Malaysia: Doctor Review of withdrawn Ivermectin study

Referenced article: July 15, 2021: https://amp.theguardian.com/science/2021/jul/16/huge-study-supporting-ivermectin-as-covid-treatment-withdrawn-over-ethical-concerns

Review of the withdrawn Ivermectin study as published in the Guardian by Melissa Davy on July 15, 2021.

From Malaysia:

Capt. Dr. Wong Ang Peng, (Rtd)

July 16, 2021

This is regarding the Elgazarr study "Efficacy and safety of ivermectin for treatment and prophylaxis of Covid-19 pandemic”, which was published preprint in Research Square Website, and now the website has withdrawn the publication without giving reason.

My comments:

1. Regarding ‘plagiarism’ in the abstract. It is a norm for researchers, when writing scientific papers, read each other’s publications. Often phrases are commonly used, including the whole sentence, and it is difficult to say who copies from whom. Unless the whole long paragraph is copied, accusing plagiarism in a phrase or a sentence that is commonly used is lame.

2. The Master student, Lawrence, claimed to have seen the raw data. This is odd. Raw data are coded, protected, kept under lock and key, and not allowed to be retrieved from electronic system, during and after the trial. The retrieval system is well protected. During the trial there would be neutral inspectorate to monitor its conduct and data collection. How this Master student gained access to the raw data is a bewilderment.

3. Regarding the raw data contradicting the study protocol:

(a) “Study done on 18 – 80 years old, but at least three patients in the dataset were under 18”. Wrong. The study protocol mentioned subjects from aged 14 to 80.

(b) “Study from 8 June to 20 September 2020”. Wrong. Elgazzar et al had their study from 8 June to 15 September.

(c) “Most patients who died were admitted into hospital and died before the 8th of June according to the raw data”. Where is this so-called raw data? This information is not mentioned in the published paper. Raw data is not accessible by just anybody.

(d) “One patient left hospital on the non-existent date of 31/06/2020”. Where did this come from? The published paper does not mention the date 31/06/2020.

4. “The authors claim that four out of 100 patients died in their standard treatment group”. “According to the original data, the number was 0, the same as the ivermectin group. In their ivermectin treatment group for severe Covid-19, the authors claim two patients died, but the number in the raw data is four”. Melissa Davy of Guardian is twisting fact here. In the published paper, for mortality, Elgazzar et al were comparing the mild/moderate Covid patients between ivermectin and hydroxychloroquine groups, and severe cases for both the ivermectin and hydroxychloroquine groups. It was NOT comparing ivermectin with standard treatment. Where did the “four” died for severe Covid-19 come from? Even if it is true as Davy claimed, it is not surprising for severe cases to die.

5. “The main error is that at least 79 of the patient records are obvious clones of other records”. No evidence is cited for this accusation. Where were these so-called clones cited from?

6. In scientific publication, for any retraction the reason is always stated, unless the authors themselves volunteer the retraction.

In another published criticism of the Elgazzar et al study by Gideon M-K, Health Nerd, “Is ivermectin for Covid-19 based on fraudulent research?”: https://gidmk.medium.com/is-ivermectin-for-covid-19-based-on-fraudulent-research-5cc079278602

My additional comments are:

1. The Table 4 regarding mortality outcome is fake. Gideon added the last two columns. The original paper of Elgazzar et al is without the last two columns.

2. Regarding getting dead people from data files (coloured blue and green), where do these come from? This is manufactured accusation.

3. The accusation from two writers against the Elgazzar ivermectin study is swift, caustic and appears coordinated. It is not easy to write a comprehensive accusation in such short time. Detailed analysis is necessary, and it takes time.

4. The RCT was conducted in two hospitals – Benha and Kafrelsheikh Hospitals. Gideon implied that the Elgazzar study might not have happened and therefore a fraud. This is a very serious accusation. If true, the reputation of these hospitals and the integrity of Dr Elgazzar and colleagues are at stake.

5. It is clear the ivermectin bashing is planned and orchestrated.

Captain Dr. Wong Ang Peng (Rtd) is a scientist and researcher with interests in economics, politics and health issues.

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In May, 2021, Dr. Peng wrote a letter response to the Ministry of Health in Malaysia on Ivermectin and it was signed by many doctors and sent to the Health Director General: https://www.malaysiakini.com/letters/575402

Twitter post of Peng's May letter: https://twitter.com/louisaclary/status/1395448787213160455?s=21