Ivermectin during the COVID-19 pandemic

Ivermectin is an antiparasitic drug that is well-established for use in animals and people.[1]

Early in the COVID-19 pandemic, laboratory research suggested ivermectin might have a role in preventing or treating COVID-19.[2] Online misinformation campaigns and advocacy boosted the drug's profile among the public. While scientists and physicians largely remained sceptical, some nations adopted ivermectin as part of their pandemic-control efforts. Some people, desperate to use ivermectin without a prescription, took veterinary preparations leading to shortages of supplies of ivermectin for animal treatment—leading to the FDA tweeting "You are not a horse" to draw attention to the issue.[3]

Subsequent research failed to confirm the utility of ivermectin for COVID-19,[4] and in 2021 it emerged that many of the studies demonstrating benefit were faulty, misleading, or fraudulent.[5][6] Nevertheless, misinformation about ivermectin continued to be propagated on social media and the drug remained a cause célèbre for anti-vaccinationists and conspiracy theorists.[7]

Research and clinical guidelines

Some In vitro drug screening studies early in the pandemic showed that ivermectin has antiviral effects against several distinct positive-sense single-strand RNA viruses, including SARS-CoV-2.[8] Subsequent studies found that ivermectin could inhibit replication of SARS-CoV-2 in monkey kidney cell culture with an IC50 of 2.2–2.8 μM.[2][9] Based on this information, however, doses much higher than the maximum approved or safely achievable for use in humans would be required for an antiviral effect while treating COVID-19.[10][11] Aside from practical difficulties, such high doses are not covered by current human-use approvals of the drug and may be toxic, as the antiviral mechanism of action is believed to be via the suppression of a host cellular process,[10] specifically the inhibition of nuclear transport by importin α/β1.[12][13][14] Several other drugs which inhibit importin α/β1 at therapeutic doses have failed clinical trials due to systemic toxicity and a narrow therapeutic window.[15]

To resolve uncertainties from previous small or poor-quality studies, as of June 2021, large scale trials were underway in the United States and the United Kingdom.[16][17]

Research limitations, ethics and fraud

Many studies on ivermectin for COVID‑19 have serious methodological limitations, resulting in very low evidence certainty.[13][18][19][4] Several publications that supported the efficacy of ivermectin for COVID‑19 have been retracted due to errors, unverifiable data, and ethical concerns.[7][20][21]

Several high-profile publications purporting to demonstrate reduced mortality in COVID-19 patients were later retracted due to suspected data falsification.[22][23] This only added to confusion among the media and lay public,[21] as these publications had been widely cited by ivermectin supporters and included in meta-analyses.[20][7][24]

In February 2022, the American Journal of Therapeutics issued expressions of concern against two positive systematic reviews of ivermectin for COVID-19 which it had published in 2021, because of suspicions about the underlying data that would undermine these papers' findings of benefit.[25][26][27]

In Mexico City the government distributed ivermectin widely as a COVID-19 treatment and published the observed results on the SocArXiv archive as a research paper. The paper was subsequently withdrawn by the archive citing concerns that it was unethical, as it effectively was an experiment carried out on people without gaining informed consent. Philip N. Cohen of the SocArXiv steering committee said "the article is of very poor quality or deliberately false and misleading" and that its removal was justified to prevent public harm.[28]

Clinical guidance

  • In February 2021, Merck, the developer of the drug, issued a statement saying that there is no good evidence ivermectin is effective against COVID‑19, and that attempting such use may be unsafe.[29][30]
  • After reviewing the evidence on ivermectin, the European Medicines Agency (EMA) advised against its use for prevention or treatment of COVID‑19 and that "the available data do not support its use for COVID‑19 outside well-designed clinical trials."[31]
  • The U.S. National Institutes of Health COVID‑19 Treatment Guidelines state that there is insufficient evidence for ivermectin to allow for a recommendation for or against its use.[32]
  • In the United Kingdom, the national COVID‑19 Therapeutics Advisory Panel determined that the evidence base and plausibility of ivermectin as a COVID‑19 treatment were insufficient to pursue further investigations.[33]
  • Ivermectin is not approved by the U.S. Food and Drug Administration (FDA) for use in treating any viral illness and is not authorized for use to treat COVID‑19 within the European Union.[32][31]
  • The WHO also said that ivermectin should not be used to treat COVID‑19 except in a clinical trial.[34]
  • The Brazilian Health Regulatory Agency, Brazilian Society of Infectious Diseases, and Brazilian Thoracic Society issued position statements advising against the use of ivermectin for prevention or treatment of early-stage COVID‑19.[35][36][37]

