Note: The risk of bias by domain corresponds to the highest risk of bias among outcomes by domain.
The overall risk of bias corresponds to the overall highest risk of bias assessed among outcomes.
Bias | Author's judgement | Support for judgement |
Randomization |
High |
Quote: “Patients recruited at dates with odd number were allocated to Ivermectin-Doxycycline group while other patients were allocated to the control group. All of critical patients were allocated to the Ivermectin-Doxycycline group”
Comment: Allocation sequence not random. Allocation sequence not concealed. |
Deviations from intervention |
High |
Quote: “All critical patients were allocated to the Ivermectin-Doxycycline group.”
Comment: Unblinded study. No information on participant cross-over(no flow chart) No information on administration of co-interventions of interest: antivirals, corticosteroids, biologics. Hence, no information on whether deviations arose due to the trial context. No information on whether data were analyzed appropriately to estimate the effect of assignment to intervention. No information on whether there is substantial impact of failure to analyze participants according to their randomized assignment (no flow chart or data on exclusions, loss to follow-up etc.) Risk assessed to be high for outcome: Mortality (D60). |
Missing outcome data |
High |
Comment: unclear number randomized; 140 patients analyzed.
No information on whether data were available for all randomized participants. No evidence that the result was not biased. No information on whether missingness could or is likely to depend on true value of the outcome. Risk assessed to be high for the outcome: Mortality (D60). |
Measurement of the outcome |
Low |
Comment: Method of measuring the outcome probably appropriate.
Measurement or ascertainment of outcome probably does not differ between groups. Blinded study (outcome assessor). Risk assessed to be low for the outcome: Mortality (D60). |
Selection of the reported results |
Some concerns |
Comment: The protocol, statistical analysis plan were not available. Registry was available but retrospectively registered.
No information on whether the result was selected from multiple outcome measurements or analyses of the data. No information on whether the trial was analyzed as pre-specified. Risk assessed to be some concerns for the outcomes: Mortality (D60). |
Overall risk of bias |
High |