Abstract

Background: The use of antiviral therapies in addressing COVID-19 infection has been subject to varying approaches across different jurisdictions during the initial two years of the pandemic, with ivermectin being permitted in some regions, while banned in others. Objective: This study aimed to comprehensively review the evidence surrounding the efficacy of ivermectin, specifically in combating COVID-19 infection. Method: The efficacy of ivermectin has been assessed through an extensive review of scientific literature. Additionally, a comparative analysis has been conducted, evaluating cases and fatalities in states and countries that either have embraced or rejected ivermectin and other antiviral treatments. Results: A thorough examination of the scientific literature has revealed a predominantly positive trend supporting the utilization of ivermectin, evident in works published up to October 2021 and continuing in subsequent publications. Insights drawn from 217 studies have indicated improvements of 85%, 62%, and 41% for prophylaxis, early treatment, and late treatment, respectively. This positive effect, particularly in prophylaxis, has been further substantiated by analyzing cases and fatalities during the mid-2021 Indian outbreak. The success of the ivermectin-based Uttar Pradesh kit has been highlighted by the notably expedited reduction in cases and fatalities compared to other Indian states employing alternative approaches. Moreover, when contrasting countries that have prohibited ivermectin and other antivirals (e.g., the United States and the United Kingdom) with nations endorsing various antiviral strategies, including ivermectin, or with historical use of ivermectin (e.g., Africa, India, Saudi Arabia, or the United Arab Emirates), the advantages of endorsing rather than discouraging antiviral therapies have become evident. Conclusion: The majority of scientific literature has been found to support the use of ivermectin against COVID-19 infection, consistent with the lesser impact of COVID-19 infections observed in Indian states that have either utilized or abstained from ivermectin, as well as in countries that have either adopted or rejected antiviral treatments.

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