Regulatory status and off-label use

Misinformation, lower degrees of trust, and a sense of despair over increasing case and death counts have led to an increase in ivermectin's use in Central and Eastern Europe, Latin America,[38][39] and South Africa. A black market has also developed in many of these countries where official approval has not been granted.[40]

The viral social media misinformation about ivermectin has gained particular attention in South Africa where an anti-vaccination group called "South Africa Has A Right To Ivermectin" has been lobbying for the drug to be made available for prescription.[33] Another group, the "Ivermectin Interest Group" launched a court case against the South African Health Products Regulatory Authority (SAHPRA), and as a result a compassionate use exemption was granted. SAHPRA stated in April 2021 that "At present, there are no approved treatments for COVID-19 infections."[33] In September 2021, SAHPRA repeated warnings against fake news and misinformation and took up the FDA's stance about ivermectin.[41]

Despite the absence of high-quality evidence to suggest any efficacy and advice to the contrary, some governments have allowed its off-label use for prevention and treatment of COVID‑19. Countries that have granted such official approval for ivermectin include the Czech Republic,[40] Slovakia,[40] Mexico,[42] Peru (later rescinded),[43][44] India[45][46] (later rescinded),[47] and the Philippines.[48] Cities that have launched campaigns of massive distribution of ivermectin include Cali, Colombia;[49] and Itajai, Brazil.[50]

Ivermectin is not approved by the U.S. Food and Drug Administration (FDA) for use in treating any viral illness and is not authorized for use to treat COVID-19 within the European Union.[31] After reviewing the evidence on ivermectin, the EMA said that "the available data do not support its use for COVID-19 outside well-designed clinical trials".[31] The WHO also said that ivermectin should not be used to treat COVID-19 except in a clinical trial.[34] The Brazilian Health Regulatory Agency, Brazilian Society of Infectious Diseases, and Brazilian Thoracic Society issued position statements advising against the use of ivermectin for prevention or treatment of early-stage COVID-19.[35][36][37]

Several Latin American government health organizations recommended ivermectin as a COVID-19 treatment based, in part, on preprints and anecdotal evidence; these recommendations were later denounced by the Pan American Health Organization.[21][51]

Human use of veterinary products

 U.S. FDA Twitter
@US_FDA

You are not a horse. You are not a cow. Seriously, y'all. Stop it.

21 August 2021[52]

As people began using veterinary preparations of ivermectin for personal use stocks began to decline, requiring vendors to ration their sales and raise prices.[3] In the United States supplies of horse dewormer paste began to run low as people used it for themselves; some vendors required their customers to show a picture of themselves and their horses together, to provide assurance they were purchasing the paste for animal use.[53][54]

In August 2021 the CDC issued a health alert prompted by a sharp rise in calls to poison control centres about ivermectin poisoning. The CDC described two cases requiring hospitalization; in one, a person had drunk an injectable ivermectin product intended for use in cattle.[55]

Intellectual property and economics

As the patent on ivermectin has expired, generic drug manufacturers have been able to enjoy significantly increased revenue prompted by the spike in demand. One Brazilian company, Vitamedic Industria Farmaceutica, saw its annual revenue from ivermectin sales increase more that fivefold in 2020 to, US$85 million.[56]

