Repurposing Anthelmintic Drugs for COVID-19 Treatment: A Comprehensive Meta-Analysis of Randomized Clinical Trials on Ivermectin and Mebendazole
Open accessAbstract
Background: The COVID-19 pandemic necessitated the urgent exploration of therapeutic options, including drug repurposing. Anthelmintic drugs such as ivermectin and mebendazole have garnered interest due to their potential antiviral and immunomodulatory properties. However, conflicting evidence from randomized clinical trials (RCTs) necessitates a comprehensive meta-analysis to determine their efficacy and safety in COVID-19 management. Objective: This meta-analysis evaluates the clinical efficacy of ivermectin and mebendazole in treating COVID-19 by analyzing their impact on viral clearance, symptom resolution, hospitalization duration, and safety profiles. Methods: A systematic search of Scopus, PubMed, Embase, and the Cochrane Library was conducted following PRISMA guidelines to identify RCTs published up to February 2025. Eligible studies included adult patients with confirmed COVID-19 who received ivermectin or mebendazole compared with a placebo or standard of care. Data extraction and risk of bias assessment were performed using the Cochrane Risk of Bias Tool. Statistical heterogeneity was evaluated using the I2 statistic, and pooled effect sizes were calculated for primary clinical outcomes. Results: Twenty-three RCTs (n = 12,345) were included, with twenty-one studies on ivermectin and two on mebendazole. The pooled analysis suggested no statistically significant improvement in viral clearance (p = 0.39), hospitalization duration (p = 0.15), or symptom resolution (p = 0.08) with ivermectin or mebendazole. However, individual studies indicated potential benefits, particularly for mebendazole, in reducing viral load and inflammation. Both drugs exhibited favorable safety profiles, with no significant increase in adverse events. Conclusions: The promising propensities observed in selected studies underscore the potential of ivermectin and mebendazole as adjunct therapies for COVID-19. With well-established safety profiles, immunomodulatory effects, and affordability, these drugs present strong candidates for further exploration. Advancing research through well-designed, large-scale RCTs will help unlock their full therapeutic potential and expand treatment options in the fight against COVID-19.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Methodological quality of included randomized controlled trials was assessed using the Cochrane Risk of Bias Tool 2.0 (RoB 2).
“Methodological quality of included randomized controlled trials was conducted using the Cochrane Risk of Bias Tool 2.0 (RoB 2) which examines five domains consisting of randomization process deviations from intended interventions missing outcome data measurement of outcomes and selection of reported results [36, 37].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
COVID-19 outbreak: Migration, effects on society, global environment and prevention
Chakraborty, I., & Maity, P. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.138882 · Cited by 1,801 · see citing works
Drug repurposing approach to fight COVID-19
Singh, T. U., Parida, S., Lingaraju, M. C., Kesavan, M., Kumar, D., & Singh, R. K. (2020) · Pharmacological Reports · doi:10.1007/s43440-020-00155-6 · Cited by 482 · see citing works
Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19
López‐Medina, E., López, P., Hurtado, I. C., Davalos, D. M., Ramírez, Ó., Martínez, E., Sánchez, J. A. D., Oñate, J., Chavarriaga, H., Herrera, S. V., et al. (2021) · JAMA · doi:10.1001/jama.2021.3071 · Cited by 378 · see citing works
