comparator:
Hospital duration, mean
SC+ Placebo, N=23
days:
IVM: 9.6
IVM+DOXY: 10
under
Pb: 9.7

No statistically
significant differences in
any of the outcomes.
Released

link to page 15 link to page 16 Chaccour et al,
RCT, Double-
Patients diagnosed
IVM: Single dose of 400
Symptoms:
Universidad
Small pilot study, no
1982
SAINT trial
blind
with COVID-19 in
mcg/kg ivermectin, N=12
IVM group reported
de Navarra,
evidence of benefit.
NCT04390022[5]
Phase2/pilot
the emergency
Comparator: placebo, N=12
fewer patient-days of
Spain

study of N=24
room with a
symptoms overall,
Act
patients to
positive PCR.
primarily driven by
evaluate if
Patients at low risk
less anosmia/hyposmia
ivermectin
of progressing to
and cough.
reduces nasal
severe disease:

viral carriage
patients with
No significant difference
serious
in the proportion of PCR
comorbidities were
positive patients, viral
excluded.
loads, or lower IgG titers
post-treatment.
Shakhsi Niaee et al
Phase 2 RCT,
Adults over 18 with
IVM arms (N=180 total):
Mortality:
Qazvin
All patients received
2020. Preprint.[9]
placebo-
clinical symptoms
1) single dose ivermectin
IVM: 3.3%
science &
hydroxychloroquine
Information
controlled 6
suggestive of
(200mcg/Kg, 1 pill per day)
Comparator arms: 18.3%  technology
200mg/kg twice per
arm trial: SOC,
COVID-19. Mild to
+SC, N=30
P-value not reported
park, Iran
day as part of SC.
SOC+placebo,
severe COVID-19
2) three low interval doses of
(not statistically

and 4 arms
disease confirmed
ivermectin (200, 200, 200
significant)
The two comparator
were different
by CT scan or
mcg/Kg, 3 pills in 1, 3 and 5

arms were combined,
regimens of
positive RT-PCR.
interval days) +SC, N=30
Other outcomes:
as were the 4 IVM
IVM.
3) single dose ivermectin
Evidence of difference
arms.
Official
(400mcg/Kg, 2 pills per day)
among all 6 treatment

+SC, N=30
groups for duration of

4) three high interval doses of
hospital stay and low O2,
ivermectin (400, 200, 200
fever, and tachypnea,
the
mcg/Kg, 4 pills in 1, 3 and 5
but no evidence of
interval days+SC, N=30
benefit for IVM over

comparator groups for
Comparator arms:
any of those outcomes.
5) common regimen based on

under Iran health ministry
No statistically
(Hydroxychloroquine
significant difference for
200mg/kg twice per day),
any of the outcomes.
N=30
Released

link to page 16 6) placebo plus common
1982
regime, N=30
Act
Podder, et al.[10]
Open-label,
Patients aged 18
IVM:
No significant
Bangladesh
No significant
Preprint
RCT with
and over with mild
200 micrograms/kg single
differences between the
differences between
ivermectin
to moderate
dose+SC, N=32
treatment and control
treatment and control
Information
and SC
COVID-19. Patients

arms for any outcomes,
groups. Small sample
comparator
with known pre-
Comparator:
including recovery time,
size.
arms.
existing
SC, N=30
number of patients with
hypersensitivity to
negative RT-PCR on day
Ivermectin,
10.
pregnant and
lactating mothers,
Official
and patients taking
other
antimicrobials or
hydroxychloroquin
the
e were excluded.
under
Released

link to page 16 link to page 15 Ravikirti et al.[7]
RCT, placebo-
Patients with mild
IVM: 12 mg on day 1 and day
Mortality:
Bihar, India
Mortality benefit in the
1982
Preprint
controlled
to moderate
2, N=55
IVM 0% (0/55)
IVM arm, but mortality
COVID-19, aged 18

Placebo: 6.9% (4/58)
was not a prespecified
and over, no
Comparator: Placebo+SC,

outcome.
Act
contraindications
N=58
No significant
to ivermectin.
differences between the
groups for any
outcomes, i.e., negative
RT-PCR on day 6,
symptoms day 6,
discharge status day 10,
ICU admission,
ventilation.
Charchar, et al.[2]
Open-label
Adult patients (18-
IVM: 12mg day 1, 12 mg after
Symptomatic at day 7:
Lahore, India No significant
RCT
75) with mild
12 hours, and 12mg after 24
IVM: 36% (9/25)
differences
Information
disease only
hours+SC, N=25
Control: 40% (10/25)

No significant difference
Comparator: SC, N=25
Official
the
under
Released

link to page 16 Krolewiecki, et
RCT
Adult patients with
IVM:
Viral load reduction:
Argentina
No significant
1982
al.[11]
mild or moderate
standard of care plus oral IVM
No significant difference
differences in
NCT004381884
COVID-19
at 0·6 mg/kg/day for 5 days,

prespecified outcomes.
Preprint
N=30
Post-hoc difference
Act

comparing patients with
Comparator:
high IVM plasma levels
standard of care, N=15
and controls
SC=Standard of care; IVM=Ivermectin; DOXY=Doxycycline
Information
Official
the
under
Released

link to page 15 link to page 16 link to page 16 link to page 16 link to page 16 link to page 16 link to page 16 link to page 16 link to page 16 link to page 16