In Australia in 2020 Thomas Borody, a professor and gastroenterologist, announced that he had discovered a "cure" for COVID-19: a combination of ivermectin, doxycycline and zinc. In a media interview Borody stated "The biggest thing about this is no one will make money from this".[57] It later emerged that Topelia Australia, Borody's company, had filed a patent for the drug combination.[57][58] Borody was accused of not adequately disclosing his conflict of interest.[59]

In October 2021 a large network of companies selling hydroxychloroquine and ivermectin was disclosed in the US, targeting primarily right-wing and vaccine-hesitant groups through social media and conspiracy videos by anti-vaccine activists such as Simone Gold. The network had 72,000 customers who collectively paid $15 million for consultations and medications.[60]

Misinformation and advocacy

Ivermectin became a cause célèbre for right-wing figures promoting it as a supposed COVID treatment.[7] Misinformation about ivermectin's efficacy spread widely on social media, fueled by publications that have since been retracted,[21][20] misleading "meta-analysis" websites with substandard methods,[13][61] and conspiracy theories about efforts by governments and scientists to "suppress the evidence."[62][63]

Social media advocacy

Bret Weinstein took ivermectin live on YouTube while co-hosting the "Dark Horse" podcast.[64]

Ivermectin has been championed by a number of social media influencers.

American podcaster and author Bret Weinstein took ivermectin during a livestream video and said both he and his wife Heather Heying had not been vaccinated because of their fears concerning COVID-19 vaccines.[64] In response, YouTube demonetized the channel.[65]

In the United Kingdom, retired nurse educator and YouTube influencer John Campbell has posted videos carrying false claims about the use of ivermectin in Japan as a possible cause of a "miracle" decline in cases. In reality there is no evidence of ivermectin use in Japan and it is not approved as a COVID-19 treatment.[66] In February 2022, reports also appeared falsely claiming that the Japanese company Kowa had been able to evidence the efficacy of ivermectin in a phase III trial.[67]

Misleading meta-analysis websites

During the pandemic, a number of misleading websites appeared purporting to show meta-analyses of clinical evidence in favor of ivermectin's use in treating COVID-19.[13][61] The sites in question had anonymous owners, multiple domains which redirected to the same content, and used many colourful, but misleading, graphics to communicate their point.[68][13] The web servers used for these sites are the same as those previously used to spread misinformation about hydroxychloroquine.[69]

While these sites gained traction among many non-scientists on social media, they also violated many of the basic norms of meta-analysis methodology. Notably, many of these sites included studies with widely different dosages of the treatment, an open-label design (in which experimenters and participants both know who is in the control group), poor-quality control groups (such as another untested treatment which may worsen outcomes), or no control group at all.[61] Another issue is the inclusion of multiple ad-hoc un-published trials which did not undergo peer-review, and which had different incompatible outcome measures.[70] Such methodological problems are known to distort the findings of meta-analyses and cause spurious or false findings.[71] The misinformation communicated by these sites created confusion among the public and policy makers.[13]

Fake endorsement

William C. Campbell, nobel laureate and co-inventor of ivermectin. A fake tweet circulated purporting to show he supported ivermectin as a COVID-19 treatment.

On Twitter, a tweet spread with a photograph of William C. Campbell, the co-inventor of ivermectin, alongside a fabricated quotation saying that he endorsed ivermectin as a COVID treatment. Campbell reacted by saying "I utterly despise and deny the remarks attributed to me on social media" adding that his field of expertise was not virology so he would never comment in such a way.[72][73]

Scientists targeted

In July 2021 Andrew Hill, a senior research fellow at Liverpool University, published a meta-analysis of ivermectin use for COVID which suggested it may be beneficial.[74][33] However, as research fraud subsequently emerged in some studies included in the meta-analysis, Hill revised his analysis to discount the suspect evidence, and found the apparent success of ivermectin evaporated as a result. Writing for The Guardian Hill recounts how the revision led to him being attacked on social media as being supposedly in the pay of Bill Gates, and how he was sent photos of coffins and hanged nazis.[75]

Epidemiologist Gideon Meyerowitz-Katz has identified ivermectin as being one of the most politicized topics in the pandemic, alongside vaccination. Meyerowitz-Katz has used social media to publicize flaws in ivermectin research and as a result, he says, has received more death threats than for any other topic he has engaged with.[74]

