Effect of Ivermectin prophylaxis in prevention of COVID 19: Meta-analysis and systematic review

Ivermectin was popular drug on trial for preventive and therapeutic role in COVID-19. However, there is disagreement concerning the validity of its clinical efficacy. Hence, we conducted a Meta-analysis and Systematic review for effect of Ivermectin Prophylaxis in prevention of COVID-19. The online databases of PubMed (Central), Medline, and Google scholar for randomized controlled trials, non-randomized trial and prospective cohort study were searched up to March 2021. Nine studies were included for analysis, out of which four were Randomized controlled Trial (RCTs), Two Non-RCTs and three cohort studies. Four randomized trial evaluated prophylactic drug Ivermectin, two combination of topical nasal carrageenan and oral Ivermectin two study used in combination of personal protective equipment (PPE) one with Ivermectin and one with Ivermectin/ Iota-Carrageenan (IVER/IOTACRC). In the pooled analysis we observed non-significant less COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (Relative Risk (RR) = 0.27 and Confidence Interval (CI) = 0.05, 1.41) with significant heterogeneity (I² = 97.1%, P < 0.001) The pooled analysis involving the Non-RCTs studies also did not observe significant reduction in the COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (RR = 0.01 and CI = 0.00, 7.97) with significant heterogeneity between the studies (P < 0.001).Hence,we conclude that Ivermectin is not the 'magical silver weapon' against COVID-19.