Key Points
Question
Does prevalence of strongyloidiasis interact with the relative risk (RR) of mortality in ivermectin trials for the treatment of COVID-19?
Findings
In this meta-analysis of 12 randomized clinical trials involving 3901 patients, favorable mortality results were limited to trials in high-prevalence regions, with no evidence that ivermectin had a mortality benefit in low-prevalence regions. Meta-regression found an association between the regional prevalence of strongyloidiasis and risk of mortality, with a decrease in RR of 39% for each 5% increase in strongyloidiasis prevalence.
Meaning
Evidence supports that strongyloidiasis prevalence interacts with the RR of mortality in ivermectin trial results; no evidence was found to suggest ivermectin has any role in preventing mortality in patients with COVID-19 in regions where strongyloidiasis is not endemic.
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