Front Line COVID-19 Critical Care Alliance

In December 2020, the chair of the US Senate Homeland Security Committee, Ron Johnson, used a Senate hearing to promote fringe theories about, and unproven treatments for, COVID-19, including ivermectin.[76] Among the witnesses was Pierre Kory, a pulmonary and critical care doctor, who erroneously described ivermectin as "miraculous" and a "wonder drug" to be used against COVID-19. Video footage of his statements went viral on social media, receiving over one million views as of 11 December 2020.[62]

In the United States, the use of ivermectin for COVID-19 is championed by an organization led by Kory called Front Line COVID-19 Critical Care Alliance (FLCCC),[33] which promotes "the global movement to move #Ivermectin into the mainstream".[63] The effort has gone viral on social media, where it has been adopted by COVID deniers, anti-vaccination proponents, and conspiracy theorists.[63] A review article by FLCCC members on the efficacy of ivermectin, which had been provisionally accepted by a Frontiers in Pharmacology, was subsequently rejected on account of what the publisher called "a series of strong, unsupported claims based on studies with insufficient statistical significance" meaning that the article did "not offer an objective [or] balanced scientific contribution to the evaluation of ivermectin as a potential treatment for COVID-19".[77] David Gorski has written that the narrative of ivermectin as a "miracle cure" for COVID-19 is a "metastasized" version of a similar conspiracy theory around the drug hydroxychloroquine, in which unspecified powers are thought to be suppressing news of the drug's effectiveness for their own profit.[78]

Pfizer's drug development

Conspiracy theorists on the internet have claimed that Pfizer's anti-COVID-19 drug paxlovid is merely "repackaged ivermectin". Their claims are based on a narrative that Pfizer is suppressing the true benefits of ivermectin and rely on superficial correspondences between the drugs and a misunderstanding of their respective pharmokinetics.[79] Paxlovid is a combination drug of two small-molecule antiviral compounds (nirmatrelvir and ritonavir) which have no connection to ivermectin.[80]

Aftermath

The widespread misconduct found in ivermectin/COVID-19 research has prompted introspection within the scientific community.[81]

Australian epidemiologist Gideon Meyerowitz-Katz wrote "There are no two ways about it: Science is flawed". Meyerowitz-Katz estimates that as of December 2021, credence in flawed research had led to ivermectin being perhaps the most used medication worldwide during the pandemic, and that the scale of the problem suggested a radical rethink was needed of how medical research was assessed.[82]

