03 January 2021


URGENT CV-19 information:

Ivermectin reduces the risk of death from CV-19 – a rapid review and meta-analysis in support of the recommendation of the Front Line CV-19 Critical Care Alliance.


Tess Lawrie MBBCh, PhD;

E-BMC Ltd, Office 305, Northgate House, Upper Borough Walls, Bath, United Kingdom

Email: info@e-bmc.co.uk

Website: www.e-bmc.co.uk:

ORCID iD 0000-0002-5500-8590



Background to this rapid review

Recently a group of expert critical care physicians, called the Front Line CV-19 Critical Care Alliance (FLCCC), reviewed the evidence on the effects of ivermectin on SARS-CoV-2 virus and CV-19 infections.1 They concluded that the evidence on ivermectin “demonstrates a strong signal of therapeutic efficacy” and recommended that ivermectin isadopted globally and systematically for the prophylaxis and treatment of CV-19.1

Ivermectin is an anti-parasitic medication widely used in low- and middle-income countries to treat parasitic worm infections in adults and children.[1,2] Having been used for decades for this purpose, it is considered extremely safe and effective [2,3] and has an increasing list of indications due to its antiviral and anti-inflammatory properties.[4] On the WHO’s Model List of Essential Medicines it is retained in the form of a 3 mg tablet. [5] For parasitic infections in adults, ivermectin is commonly administered as a single 12 mg oral dose (0.2mg/kg).

The FLCCC review summarizes the findings of 27 studies evaluating ivermectin for prophylaxis and treatment of CV-19 infection; however, it does not include metaanalyses for the majority of outcomes. The FLCCC has called upon national and international health care agencies to devote the necessary resources to checking and confirming this groundbreaking evidence.

Given the urgency of the situation, I, Dr Tess Lawrie, undertook this rapid systematic review and meta-analysis of studies included in the FLCCC paper to validate the FLCCC’s conclusions.

Target audience

This report is aimed primarily at health professionals and policymakers.


Study selection, data extraction and outcome measures I downloaded the available texts of the 27 studies included in the FLCCC summary tables. 1 From this list, I included randomized controlled trials (RCTs) and controlled observational studies (OCTs), excluding case-control studies and case series due to their higher risk of bias.

I extracted data on the characteristics of the studies, risk of bias and important CV-19 health outcomes (see Box 1), which I compiled with reference to the FLCCC review tables. Risk of study bias was assessed using the Cochrane Handbook for Systematic Reviews of Interventions and the ROBINS-I tools for RCTs, respectively.


Download and read the full PDF here.