Given the urgency of the ongoing COVID-19 pandemic, its complications and deaths, the discovery of new mutated strains and the potential for re-emergence of novel coronaviruses, the reuse of drugs such as ivermectin may deserve attention. This review article aims to discuss the potential mechanisms of action of ivermectin against SARS-CoV-2, and COVID-19 by summarizing the available literature since the onset of the disease. Ivermectin inhibits the replication of SARS-CoV-2 in vitro at concentrations not readily achievable with currently approved doses. There is limited evidence to support its clinical use in COVID-19 patients In this comprehensive systematic review, multiple studies have reported that ivermectin exhibits antiviral properties against a wide range of RNA viruses, including Zika, dengue, yellow fever, West Nile, Hendra, Newcastle, Venezuelan equine encephalitis, chikungunya, Semliki Forest, Sindbis, Avian influenza A, Porcine Reproductive and Respiratory Syndrome, Human immunodeficiency virus type 1, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Furthermore, some studies have indicated that ivermectin also shows antiviral effects against DNA viruses, such as Equine herpes type 1, BK polyomavirus, pseudorabies, porcine circovirus 2, and bovine herpesvirus 1. Ivermectin's antiviral actions are attributed to its involvement in various biological mechanisms, suggesting its potential as a candidate for treating a wide array of viruses, including COVID-19, and other positive-sense single-stranded RNA viruses. This systematic review encompasses evidence dating back to 1970, underscoring ivermectin's capacity to combat a diverse array of viral infections. The findings of this study suggest that ivermectin might serve as a valuable antiviral agent for viruses, especially those with positive-sense single-stranded RNA genomes. Notably, experimental studies have shown significant effectiveness when ivermectin is administered during the early stages of infection, which implies its potential in early treatment or prevention. However, it's important to note that confirming these assertions requires human studies and clinical trials.
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