See also

References

  1. ↑ Molyneux DH, Ward SA (December 2015). "Reflections on the Nobel Prize for Medicine 2015--The Public Health Legacy and Impact of Avermectin and Artemisinin". Trends in Parasitology. 31 (12): 605–607. doi:10.1016/j.pt.2015.10.008. PMID 26552892.
  2. 1 2 Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM (June 2020). "The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro". Antiviral Research. 178: 104787. doi:10.1016/j.antiviral.2020.104787. PMC 7129059. PMID 32251768.
  3. 1 2 Woo E (28 September 2021). "How Covid Misinformation Created a Run on Animal Medicine". New York Times.
  4. 1 2 Popp M, Stegemann M, Metzendorf MI, Gould S, Kranke P, Meybohm P, et al. (July 2021). "Ivermectin for preventing and treating COVID-19". The Cochrane Database of Systematic Reviews. 7 (8): CD015017. doi:10.1002/14651858.cd015017.pub2. PMC 8406455. PMID 34318930.
  5. ↑ Lawrence JM, Meyerowitz-Katz G, Heathers JA, Brown NJ, Sheldrick KA (November 2021). "The lesson of ivermectin: meta-analyses based on summary data alone are inherently unreliable". Nature Medicine. 27 (11): 1853–1854. doi:10.1038/s41591-021-01535-y. PMID 34552263. S2CID 237607620.
  6. ↑ "Ivermectin: How false science created a Covid 'miracle' drug". BBC News. 6 October 2021.
  7. 1 2 3 4 Meslissa Davey (15 July 2021). "Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns". The Guardian.
  8. ↑ Heidary F, Gharebaghi R (September 2020). "Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen". The Journal of Antibiotics. 73 (9): 593–602. doi:10.1038/s41429-020-0336-z. PMC 7290143. PMID 32533071.
  9. ↑ Şimşek Yavuz S, Ünal S (April 2020). "Antiviral treatment of COVID-19". Turkish Journal of Medical Sciences. 50 (SI-1): 611–619. doi:10.3906/sag-2004-145. PMC 7195979. PMID 32293834.
  10. 1 2 Bray M, Rayner C, Noël F, Jans D, Wagstaff K (June 2020). "Ivermectin and COVID-19: A report in Antiviral Research, widespread interest, an FDA warning, two letters to the editor and the authors' responses". Antiviral Research. 178: 104805. doi:10.1016/j.antiviral.2020.104805. PMC 7172803. PMID 32330482.
  11. ↑ López-Medina E, López P, Hurtado IC, Dávalos DM, Ramirez O, Martínez E, et al. (April 2021). "Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19: A Randomized Clinical Trial". JAMA. 325 (14): 1426–1435. doi:10.1001/jama.2021.3071. PMC 7934083. PMID 33662102.
  12. ↑ Yang SN, Atkinson SC, Wang C, Lee A, Bogoyevitch MA, Borg NA, Jans DA (May 2020). "The broad spectrum antiviral ivermectin targets the host nuclear transport importin α/β1 heterodimer". Antiviral Research. 177: 104760. doi:10.1016/j.antiviral.2020.104760. PMID 32135219. S2CID 212565030.
  13. 1 2 3 4 5 6 Garegnani LI, Madrid E, Meza N (April 2021). "Misleading clinical evidence and systematic reviews on ivermectin for COVID-19". BMJ Evidence-Based Medicine. doi:10.1136/bmjebm-2021-111678. PMID 33888547.
  14. ↑ Wagstaff, KylieM.; Sivakumaran, Haran; Heaton, StevenM.; Harrich, David; Jans, DavidA. (1 May 2012). "Ivermectin is a specific inhibitor of importin α/β-mediated nuclear import able to inhibit replication of HIV-1 and dengue virus". Biochemical Journal. 443 (Pt 3): 851–856. doi:10.1042/BJ20120150. ISSN 0264-6021. PMC 3327999. PMID 22417684.
  15. ↑ Kosyna, Friederike K.; Depping, Reinhard (November 2018). "Controlling the Gatekeeper: Therapeutic Targeting of Nuclear Transport". Cells. 7 (11): 221. doi:10.3390/cells7110221. PMC 6262578. PMID 30469340. Retrieved 23 January 2022.
  16. ↑ Schraer R (23 June 2021). "Covid: Ivermectin to be studied as possible treatment in UK". BBC News. Retrieved 23 June 2021.