Observational studies
There have been several observational studies and systematic reviews reporting the outcomes for patients that
received ivermectin as part of their therapy. Padhy et al[3] performed a recent systematic review of four
observational studies, and found a statistically significant effect on mortality and symptoms, although the quality of
evidence was very low. Another recent systematic review of twelve studies[12] (five retrospective cohort studies, six
randomized clinical trials and one case series) reported that ivermectin was not associated with reduced mortality or
1982
differences in patient recovery. Both systematic reviews noted that the quality of evidence was very low.
Other reviews
Act
A recent review by the New South Wales’ Agency for Clinical Innovation concluded that there was insufficient
evidence to support the use of ivermectin for prophylaxis or treatment of COVID-19.[13]
The US CDC issued current recommendations for clinicians regarding investigational therapeutics for patients with
COVID-19,  in conjunction with the US National Institutes of Health.[14, 15] Ivermectin is not a therapy that is
recommended for treatment of COVID-19 at this time by the US NIH; specifically, with regard to anti-viral therapies,
the US NIH found there was insufficient data for or against ivermectin as a therapy for COVID-19.[16]
Neither the US Food and Drug Administration (US FDA) nor the European Medicines Agency (EMA) has approved
ivermectin for prevention or treatment for COVID-19.[17, 18]
Information
The World Health Organization’s guidelines on therapeutics for COVID-19 do not include ivermectin as a
recommended therapy.[19]
Cochrane review
There are no completed reviews of therapies for COVID-19. A protocol for a Cochrane review has been published,
Official
but there is no expected date for publication of results.[20]
Conclusions
the
In order for a therapy to be approved for a specific indication, evidence from high-quality randomized controlled
trials are required to demonstrate benefit and begin to assess safety.
There are few, small randomized clinical trials evaluating ivermectin as a therapy for COVID-19. Results are mixed,
with most studies showing no benefit. Generally, the quality of evidence is low: the majority are preprint, non-peer-
reviewed trials, with small sample sizes.
under
In addition, there are several observational studies of ivermectin. One recent systematic review, of 4 observational
studies found a statistically significant effect on mortality and symptoms, but the quality of evidence was very low.
There is no strong evidence to date of benefit for ivermectin as a therapy for COVID-19.

Released

1982

Act

Information

Official

the

under

Next Steps
Released

In the development of this

work, the following parties

have been consulted with:
What are the implications
and considerations of this

1982
advice on Te Tiriti o Waitangi
and equity?

Act
Resources used:
Ministry of Health Policies
☐ Yes
and Procedures
☐ No
External Health
☐ Yes
Scientific organisations
☐ No
☐ Yes
Information
Existing database of RFAs

☐ No
☐ Yes
Internal MH Advice

☐ No
Official
☐ Yes
External Expert Advice

☐ No  the
☐ Yes
Literature Review

☐ No

References
under
1.
Ahmed, S., et al., A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of
illness. Int J Infect Dis, 2020. 103: p. 214-216.
2.
Chachar, A., et al., Effectiveness of Ivermectin in SARS-CoV-2/COVID-19 Patients. International Journal of
Sciences, 2020. 9(9): p. 31-5.
3.
Padhy, B.M., et al., Therapeutic potential of ivermectin as add on treatment in COVID 19: A systematic review
and meta-analysis. J Pharm Pharm Sci, 2020. 23: p. 462-469.
4.
(Medsafe), N.Z.M.a.M.D.S.A. New Zealand Data Sheet: Stromectol ivermectin tablets. New Zealand Data
Sheet 2019 28 February 2019 [cited 2021 19 January 2021]; Available from:
Released
https://www.medsafe.govt.nz/profs/datasheet/s/Stromectoltab.pdf.
5.
Chaccour, C., et al., The effect of early treatment with ivermectin on viral load, symptoms and humoral
response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical
trial. EClinicalMedicine, 2021: p. 100720.
6.
Mahmud, R. Clinical Trial of Ivermectin Plus Doxycycline for the Treatment of Confirmed Covid-19 Infection.
2020 09 October 2020 [cited 2021 03 February 2021]; Available from:
https://clinicaltrials.gov/ct2/show/NCT04523831.

7.
Ravikirti, et al., Ivermectin as a potential treatment for mild to moderate COVID-19 – A double blind
randomized placebo-controlled trial. medRxiv, 2021: p. 2021.01.05.21249310.
8.
Hashim, H.A., et al., Controlled randomized clinical trial on using Ivermectin with Doxycycline for treating
COVID-19 patients in Baghdad, Iraq. medRxiv, 2020: p. 2020.10.26.20219345.
9.
Niaee, M., et al., Ivermectin as an adjunct treatment for hospitalized adult COVID-19 patients: A randomized
multi-center clinical trial. Research Square, 2021.
10.
Podder, C., et al., Outcome of ivermectin treated mild to moderate COVID-19 cases: a single-centre, open-
label, randomised controlled study. IMC Journal of Medical Science, 2020. 14.
1982
11.
Krolewiecki, A., et al. Antiviral Effect of High-Dose Ivermectin in Adults with COVID-19: A Pilot Randomised,
Controlled, Open Label, Multicentre Trial. . Lancet Preprints, 2020. DOI: 10.2139/ssrn.3714649.
12.
Castañeda-Sabogal, A., et al., Outcomes of Ivermectin in the treatment of COVID-19: a systematic review and
meta-analysis. medRxiv, 2021: p. 2021.01.26.21250420.
Act
13.
Innovation, N.S.W.A.f.C., COVID-19 Critical Intelligence Unit Evidence Check: Ivermectin and COVID-19, in
COVID-19 Critical Intelligence Unit Evidence Checks, N.S.W.A.f.C. Innovation, Editor. 2020, Agency for Clinical
Innovation: aci.health.nsw.gov.au.
14.
NIH, U. Therapeutic management of adults with COVID-19. COVID-19 Treatment Guidelines 2021 11
February 2021 [cited 2021 15 February 2021]; Available from:
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