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The antiparasitic drug ivermectin inhibits in-vitro replication of viruses. However, there has been conflicting information about the effectiveness of ivermectin for treating COVID-19 and preventing SARS-CoV-2 infection.

COVID-19 infections require affordable, widely accessible, and efficient treatments. Ivermectin’s effectiveness in treating COVID-19 infections has yielded conflicting results in clinical trials. The drug is believed to work through a molecular mechanism that inhibits the replication of the SARS-CoV-2 infection in the early stages.

Ivermectin was evaluated in randomized controlled trials alongside the standard of care, a placebo, and another effective intervention for the treatment of individuals with a confirmed diagnosis of COVID-19, regardless of the severity of the illness or the location of care. It was also evaluated for the prevention of SARS-CoV-2 infection. Trials with more than 1000 participants were included up until April 2022.

The Cochrane RoB 2 tool was used to assess randomized controlled trials and check for bias. Researchers utilized GRADE to assess the degree of evidence for certain outcomes in the following contexts and demographics:

  1. To care for inpatients with mild-to-severe COVID-19;
  2. To manage mild COVID-19 in outpatients (outcomes: mortality, clinical deterioration or improvement, adverse events, quality of life, and viral clearance);
  3. To stop the spread of SARS-CoV-2.

Currently, there is low- to high-certainty evidence that ivermectin does not help outpatient COVID-19 patients. It is unclear whether ivermectin prevents clinical worsening or death or whether it increases serious adverse events or improves viral clearance. Similarly, for inpatients there is low- or very low-certainty evidence that ivermectin can prevent clinical worsening, mortality, or adverse events. According to this recent review, there is no evidence to suggest that ivermectin is appropriate for preventing or treating SARS-CoV-2 infection. 

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Popp, M., Stegemann, M., Metzendorf, M. I., Gould, S., Kranke, P., Meybohm, P., Skoetz, N., & Weibel, S. (2021). Ivermectin for preventing and treating COVID-19. Cochrane Database Syst Rev, 7(7), Cd015017. https://doi.org/10.1002/14651858.CD015017.pub2