  17. ↑ "COVID-19 Therapeutics Prioritized for Testing in Clinical Trials". National Institutes of Health. 21 July 2020. Retrieved 27 June 2021.
  18. ↑ Bartoszko JJ, Siemieniuk RA, Kum E, Qasim A, Zeraatkar D, Ge L, et al. (April 2021). "Prophylaxis against covid-19: living systematic review and network meta-analysis". BMJ (Systematic review). 373: n949. doi:10.1136/bmj.n949. PMC 8073806. PMID 33903131.
  19. ↑ Roman YM, Burela PA, Pasupuleti V, Piscoya A, Vidal JE, Hernandez AV (June 2021). "Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials". Clinical Infectious Diseases. doi:10.1093/cid/ciab591. PMC 8394824. PMID 34181716.
  20. 1 2 3 Piller C, Servick K (4 June 2020). "Two elite medical journals retract coronavirus papers over data integrity questions". Science. Retrieved 5 June 2020.
  21. 1 2 3 4 "Surgisphere Sows Confusion About Another Unproven COVID-19 Drug". The Scientist Magazine®. 16 June 2020. Retrieved 9 July 2020.{{cite web}}: CS1 maint: url-status (link)
  22. ↑ Servick K, Enserink M (2 June 2020). "A mysterious company's coronavirus papers in top medical journals may be unraveling". Science. AAAS. Retrieved 3 June 2020.
  23. ↑ Lowe D (11 May 2020). "What's Up With Ivermectin?". science.com. Retrieved 4 June 2020.
  24. ↑ Reardon S (August 2021). "Flawed ivermectin preprint highlights challenges of COVID drug studies". Nature. 596 (7871): 173–174. Bibcode:2021Natur.596..173R. doi:10.1038/d41586-021-02081-w. PMID 34341573. S2CID 236883132.
  25. ↑ "Ivermectin papers slapped with expressions of concern". Retraction Watch. 11 February 2022.
  26. ↑ Manu P (7 February 2022). "Expression of Concern for Bryant a, Lawrie TA, Dowswell T, Fordham EJ, Mitchell S, Hill SR, Tham TC. Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis to Inform Clinical Guidelines. Am J Ther. 2021;28(4): e434-e460". doi:10.1097/CND.0000000000000400. {{cite journal}}: Cite journal requires |journal= (help)
  27. ↑ Manu P (7 February 2022). "Expression of Concern for Kory P, Meduri GU, Varon J, Iglesias J, Marik PE. Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. Am J Ther. 2021;28(3) e299–e318". doi:10.1097/MJT.0000000000001481. {{cite journal}}: Cite journal requires |journal= (help)
  28. ↑ Cuenca A (4 February 2022). "Falso y engañoso estudio del GobCDMX sobre Ivermectina para tratar Covid". Capital CDMX (in Spanish).
  29. ↑ Gorski DH (15 April 2021). "Ivermectin is the new hydroxychloroquine". Science-Based Medicine.
  30. ↑ "Merck Statement on Ivermectin use During the COVID-19 Pandemic". Merck. 4 February 2021.
  31. 1 2 3 4 "EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials" (Press release). European Medicines Agency. 22 March 2021.
  32. 1 2 "The COVID-19 Treatment Guidelines Panel's Statement on the Use of Ivermectin for the Treatment of COVID-19". National Institutes of Health. 14 January 2020.
  33. 1 2 3 4 5 Wadvalla BA (April 2021). "Covid-19: Ivermectin's politicisation is a warning sign for doctors turning to orphan treatments". BMJ. 373: n747. doi:10.1136/bmj.n747. PMID 33795225. S2CID 232484313.
  34. 1 2 "WHO advises that ivermectin only be used to treat COVID-19 within clinical trials". World Health Organisation. 31 March 2021.
  35. 1 2 de Oliveira Quintanilha D (13 July 2020). "Anvisa se manifesta contra o uso da ivermectina na Covid-19" [Anvisa speaks out against the use of ivermectin in Covid-19]. PEBMED (in Portuguese).
  36. 1 2 "Atualizações e Recomendações sobre a Covid-19" [Updates and recommendations on Covid-19] (PDF) (in Portuguese). Sociedade Brasileira de Infectologia. 9 December 2020.