COVID-19 PANDEMIA AND PUBLIC AND GLOBAL MENTAL HEALTH FROM THE PERSPECTIVE OF GLOBAL HEALTH SECURITY
Jakovljević, M., Bjedov, S., Jakšić, N., & Jakovljević, I. (2020) · Psychiatria Danubina · doi:10.24869/psyd.2020.6 · Cited by 323 · see citing works
Rajter, J. C., Sherman, M. S., Fatteh, N., Vogel, F., Sacks, J., & Rajter, J.-J. (2020) · CHEST Journal · doi:10.1016/j.chest.2020.10.009 · Cited by 317 · see citing works
Rapid repurposing of drugs for COVID-19
Guy, R. K., DiPaola, R. S., Romanelli, F., & Dutch, R. (2020) · Science · doi:10.1126/science.abb9332 · Cited by 304 · see citing works
A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness
Ahmed, S., Karim, M. M., Ross, A. G., Hossain, M. S., Clemens, J. D., Sumiya, M. K., Phru, C. S., Rahman, M., Zaman, K., Somani, J., et al. (2020) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2020.11.191 · Cited by 296 · see citing works
Bryant, A., Lawrie, T. A., Dowswell, T., Fordham, E. J., Mitchell, S. A., Hill, S., & Tham, T. (2021) · American Journal of Therapeutics · doi:10.1097/mjt.0000000000001402 · Cited by 262 · see citing works
Effect of Early Treatment with Ivermectin among Patients with Covid-19
Reis, G., Silva, E. A. S. M., Silva, D. C. M., Thabane, L., Milagres, A. C., Ferreira, T. S., dos Santos, C. V. Q., Campos, V. H. S., Nogueira, A. M. R., de Almeida, A. P. F. G., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2115869 · Cited by 249 · see citing works
Ivermectin and COVID-19: Keeping Rigor in Times of Urgency
Chaccour, C., Hammann, F., Ramón‐García, S., & Rabinovich, N. R. (2020) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.20-0271 · Cited by 174 · see citing works
Ivermectin for preventing and treating COVID-19
Popp, M., Reis, S., Schießer, S., Hausinger, R. I., Stegemann, M., Metzendorf, M.-I., Kranke, P., Meybohm, P., Skoetz, N., & Weibel, S. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd015017.pub3 · Cited by 169 · see citing works
Drug repurposing strategies for COVID-19
Senanayake, S. L. (2020) · Future Drug Discovery · doi:10.4155/fdd-2020-0010 · Cited by 141 · see citing works
Utilizing drug repurposing against COVID-19 – Efficacy, limitations, and challenges
Parvathaneni, V., & Gupta, V. (2020) · Life Sciences · doi:10.1016/j.lfs.2020.118275 · Cited by 138 · see citing works
Roman, Y. M., Burela, P. A., Pasupuleti, V., Piscoya, A., Vidal, J. E., & Hernández, A. V. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab591 · Cited by 133 · see citing works
Vallejos, J. A., Zoni, R., Bangher, M. D. C., Villamandos, S., Bobadilla, A., Plano, F., Campias, C., Campias, E. C., Medina, M. F., Achinelli, F., et al. (2021) · BMC Infectious Diseases · doi:10.1186/s12879-021-06348-5 · Cited by 113 · see citing works
Abd-Elsalam, S. M., Noor, R. A. A., Badawi, R., Khalaf, M. A., Esmail, E. S., Soliman, S., Ghafar, M. S. A. E., Elbahnasawy, M. G., Moustafa, E. F., Hassany, S. M., et al. (2021) · Journal of Medical Virology · doi:10.1002/jmv.27122 · Cited by 110 · see citing works
Naggie, S., Boulware, D. R., Lindsell, C. J., Stewart, T. G., Gentile, N., Collins, S. P., McCarthy, M. W., Jayaweera, D. T., Castro, M., Sulkowski, M., et al. (2022) · JAMA · doi:10.1001/jama.2022.18590 · Cited by 102 · see citing works
Shahbaznejad, L., Davoudi, A., Eslami, G., Markowitz, J. S., Navaeifar, M. R., Hosseinzadeh, F., Movahedi, F. S., & Rezai, M. S. (2021) · Clinical Therapeutics · doi:10.1016/j.clinthera.2021.04.007 · Cited by 80 · see citing works
Repurposing drugs for the management of COVID-19
Cusinato, J., Cau, Y., Calvani, A. M., & Mori, M. (2020) · Expert Opinion on Therapeutic Patents · doi:10.1080/13543776.2021.1861248 · Cited by 79 · see citing works
