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49 antiandrogen COVID-19 controlled studies, 17 RCTs
44% improvement
for early treatment, RR
0.56
[0.45-0.69]
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Cadegiani
77%
0.23 [0.08-0.66]
recov. time
8 (n)
262 (n)
Improvement, RR [CI]
Treatment
Control
Cadegiani
83%
0.17 [0.06-0.51]
recov. time
8 (n)
262 (n)
Cadegiani
38%
0.62 [0.42-0.91]
viral time
8 (n)
262 (n)
McCoy (DB RCT)
80%
0.20 [0.01-4.13]
death
0/134
2/134
censored, see details CS3
McCoy (DB RCT)
97%
0.03 [0.00-0.47]
ventilation
0/134
17/134
censored, see details CS3
McCoy (DB RCT)
91%
0.09 [0.03-0.27]
hosp.
3/134
35/134
censored, see details CS3
Cadegiani (DB RCT)
62%
0.38 [0.18-0.82]
no recov.
7/44
18/43
Cadegiani (DB RCT)
44%
0.56 [0.40-0.79]
recov. time
44 (n)
43 (n)
Cadegiani (DB RCT)
40%
0.60 [0.44-0.81]
recov. time
44 (n)
43 (n)
Cadegiani (DB RCT)
63%
0.37 [0.02-8.85]
death
0/75
1/102
Cadegiani (DB RCT)
90%
0.10 [0.01-1.84]
ventilation
0/75
5/102
Cadegiani (DB RCT)
86%
0.14 [0.03-0.60]
hosp.
2/75
19/102
Kintor (DB RCT)
67%
0.33 [0.01-8.16]
death
0/365
1/365
Kintor (DB RCT)
50%
0.50 [0.15-1.65]
hosp.
4/365
8/365
Kintor (DB RCT)
67%
0.33 [0.01-8.16]
death
0/360
1/361
Kintor (DB RCT)
71%
0.29 [0.06-1.37]
hosp.
2/360
7/361
Kintor (DB RCT)
67%
0.33 [0.01-8.16]
death
0/346
1/347
Kintor (DB RCT)
92%
0.08 [0.01-0.79]
hosp.
0/346
6/347
Kintor (DB RCT)
74%
0.26 [0.13-0.51]
viral+
365 (n)
365 (n)
Hunt
39%
0.61 [0.51-0.73]
death
167/1,788
1,445/24,720
Vicenzi
93%
0.07 [0.04-0.53]
death
30 (n)
39 (n)
OT1
Vicenzi
81%
0.19 [0.07-0.53]
death/int.
30 (n)
39 (n)
OT1
Goren
81%
0.19 [0.03-1.28]
ICU
1/12
17/36
Goren
86%
0.14 [0.02-0.94]
ICU
1/12
38/65
Goren
-50%
1.50 [0.15-15.1]
death
1/12
2/36
Goren
-35%
1.35 [0.17-11.1]
death
1/12
4/65
Mareev (RCT)
11%
0.89 [0.65-1.22]
no recov.
33 (n)
33 (n)
CT2
Mareev (RCT)
39%
0.61 [0.14-0.97]
no recov.
14/24
20/21
CT2
Mareev (RCT)
8%
0.92 [0.77-1.09]
hosp. time
33 (n)
33 (n)
CT2
Mareev (RCT)
87%
0.13 [0.01-2.25]
viral+
0/17
3/13
CT2
Zarehoseinz.. (RCT)
75%
0.25 [0.03-2.14]
death
1/40
4/40
Zarehoseinz.. (RCT)
0%
1.00 [0.06-15.4]
ICU
1/40
1/40
Ghandehari (RCT)
-22%
1.22 [0.08-18.2]
death
1/18
1/22
Ghandehari (RCT)
85%
0.15 [0.01-2.82]
ventilation
0/18
3/22
Ghandehari (RCT)
76%
0.24 [0.03-1.91]
progression
1/18
5/22
Ghandehari (RCT)
39%
0.61 [0.18-2.11]
progression
3/18
6/22
Ersoy (ICU)
46%
0.54 [0.36-0.81]
death
14/30
26/30
ICU patients
Welén (RCT)
80%
0.20 [0.01-4.65]
death
0/29
1/10
Welén (RCT)
31%
0.69 [0.07-6.81]
ventilation
2/29
1/10
Welén (RCT)
-133%
2.33 [1.06-5.00]
no disch.
29 (n)
10 (n)
Welén (RCT)
-50%
1.50 [1.10-2.04]
hosp. time
29 (n)
10 (n)
Cadegiani (DB RCT)
78%
0.22 [0.16-0.30]
death
45/423
171/355
Cadegiani (DB RCT)
79%
0.21 [0.15-0.30]
death
34/423
138/355
Cadegiani (DB RCT)
45%
0.55 [0.49-0.62]
no recov.
423 (n)
355 (n)
Cadegiani (DB RCT)
55%
0.45 [0.39-0.52]
no recov.
423 (n)
355 (n)
Cadegiani (DB RCT)
33%
0.67 [0.54-0.82]
hosp. time
423 (n)
355 (n)
Davarpanah
78%
0.22 [0.08-0.55]
hosp.