  37. 1 2 "Posicionamento da Sociedade Brasileira de Pneumologia e Tisiologia Sobre o Colapso em Manaus e Tratamento Preventivo e Precoce da Covid-19" [Brazilian Thoracic Society Position Statement on the Collapse in Manaus and the Preventive and Early Treatment of Covid-19] (in Portuguese). Sociedade Brasileira de Pneumologia e Tisiologia. 17 January 2021. Retrieved 18 January 2021.
  38. ↑ Mega ER (October 2020). "Latin America's embrace of an unproven COVID treatment is hindering drug trials". Nature. 586 (7830): 481–482. Bibcode:2020Natur.586..481M. doi:10.1038/d41586-020-02958-2. PMID 33077974.
  39. ↑ Molento MB (December 2020). "COVID-19 and the rush for self-medication and self-dosing with ivermectin: A word of caution". One Health. Elsevier BV. 10: 100148. doi:10.1016/j.onehlt.2020.100148. PMC 7313521. PMID 32632377.
  40. 1 2 3 "The rise and fall of a coronavirus 'miracle cure'". Politico. 30 March 2021. Retrieved 31 May 2021.
  41. ↑ "FDA's stance on ivermectin aligned to SAHPRA's position". SAHPRA. 3 September 2021. Retrieved 23 December 2021.
  42. ↑ Ferrer A (22 January 2021). "Médicos en CDMX suministran ivermectina y azitromicina para tratar pacientes con COVID-19". El Financiero (in Spanish). Retrieved 18 July 2021.{{cite web}}: CS1 maint: url-status (link)
  43. ↑ Andina (13 October 2020). "Covid-19: Minsa aprueba resolución que deja sin efecto el uso de tres medicamentos" (in Spanish). Agencia Peruana de Noticias.
  44. ↑ "Ivermectina vuelve a ser incluida en tratamiento covid-19" (in Spanish). Extra. 22 January 2021.
  45. ↑ Mishra M (13 May 2021). "Indian states turn to anti-parasitic drug to fight COVID-19 against WHO advice". Reuters. Retrieved 30 May 2021.
  46. ↑ "Fact check: No link between India's falling COVID-19 cases and hydroxychloroquine". USA Today. 21 May 2021. Retrieved 25 May 2021.
  47. ↑ Mordani S (7 June 2021). "DGHS drops Ivermectin, Doxycycline from Covid-19 treatment; ICMR rules unchanged". India Today. Retrieved 18 July 2021.
  48. ↑ "FDA approves drug company's request to manufacture ivermectin". The Manila Times. 7 May 2021. Retrieved 18 July 2021.
  49. ↑ Casa Editorial El País Cali. "Empezarán a usar Ivermectina en tratamiento de pacientes covid en Cali, dice Ospina". elpais.com.co (in Spanish). El País. Retrieved 12 July 2021.
  50. ↑ Prefeitura de Itajaí (6 July 311). "Itajaí vai implantar tratamento profilático à COVID-19 | Município de Itajaí". Prefeitura de Itajaí. Retrieved 22 December 2021.
  51. ↑ "Lancet, NEJM Retract Surgisphere Studies on COVID-19 Patients". The Scientist Magazine®. Retrieved 23 July 2021.
  52. ↑ U.S. FDA [@US_FDA] (21 August 2021). "You are not a horse. You are not a cow. Seriously, y'all. Stop it" (Tweet). Archived from the original on 21 August 2021 – via Twitter.
  53. ↑ Milman O (20 September 2021). "US horse owners face ivermectin shortage as humans chase unproven Covid 'cure'". The Guardian.
  54. ↑ Pengelly M (23 August 2021). "'You are not a horse': FDA tells Americans stop taking dewormer for Covid". The Guardian.
  55. ↑ "Rapid Increase in Ivermectin Prescriptions and Reports of Severe Illness Associated with Use of Products Containing Ivermectin to Prevent or Treat COVID-19" (Health alert). Centers for Disease Control and Prevention. 26 August 2021.
  56. ↑ Einhorn B, Kay C (13 October 2021). "Ivermectin Doesn't Help Covid, But Generic Drug Makers Are Cashing In". Bloomberg Businessweek.
  57. 1 2 Alexander, Harriet (22 October 2021). "How a false science 'cure' became Australia's contribution to the pandemic". Sydney Morning Herald.
  58. ↑ "Topelia Australia launches US$25M Series A call for COVID-19 ATT Ziverdox". BioSpace. Retrieved 18 October 2021.
