"Abstract
Aim: This critical appraisal is focused on three published case series of 119 COVID-19 patients with hypoxemia who were successfully treated in the United States, Zimbabwe, and Nigeria with similar off-label multidrug treatments that may include ivermectin, nebulized nanosilver, doxycycline, zinc, and vitamins C and D, resulting in rapid recovery of oxygen levels....
4. Discussion
4.1. Summary of findings on strength of association: We analyzed the case series of hypoxemic patients reported by Hazan et al., Stone et al., and Babalola et al. using a self-controlled case series methodology combined with the recently introduced case series statistical analysis technique, and showed clear and convincing evidence of the existence of some hospitalization rate reduction. In this context, 'clear and convincing' means that the result is statistically significant with at least 95% confidence, and we also have at least 95% confidence that the result cannot be overturned by any selection bias that can result, if the patient sample is randomly selected from the general population...
5. Conclusion
Our statistical analysis has shown that the existence of some hospitalization rate reduction is clear and convincing when the Stone/Gill or Hazan multidrug protocol is employed in severely hypoxemic patients, and it is also very resilient to systemic selection bias. The existence of a mortality rate reduction effect is shown by the preponderance of evidence by combining the Hazan and Stone case series, and the threshold to clear and convincing can be crossed only when combining all three case series. These findings support the strength of association between the Hazan and Stone/Gill multidrug protocols and reduction in hospitalizations and deaths. Combined with previous results establishing the Bradford Hill criteria of temporality, biological gradient, consistency, biological plausibility, and coherence they lend support to the adoption of these ivermectin-based multidrug treatment protocols by practicing physicians for the treatment of hypoxemic COVID-19 patients as a community standard of care."
Version 9 of this article.