6/103
23/103
CT2
Davarpanah
67%
0.33 [0.16-0.71]
progression
8/103
24/103
CT2
Davarpanah
64%
0.36 [0.21-0.60]
recov. time
103 (n)
103 (n)
CT2
Kotfis (RCT)
17%
0.83 [0.25-2.74]
death
4/24
5/25
Kotfis (RCT)
11%
0.89 [0.35-2.28]
ICU
6/24
7/25
Kotfis (RCT)
30%
0.70 [0.24-2.01]
TFS
24 (n)
25 (n)
Abbasi (SB RCT)
55%
0.45 [0.18-1.13]
death
5/51
19/87
Abbasi (SB RCT)
34%
0.66 [0.30-1.48]
ventilation
7/51
18/87
Abbasi (SB RCT)
19%
0.81 [0.42-1.59]
ICU
10/51
21/87
Abbasi (SB RCT)
47%
0.53 [0.39-0.72]
no recov.
51 (n)
87 (n)
Gomaa (DB RCT)
91%
0.09 [0.01-1.56]
death
0/25
5/25
CT2
Gomaa (DB RCT)
91%
0.09 [0.01-1.56]
ventilation
0/25
5/25
CT2
Gomaa (DB RCT)
44%
0.56 [0.40-0.79]
recov. time
25 (n)
25 (n)
CT2
Gomaa (DB RCT)
33%
0.67 [0.52-0.85]
no recov.
25 (n)
25 (n)
CT2
Hsieh
88%
0.12 [0.01-2.22]
death
0/117
4/143
CT2
Hsieh
51%
0.49 [0.10-2.47]
ventilation
2/117
5/143
CT2
Hsieh
30%
0.70 [0.21-2.33]
ICU
4/117
7/143
CT2
Hsieh
88%
0.12 [0.01-2.22]
no recov.
0/117
4/143
CT2
Hsieh
36%
0.64 [0.51-0.80]
viral load
117 (n)
143 (n)
CT2
HITCH
Nickols (DB RCT)
18%
0.82 [0.32-1.82]
death
11/62
7/34
HITCH
Nickols (DB RCT)
-19%
1.19 [0.50-2.84]
ventilation
13/62
6/34
HITCH
Nickols (DB RCT)
-17%
1.17 [0.50-2.28]
no recov.
15/62
7/34
HITCH
Nickols (DB RCT)
-20%
1.20 [0.02-92.1]
hosp. time
62 (n)
34 (n)
Gordon (DB RCT)
82%
0.18 [0.03-0.94]
death
n/a
n/a
Gordon (DB RCT)
76%
0.24 [0.03-1.63]
ventilation time
n/a
n/a
Gordon (DB RCT)
73%
0.27 [0.09-0.86]
ICU
n/a
n/a
Nicastri (DB RCT)
52%
0.48 [0.08-2.70]
oxygen
20 (n)
19 (n)
Nicastri (DB RCT)
7%
0.93 [0.18-4.76]
oxygen
22 (n)
19 (n)
Nicastri (DB RCT)
-4%
1.04 [0.20-5.26]
oxygen
20 (n)
19 (n)
Nicastri (DB RCT)
40%
0.60 [0.11-2.94]
oxygen
22 (n)
19 (n)
Nicastri (DB RCT)
69%
0.31 [0.05-1.85]
viral+
20 (n)
19 (n)
Nicastri (DB RCT)
10%
0.90 [0.18-4.55]
viral+
22 (n)
19 (n)
Wadhwa (RCT)
72%
0.28 [0.09-0.85]
progression
4/74
9/46
Wadhwa (RCT)
49%
0.51 [0.27-0.95]
no disch.
13/74
16/46
Wadhwa (RCT)
18%
0.82 [0.67-1.00]
recov. time
74 (n)
46 (n)
Barnette (DB RCT)
55%
0.45 [0.27-0.74]
death
19/94
23/51
Barnette (DB RCT)
49%
0.51 [0.33-0.76]
ventilation time
98 (n)
52 (n)
Barnette (DB RCT)
44%
0.56 [0.40-0.80]
ICU
98 (n)
52 (n)
Barnette (DB RCT)
26%
0.74 [0.57-0.97]
hosp. time
98 (n)
52 (n)
Montopoli
95%
0.05 [0.00-12.3]
death
0/5,273
18/37,161
Montopoli
75%
0.25 [0.09-0.76]
severe case
1/5,273
31/37,161
Montopoli
75%
0.25 [0.09-0.65]
cases
4/5,273
114/37,161
Holt
-129%
2.29 [1.59-3.32]
death/ICU
16/31
148/658
Koskinen
46%
0.54 [0.06-5.16]
death
1/134
3/218
Koskinen
46%
0.54 [0.06-5.16]
death/ICU
1/134
3/218
Koskinen
11%
0.89 [0.34-2.34]
cases
6/134
11/218
Patel
55%
0.45 [0.11-1.47]
death
4/22
10/36
Patel
69%
0.31 [0.05-1.81]
ventilation
22 (n)
36 (n)
Patel
77%
0.23 [0.06-0.79]
hosp.