  59. ↑ "Doctor who advocated Covid-19 therapy including ivermectin applied for patent on same unproven treatment". The Guardian. 18 October 2021. Retrieved 18 October 2021.
  60. ↑ Lee M (28 September 2021). "Network of Right-Wing Health Care Providers Is Making Millions Off Hydroxychloroquine and Ivermectin, Hacked Data Reveals". The Intercept. Retrieved 7 October 2021.
  61. 1 2 3 Molento MB (December 2021). "Ivermectin against COVID-19: The unprecedented consequences in Latin America". One Health. 13: 100250. doi:10.1016/j.onehlt.2021.100250. PMC 8050401. PMID 33880395.
  62. 1 2 Dupuy B (11 December 2020). "No evidence ivermectin is a miracle drug against COVID-19" (Fact check). AP News.
  63. 1 2 3 Sharma R (24 February 2021). "What is Ivermectin? Why social media creates Covid 'miracle drugs' – and why you shouldn't trust the crowd". inews.co.uk.
  64. 1 2 Merlan A (24 June 2021). "Why Is the Intellectual Dark Web Suddenly Hyping an Unproven COVID Treatment?". Vice.
  65. ↑ Merlan A (1 July 2021). "The Ivermectin Advocates' War Has Just Begun". Vice. Retrieved 1 July 2021.
  66. ↑ Satherley D (26 November 2021). "Did mutations or ivermectin help stamp out Delta in Japan?". Newshub (Fact check).
  67. ↑ Marjanović, Petar (4 February 2022). "Ivermectin-Studie geht viral – sie ist aber irreführend". watson.ch (Fact check) (in German). Retrieved 4 February 2022.
  68. ↑ Chaccour C. "Ivermectin and COVID-19: How a Flawed Database Shaped the Pandemic Response of Several Latin-American Countries - Blog". ISGlobal. Retrieved 23 June 2021.
  69. ↑ Merlan A (24 June 2021). "Why Is the Intellectual Dark Web Suddenly Hyping an Unproven COVID Treatment?". Vice.
  70. ↑ Davis JJ. "Will Ivermectin Cure COVID-19?". opmed.doximity.com. Retrieved 23 June 2021.
  71. ↑ Deeks JJ, Higgins JP, Altman DG, et al. (Cochrane Statistical Methods Group) (26 September 2008). "Analysing Data and Undertaking Meta-Analyses". Cochrane Handbook for Systematic Reviews of Interventions: 243–296. doi:10.1002/9780470712184.ch9. ISBN 9780470712184.
  72. ↑ "Drew University Nobel Prize Winner Refutes Ivermectin Meme". Drew University. September 2021.
  73. ↑ Kessler G (8 September 2021). "False meme: Nobel laureate did not say ivermectin 'cures' covid-19". Washington Post (Fact check).
  74. 1 2 Nogrady B (13 October 2021). "'I hope you die': how the COVID pandemic unleashed attacks on scientists". Nature (News feature). 598 (7880): 250–253. Bibcode:2021Natur.598..250N. doi:10.1038/d41586-021-02741-x. PMID 34645996. S2CID 238858471.
  75. ↑ Hill A (13 October 2021). "How my ivermectin research led to Twitter death threats". The Guardian.
  76. ↑ Qiu L (17 December 2020). "The election is over, but Ron Johnson keeps promoting false claims of fraud". The New York Times. ISSN 0362-4331. Retrieved 18 December 2020.
  77. ↑ Offord C (2 March 2021). "Frontiers Removes Controversial Ivermectin Paper Pre-Publication". The Scientist.
  78. ↑ Gorski DH (28 December 2020). "2020 and the pandemic: A year of (some) physicians behaving badly". Science-Based Medicine.
  79. ↑ Gorski D (15 November 2021). "Pfizer's new COVID-19 protease inhibitor drug is not just 'repackaged ivermectin'". Science-Based Medicine.
  80. ↑ "Pfizer's new pill to prevent COVID-19 is not the same as ivermectin". AP NEWS. 1 October 2021.
  81. ↑ Piper K (17 December 2021). "How bad research clouded our understanding of Covid-19". Vox.
  82. ↑ Meyerowitz-Katz G (11 December 2021). "'Science is flawed': COVID-19, ivermectin, and beyond". Medical News Today.
This article is issued from Offline. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.