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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
PubMed

Insights

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.
Abstract

Keywords:
COVID-19adaptive platform trialantiviralintensive careivermectinpneumonia

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