22 (n)
36 (n)
Bennani
95%
0.05 [0.00-2063]
death
0/4
18/114
Bennani
-119%
2.19 [0.37-12.9]
ICU
1/4
13/114
Bennani
25%
0.75 [0.28-2.02]
hosp.
2/4
76/114
Bennani
8%
0.92 [0.16-5.15]
severe case
1/4
31/114
Ianhez
80%
0.20 [0.01-2.78]
ICU
1/17
28/357
Ianhez
66%
0.34 [0.04-2.31]
hosp.
2/17
64/357
Ianhez
-1%
1.01 [0.63-1.64]
cases
17/571
357/12,161
Lazzeri
-23%
1.23 [0.81-1.87]
death/ICU
Kwon
21%
0.79 [0.10-6.40]
death
1/799
7/4,412
Kwon
-18%
1.18 [0.70-1.96]
cases
18/799
79/4,412
Klein
-124%
2.24 [0.86-5.85]
death
6/304
13/1,475
Klein
7%
0.93 [0.55-1.56]
cases
17/304
85/1,475
Jeon
77%
0.23 [0.08-0.64]
cases
case control
Shaw (PSM)
6%
0.94 [0.90-0.98]
cases
47 (n)
97 (n)
Israel
38%
0.62 [0.41-0.91]
hosp.
case control
Jiménez-Alcaide
33%
0.67 [0.26-1.74]
death
3/11
17/50
Jiménez-Alcaide
-8%
1.08 [0.54-1.83]
progression
11 (n)
50 (n)
Jiménez-Alcaide
-68%
1.68 [0.90-3.16]
cases
11/156
50/1,193
Kazan
-229%
3.29 [0.61-17.7]
hosp.
4/138
2/227
Kazan
29%
0.71 [0.39-1.32]
cases
13/138
30/227
Schmidt (PSM)
20%
0.80 [0.46-1.34]
death
25/169
44/308
Schmidt (PSM)
2%
0.98 [0.61-1.56]
severe case
169 (n)
308 (n)
Duarte
11%
0.89 [0.59-1.11]
death
100/156
32/43
Welén
2%
0.98 [0.61-1.59]
death
21/358
167/4,980
Welén
11%
0.89 [0.54-1.46]
death
20/334
167/4,980
Welén
-151%
2.51 [1.52-4.16]
death
24/152
167/4,980
Welén
-28%
1.28 [0.82-1.99]
ICU
24/358
216/4,980
Welén
13%
0.87 [0.51-1.48]
ICU
16/334
216/4,980
Welén
21%
0.79 [0.34-1.86]
ICU
6/152
216/4,980
Welén
-23%
1.23 [0.96-1.56]
hosp.
126/358
1,108/4,980
Welén
-24%
1.24 [0.97-1.59]
hosp.
126/334
1,108/4,980
Welén
-40%
1.40 [0.98-1.99]
hosp.
66/152
1,108/4,980
Gedeborg
-25%
1.25 [0.95-1.65]
death
case control
Lyon
17%
0.83 [0.42-1.63]
death
15/944
19/994
Lyon
7%
0.93 [0.86-1.00]
cases
399/944
446/994
Lee (PSW)
21%
0.79 [0.62-0.97]
severe case
76/295
727/2,427
Lee (PSW)
11%
0.89 [0.82-0.95]
cases
295/3,057
2,427/36,096
MacFadden
7%
0.93 [0.88-0.98]
cases
n/a
n/a
Shah
-16%
1.16 [0.68-1.98]
death
148 (n)
317 (n)
Shah
19%
0.81 [0.25-2.66]
ventilation
148 (n)
317 (n)
Shah
-3%
1.03 [0.57-1.87]
severe case
148 (n)
317 (n)
Shah
4%
0.96 [0.52-1.77]
hosp.
148 (n)
317 (n)
Cousins (PSM)
81%
0.19 [0.06-0.65]
ventilation
731 (n)
731 (n)
Cousins (PSM)
66%
0.34 [0.17-0.68]
ICU
731 (n)
731 (n)
Davidsson
2%
0.98 [0.55-1.69]
IgG+
30/224
45/431
Cousins (PSM)
18%
0.82 [0.71-0.93]
death
390/12,504
479/12,504
Cousins (PSM)
12%
0.88 [0.79-0.99]
death
521/16,324
592/16,324
Cousins (PSM)
15%
0.85 [0.77-0.94]
death
671/20,690
783/20,690
Cousins (PSM)
17%
0.83 [0.77-0.91]
ventilation
936/12,504
1,118/12,504
Cousins (PSM)
17%
0.83 [0.77-0.89]
ventilation
1,212/16,324
1,459/16,324
Cousins (PSM)
10%
0.90 [0.84-0.95]
ventilation
1,524/20,690
1,701/20,690
Antiandrogen COVID-19 outcomes
c19 early .org
December 2024
1 OT: comparison with other treatment 3 CS: censored, see details
2 CT: study uses combined treatment
Favors antiandrogens
Favors control
Figure S2. Comparison of results for RCTs versus observational studies.
For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.
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