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Effectiveness and safety of ivermectin in the treatment of COVID-19: protocol for a systematic review and meta-analysis
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    RE: Effectiveness and safety of ivermectin in the treatment of COVID-19: protocol for a systematic review and meta-analysis

    Machado et al. planned a meta-analysis on the effectiveness and safety of ivermectin in the treatment of COVID-19 (coronavirus disease 2019) (1). Almost all of meta-analyses presented a lack of advantage in the effectiveness and safety of ivermectin for the treatment of COVID-19. In addition to insufficient evidence to support the use of ivermectin to treat or prevent COVID-19, there are potential toxic effects of ivermectin, including confusion, ataxia, seizures, and hypotension, which may be accelerated by inappropriate use (2). I have a comment about their study.

    Hellwig and Maia reviewed the prophylactic effect of chemotherapy with and without ivermectin administration on incidence of COVID-19 by ecological procedure among the African countries and a worldwide, respectively (3). Although there was a significant decrease of incidence in countries with accepting ivermectin administration, ivermectin could be recommended for the treatment of patients with COVID-19 by the evidence from well-designed randomized controlled trials (RCTs) with appropriate doses and treatment period.

    López-Medina et al. conducted a double-blind RCT to determine the effect of ivermectin in patients with mild COVID-19 (4). A total of 400 patients were randomized to receive ivermectin, 300 μg/kg of body weight per day for 5 days or placebo, and the authors followed symptoms for 3 weeks. The hazard ratio (95% confidence interval) of receiving ivermectin for the resolution of symptoms...

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    Conflict of Interest:
    None declared.