This is a severely flawed meta analysis. An open letter signed
by 40 physicians detailing errors and flaws, and requesting retraction, can
be found at
[trialsitenews.com].
See also
[bird-group.org].
Authors cherry-pick to include only 4 studies reporting
non-zero mortality and they initially claimed a mortality RR of 1.11
[0.16-7.65]. However, they reported incorrect values for Niaee et al.,
claiming an RR of 6.51 [2.18-19.45], when the correct RR for Niaee et al. is
0.18 [0.06-0.55]. After correction, their cherry-picked studies show >60%
mortality reduction, however authors did not correct the conclusion.
Similarly, for viral clearance and
NCT04392713, they report
20/41 treatment, 18/45 control, whereas the correct day 7 clearance numbers
are 37/41 and 20/45 (sum of clearance @72hrs and @7 days), or 17/41 and
2/45 @72 hrs.
The duration of hospital stay for Niaee et al. is also
incorrectly reported, showing a lower duration for the control group.
All of the errors are in one direction - incorrectly reporting
lower than actual efficacy for ivermectin. Authors claim to include all RCTs
excluding prophylaxis, however they only include 10 of the 24 non-prophylaxis
RCTs (28 including prophylaxis at the time of publication). Authors actually
reference meta analyses that do include the missing RCTs, so they should be
aware of the missing RCTs.
The authors state that they have no conflicts of interest on
medRxiv, however Dr. Pasupuleti’s affiliation is Cello Health, whose website
[cellohealth.com] notes that they provide services such as
“brand and portfolio commercial strategy for biotech and pharma”, and
that their clients are
"24 of the top 25 pharmaceutical
companies”.
Only one of these errors has been partially fixed as of 5/29 -
the Niaee RR was corrected, but the associated conclusion was not. Other
errors have not been corrected. Comments on this article appear to be
censored, with zero comments posted as of July 5.
Currently there are
82 ivermectin
for COVID-19 studies, showing 53%
[39‑64%] lower mortality, 31%
[11‑46%] lower ventilation, 54%
[36‑67%] lower ICU admission, 38%
[24‑49%] lower hospitalization, and 78%
[67‑86%] lower cases.
Roman et al., 6/28/2021, peer-reviewed, 6 authors.