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Ivermectin for Critically and Noncritically Ill Hospitalized Patients With COVID-19: Randomized, Embedded,
Madiha Hashmi1, Rashan Haniffa2,3, Deva Jayakumar4
1Department of Critical Care Medicine, Ziauddin University-Karachi, Sindh, Pakistan.
Critical Care Medicine
|May 8, 2026
Summary
This study found ivermectin unlikely to improve outcomes for hospitalized COVID-19 patients. Critically and noncritically ill patients showed no significant benefit in organ support-free days or survival when treated with ivermectin.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Pharmacology
Background:
- The COVID-19 pandemic necessitated rapid investigation into potential treatments.
- Ivermectin, an antiparasitic drug, was explored for its antiviral and anti-inflammatory properties against SARS-CoV-2.
Purpose of the Study:
- To evaluate the efficacy of ivermectin in improving clinical outcomes for hospitalized patients diagnosed with COVID-19.
- To assess the impact of ivermectin on mortality and organ support requirements in critically and noncritically ill patients.
Main Methods:
- An international, adaptive, randomized, controlled platform trial was conducted across multiple hospital sites.
- Patients were randomized to receive either ivermectin or standard care (control).
- The primary outcome measured was organ support-free days, incorporating in-hospital death and days free of respiratory or cardiovascular support.
Main Results:
- In critically ill patients, ivermectin did not significantly improve organ support-free days (adjusted OR, 0.94; 95% CrI, 0.40-2.07) or hospital survival (adjusted OR, 1.00; 95% CrI, 0.39-2.32).
- Among noncritically ill patients, ivermectin also showed no significant benefit in organ support-free days (adjusted OR, 1.04; 95% CrI, 0.48-2.34) or hospital survival (adjusted OR, 1.16; 95% CrI, 0.5-3.07).
- Trial enrollment was halted early due to operational futility, supported by external evidence of no benefit in non-hospitalized individuals.
Conclusions:
- Ivermectin is unlikely to be an effective treatment for improving clinical outcomes in hospitalized COVID-19 patients.
- The study provides evidence against the use of ivermectin for critically and noncritically ill COVID-19 patients.
- Further research into ivermectin for COVID-19 in hospitalized settings is not supported by these findings.
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