Repurposing drugs for treatment of COVID-19
Venkatesan, P. (2021) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(21)00270-8 · Cited by 63 · see citing works
Mohan, A., Tiwari, P., Suri, T. M., Mittal, S., Patel, A., Jain, A., Velpandian, T., Das, U. S., Boppana, T. K., Pandey, R. M., et al. (2021) · Journal of Infection and Chemotherapy · doi:10.1016/j.jiac.2021.08.021 · Cited by 59 · see citing works
Buonfrate, D., Chesini, F., Martini, D., Roncaglioni, M. C., Fernandez, M. L. O., Alvisi, M. F., Simone, I. D., Rulli, E., Nobili, A., Casalini, G., et al. (2022) · International Journal of Antimicrobial Agents · doi:10.1016/j.ijantimicag.2021.106516 · Cited by 57 · see citing works
Biber, A., Harmelin, G., Lev, D., Ram, L., Shaham, A., Nemet, I., Kliker, L., Erster, O., Mandelboim, M., & Schwartz, E. (2022) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2022.07.003 · Cited by 45 · see citing works
Muheyuddeen, G., Khan, M. Y., Ahmad, T., Srivastava, S., Verma, S., Ansari, M. S., & Sahu, N. (2024) · Scientific Reports · doi:10.1038/s41598-024-72399-8 · Cited by 36 · see citing works
Hayward, G., Yu, L.-M., Little, P., Gbinigie, O., Shanyinde, M., Harris, V., Dorward, J., Saville, B. R., Berry, N., Evans, P. H., et al. (2024) · Journal of Infection · doi:10.1016/j.jinf.2024.106130 · Cited by 31 · see citing works
Ivermectin: A Multifaceted Drug With a Potential Beyond Anti-parasitic Therapy
Kaur, B., Blavo, C., & Parmar, M. S. (2024) · Cureus · doi:10.7759/cureus.56025 · Cited by 26 · see citing works
Schilling, W. H., Jittamala, P., Watson, J. A., Ekkapongpisit, M., Siripoon, T., Ngamprasertchai, T., Luvira, V., Pongwilai, S., Cruz, C. V., Callery, J. J., et al. (2023) · eLife · doi:10.7554/elife.83201 · Cited by 21 · see citing works
Eskandari, M., Asgharzadeh, F., Askarnia-Faal, M.-M., Naimi, H., Avan, A., Ahadi, M., Vossoughinia, H., Gharib, M., Soleimani, A., Naghibzadeh, N., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-14420-6 · Cited by 17 · see citing works
Gao, X., Xuan, Y., Zhou, Z., Chen, C., Wang, D. W., & Zheng, W. (2024) · International Immunopharmacology · doi:10.1016/j.intimp.2024.112073 · Cited by 15 · see citing works
Almulhim, M. F., Ghasemian, A., Memariani, M., Karami, F., Yassen, A. S. A., Alexiou, A. T., Papadakis, M., & Batiha, G. E. (2025) · Molecular Diversity · doi:10.1007/s11030-025-11131-8 · Cited by 14 · see citing works
Manomaipiboon, A., Pholtawornkulchai, K., Poopipatpab, S., Suraamornkul, S., Maneerit, J., Ruksakul, W., Phumisantiphong, U., & Trakarnvanich, T. (2022) · Trials · doi:10.1186/s13063-022-06649-3 · Cited by 14 · see citing works
de la Rocha, C., Cid-López, M. A., Venegas-López, B. I., Gómez-Mendez, S. C., Sánchez-Ortíz, A., Pérez-Ríos, A. M., Llamas-Velázquez, R. A., Meza-Acuña, A. I., Vargas-Íñiguez, B., Rosales-Galván, D., et al. (2022) · BMC Infectious Diseases · doi:10.1186/s12879-022-07890-6 · Cited by 13 · see citing works
Advancements in the development of antivirals against SARS-Coronavirus
Kumar, M., Baig, M. S., & Bhardwaj, K. (2025) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2025.1520811 · Cited by 10 · see citing works
Wijewickrema, A., Banneheke, H., Pathmeswaran, A., Refai, F., Kauranaratne, M., Malavige, N., Jeewandara, C., Ekanayake, M., Samaraweera, D. N., Thambavita, D., et al. (2024) · BMC Infectious Diseases · doi:10.1186/s12879-024-09563-y · Cited by 10 · see citing works
Mirahmadizadeh, A., Semati, A., Heiran, A., Ebrahimi, M., Hemmati, A., Karimi, M., Basir, S., Zare, M., da Costa, A. C., Zeinali, M., et al. (2022) · Respirology · doi:10.1111/resp.14318 · Cited by 10 · see citing works
The impact of ivermectin on COVID-19 outcomes: a systematic review and meta-analysis
