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the epidemic context over that time period are not described. • For use as treatment, three meta-analyses were identified. Lawrie (2021) includes 9 RCTs and 3 observational studies; Padhy (2020) includes 4 observational studies, and Hill (preprint) includes 18 RCTs. The primary data was extracted and outcomes for mortality, intensive care unit (ICU) admission, or hospitalization were narratively summarized. • Meta-analytic findings from Lawrie (2021) were excluded due its “critically low” AMSTAR-2 assessment (though the primary studies included within that metanalysis are considered herein. Padhy (2020) was assessed as moderate quality and Hill (preprint) was assessed as low quality. Both the observational data meta-analysis and the RCT meta-analyses reported that ivermectin reduces the odds of mortality with cautions regarding study quality and possible bias, and the magnitude of the effect varies significantly from OR 0.53 (95%CI: 0.29 to 0.96) in Padhy (2020) (includes three observational studies, no RCTs) to OR 0.2 7 Last revised: February 2, 2021 (95%CI 0.12-0.52) in Hill (preprint) (includes six RCTs, no observational studies). The effect of publication bias on these findings is unclear. • Eleven of 20 extracted primary studies (four of which are RCTs; one study (observational) was conducted in outpatients, and the remaining 10 studies (four RCTs, 6 observational) conducted in inpatients) reported on the effect of ivermectin on mortality, hospitalization, or ICU admission. In the studies that included a control group (seven out of eleven), four showed a reduced risk of death and three showed no effect from ivermectin treatment. 

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