Impact Factor 4.225 | CiteScore 5.0
More on impact ›


Front. Pharmacol. | doi: 10.3389/fphar.2021.643369

Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19 Provisionally accepted The final, formatted version of the article will be published soon. Notify me

 Pierre Kory1*, G U. Meduri2, 3,  Jose Iglesias4, Joseph Varon5, Keith Berkowitz6,  Howard Kornfeld7,  Eivind Vinjevoll8, Scott Mitchell9, Fred Wagshul10 and  Paul E. Marik11
  • 1Other, United States
  • 2Memphis VA Medical Center (VHA), United States
  • 3University of Tennessee Health Science Center (UTHSC), United States
  • 4Hackensack Meridian School of Medicine, Seton Hall University, United States
  • 5University of Texas Health Science Center, United States
  • 6Center for Balanced Health, United States
  • 7Other, United States
  • 8Molde Hospital, Norway
  • 9Princess Elizabeth Hospital, Guernsey
  • 10Lung Center of America, United States
  • 11Eastern Virginia Medical School, United States

In March 2020, the Front Line COVID-19 Critical Care Alliance (FLCCC) was created and led by
Professor Paul E. Marik to continuously review the rapidly emerging basic science, translational, and clinical data to develop a treatment protocol for COVID-19. The FLCCC then recently discovered that ivermectin, an anti-parasitic medicine, has highly potent anti-viral and anti-inflammatory properties against COVID-19. They then identified repeated, consistent, large magnitude improvements in clinical outcomes in multiple, large, randomized and observational controlled trials in both prophylaxis and treatment of COVID-19. Further, data showing impacts on population wide health outcomes have resulted from multiple, large “natural experiments” that occurred when various city mayors and regional health ministries within South American countries initiated “ivermectin distribution” campaigns to their citizen populations in the hopes the drug would prove effective. The tight, reproducible, temporally associated decreases in case counts and case fatality rates in each of those regions compared to nearby regions without such campaigns, suggest that ivermectin may prove to be a global solution to the pandemic. This was further evidenced by the recent incorporation of ivermectin as a prophylaxis and treatment agent for COVID-19 in the national treatment guidelines of Belize, Macedonia, and the state of Uttar Pradesh in Northern India, populated by 210 million people. To our knowledge, the current review is the earliest to compile sufficient clinical data to demonstrate the strong signal of therapeutic efficacy as it is based on numerous clinical trials in multiple disease phases. One limitation is that half the controlled trials have been published in peer-reviewed publications, with the remainder taken from manuscripts uploaded to medicine pre-print servers. Although it is now standard practice for trials data from pre-print servers to immediately influence therapeutic practices during the pandemic, given the controversial therapeutics adopted as a result of this practice, the FLCCC argues that it is imperative that our major national and international health care agencies devote the necessary resources to more quickly validate these studies and confirm the major, positive epidemiological impacts that have been recorded when ivermectin is widely distributed among populations with a high incidence of COVID-19 infections.

Keywords: Ivermectin, COVID-19, Infectious Disease, pulmonary infection, respiratory failure

Received: 18 Dec 2020; Accepted: 13 Jan 2021.

Copyright: © 2021 Kory, Meduri, Iglesias, Varon, Berkowitz, Kornfeld, Vinjevoll, Mitchell, Wagshul and Marik. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD. Pierre Kory, Other, Madison, WI, United States,