Yengu, N. S., Raheem, A., Pons, A. G., Ho, W. L., Ali, S. M. S., Haseeb, A., Ahmad, T. K. F., & Mustafa, M. S. (2024) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000002762 · Cited by 8 · see citing works
Negi, K., Agarwal, M., Pahuja, I., Bhardwaj, B., Rawat, M., Bhaskar, A., & Dwivedi, V. P. (2023) · Oxford Open Immunology · doi:10.1093/oxfimm/iqad001 · Cited by 7 · see citing works
Repositioning anthelmintics for the treatment of inflammatory-based pathological conditions
Rodrigues, D. C. D. N., Porto, J. C. S., dos Santos, I. L., Filho, J. I. A. B., & Ferreira, P. M. P. (2024) · Inflammopharmacology · doi:10.1007/s10787-024-01605-w · Cited by 7 · see citing works
Gołębiowska, A. (2021) · Zeszyty Naukowe SGSP · doi:10.5604/01.3001.0015.6476 · Cited by 6 · see citing works
Bakshi, A., Gangopadhyay, K., Basak, S., De, R. K., Sengupta, S., & Dasgupta, A. (2025) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaf035 · Cited by 6 · see citing works
Efficacy and safety of ivermectin in patients with mild COVID-19 in Japan and Thailand
Mikamo, H., Takahashi, S., Yamagishi, Y., Hirakawa, A., Harada, T., Nagashima, H., Noguchi, C., 増古, 賢., Maekawa, H., Kashii, T., et al. (2023) · Journal of Infection and Chemotherapy · doi:10.1016/j.jiac.2023.12.012 · Cited by 5 · see citing works
The Use of Mebendazole in COVID-19 Patients: An Observational Retrospective Single Center Study
Galal, M. W., Ahmed, M., Shao, Y., Xing, C., Ali, W., Baly, A. E., Elfiky, A., Amer, K., Schoggins, J. W., Sadek, H. A., et al. (2022) · Advances in Virology · doi:10.1155/2022/3014686 · Cited by 5 · see citing works
In Silico Study, Protein Kinase Inhibition and Molecular Docking Study of Benzimidazole Derivatives
Karthick, K., Abishek, K., & Jemima, E. A. (2024) · Bioinformatics and Biology Insights · doi:10.1177/11779322241247635 · Cited by 5 · see citing works
Devi, T. L., Devi, M. M., Okram, M., & Singh, O. M. (2024) · ACS Omega · doi:10.1021/acsomega.4c05357 · Cited by 4 · see citing works
El‐Tanani, M., Ahmed, K. A., Shakya, A. K., Ammari, W. G., & Al-Shudifat, A.-E. (2023) · Pharmaceuticals · doi:10.3390/ph16060799 · Cited by 4 · see citing works
Self-citationAn in‐depth analysis of COVID‐19 treatment: Present situation and prospects
Islam, M. A., Pathak, K., Saikia, R., Pramanik, P., Das, A., Talukdar, P., Shakya, A., Ghosh, S. K., Singh, U. P., & Bhat, H. R. (2024) · Archiv der Pharmazie · doi:10.1002/ardp.202400307 · Cited by 3 · see citing works
Drug Repositioning as an Antiviral Strategy Against Emerging Viruses
Palacios-Rápalo, S. N., Cordero‐Rivera, C. D., Jesús‐González, L. A. D., Farfán-Morales, C. N., Benítez-Vega, M. L., Reyes-Ruíz, J. M., & Angel, R. M. D. (2024) · The Latin American studies book series · doi:10.1007/978-3-031-68419-7_13 · Cited by 2 · see citing works
Immunological Interventions for the Management of Coronavirus Disease 2019 (COVID-19)
Chauhan, R. S., Malik, Y. S., Saminathan, M., & Tripathi, B. N. (2024) · Springer eBooks · doi:10.1007/978-981-99-2718-0_15 · Cited by 1 · see citing works
Coronavirus Disease-2019 or the End of a Happy Globalization
Porović, S., Kurjak, A., Gaber, G., Jakovljević, M., & Vacek, V. (2020) · Donald School Journal of Ultrasound in Obstetrics & Gynecology · doi:10.5005/jp-journals-10009-1649 · Cited by 1 · see citing works
The selective effect of Ivermectin on different human coronaviruses; in-vitro studyPreprint
Shahin, A. D., Atari, N., Meningher, T., Erster, O., Avni, D., Schwartz, E., & Mandelboim, M. (2024) · Research Square · doi:10.21203/rs.3.rs-4180797/v1 · Cited by 1 · see citing works
Flagged first, then by citations
1 of the 52 references couldn’t be matched to a known paper.
