3/n The basic story is pretty astonishing. I've previously written about this study, Elgazzar et al, and why there are some indications that it's low-quality and potentially very unreliablehttps://twitter.com/GidMK/status/1407140636281638912?s=20 …
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14/n And let's not forget, pretty much the entire introduction WAS PLAGIARIZED Not good. Not good at all
14.5/n Is the study fraud? We may never know. It is really, really hard to prove anything in cases like these, and unless the authors go public we might never know what actually happened beyond the issues that we've seen so far
15/n What does this mean more broadly? Well, here's where the story gets both more interesting and somewhat darker This is currently THE BIGGEST RCT of ivermectin. It shows a mortality benefit of 90% That's huge
16/n Being such a big study, it has been included in multiple meta-analyses. With such a vast benefit, it has a very large influence on the meta-analytic resultspic.twitter.com/hkaBoyN0Dq
17/n Indeed, removing ~just this single piece of research~ from recent meta-analyses either mostly or entirely overturns the positive results that they found for ivermectin 

pic.twitter.com/Bgw7fGOFyL
18/n Worse still, the paper has been viewed over 130,000 times, and the comments are filled with medical doctors praising the authors and recommending ivermectin based on their results
19/n In other words, this single study has drive ivermectin as a treatment to thousands, perhaps millions, of people And it is either so flawed as to be totally unreliable, or potentially outright fraud
20/n But the story doesn't stop there. Remember, several meta-analyses have included this study in their results. Why would they do that? Well, they thought it was at LOW risk of bias (i.e. high-quality)pic.twitter.com/OG79Rv9MML
21/n The pretty obvious issue we now have is that this study is clearly filled with problems, yet it's been included in meta-analyses that considered it to be a piece of top-quality research
22/n At the absolute minimum, studies including this paper should revise their main analysis to exclude it until we have a reasonable explanation for all these issues
23/n But we're left with the depressing realization that somehow EVERYONE MISSED THIS I reviewed the study. While I noted concerns with the way it was reported, I never even checked to see if it was fraud
24/n How can it be that a study this problematic was used as evidence to treat 1,000s of people since November 2020, and no one noticed? No one cared?
25/n Anyway, the TL:DR is that the largest study to date of ivermectin for COVID-19, which found a HUGE benefit for the drug, has just been retracted amid very serious concerns about plagiarism and fraud This will echo in the scientific community for years to come
26/n While it is still certainly possible that ivermectin works for COVID-19, this has made a huge dent in that possibility. I await the large studies that are currently being conducted, because we really have no good evidence to rely on
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