Research works printed but not linked: 3
- [3]Zoumpourlis V. Goulielmaki M. Rizos E. Baliou S. Spandidos D.A. The COVID-19 pandemic as a scientific and social challenge in the 21st century Mol. Med. Rep. 2020 22 3035 3048 10.3892/mmr.2020.11393 32945405 PMC7453598 · DOI
- [6]Mekala R. Global Epidemics and Pandemics in the Light of Civilization, Colonization and Globalization Its Impact on Environmental Health to Contain COVID-19 One Heath Approach is Mandate: A Review Available online: https://www.researchgate.net/publication/341180553_One_Health_Review_Article (accessed on 8 January 2025)
- [26]Khan S. Back to the Future-Solutions for Parasitic Problems Rahime Şimşek1, Aqsa Farooqui2, Salah-Ud-Din Khan3 and Parasitic Infections: Immune Responses and Therapeutics Wiley New York, NY, USA 2024 1 46
Cited by
Sorted by citations
Satyam, S. M., El-Tanani, M., Patni, M. A., Rehman, A., Irshad, S. M., Raheem, R., Junais, E., John, A. A., Rassal, R. Y., Kumari, R., et al. (2026) · BMC Cardiovascular Disorders · doi:10.1186/s12872-026-05515-3 · Cited by 5 · see citing works
“…of included randomized controlled trials was conducted using the Cochrane Risk of Bias Tool 2.0 (RoB 2) which examines five domains consisting of randomization process deviations from intended interventions missing outcome data measurement of outcomes and selection of reported results [36, 37].”
InfluentialSelf-citationDong, J., Li, J., Liu, Y., Yang, Q., Xu, N., Ai, X., & Zhou, S. (2025) · Animals · doi:10.3390/ani15121811 · Cited by 2 · see citing works
Wang, X., Meng, J., Li, Y., Xiang, Y., Wu, Y., Xiong, Y., Liu, P., & Gao, S. (2026) · BMC Infectious Diseases · doi:10.1186/s12879-026-13195-9 · Cited by 1 · see citing works
Abdelwahab, S. İ., Taha, M. M. E., Sahli, K. A., Farasani, M. M., Qadri, M. M., Alarifi, A., Khardali, A., Alsaadi, K. H., Farasani, A. M., Khamjan, N. A., et al. (2025) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-025-04527-8
Basu, T., & Upadhyay, A. K. (2025) · In Silico Pharmacology · doi:10.1007/s40203-025-00447-w
COVID-19: What We Have Learnt and Where Are We Going?
Catalano, A. A. (2025) · Acta Microbiologica Hellenica · doi:10.3390/amh70040042
Examining the role of Mucuna pruriens in managing Parkinson’s disease
Nand, S., Singh, P., & Goel, F. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-34201-1.00014-4
USP5 regulates purine metabolism and represents a therapeutic target in esophageal cancer
Zhao, K., Zhang, L., Yan, M., Fang, S., Wang, Z., Song, Y., Liu, M., Zhang, C., Shao, Y., Jia, X., et al. (2026) · Cell Death and Disease · doi:10.1038/s41419-026-08683-4
Antypenko, L., Саліонов, В. О., Лисянська, Г. П., Малецький, М. М., & Antypenko, O. (2026) · Research Square · doi:10.21203/rs.3.rs-11040142/v1
- Authors
- Satyam, S. M., El-Tanani, M., Patni, M. A., Rehman, A., Wali, A. F., Rangraze, I. R., Babiker, R., Rabbani, S. A., El-Tanani, Y., & Rizzo, M.
- Affiliations
- Ras al-Khaimah Medical and Health Sciences University (AE)
- RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates
- Royal Cornwall Hospital Trust, NHS, Truro TR1 3LJ, UK
- University of Palermo (IT)
- Corresponding author
- Satyam, Shakta Mani
- ORCID
- Venue
- Antibiotics
- Publisher
- MDPI AG
- Published
- 2025-04-30
- Volume
- 14
- Issue
- 5
- Pages
- 459
- ISSN
- 2079-6382 (ISSN-L)
- PMC
- PMC12108154
- OpenAlex
- W4410036563
- Cited by
- 9
- References
- 52
- Citations by year
- 2026: 4 · 2025: 5
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Antibiotics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- COVID-19 pandemic, drug repurposing, ivermectin, mebendazole, anthelmintics, antiviral therapy, viral clearance, symptom resolution, length of hospital stay, drug safety, adjunctive therapy, immunomodulation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
