Supplementary Data — Antiandrogens reduce COVID-19 risk: real-time meta analysis of 49 studies

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 CS​3 McCoy (DB RCT) 97% 0.03 [0.00-0.47] ventilation 0/134 17/134 censored, see details CS​3 McCoy (DB RCT) 91% 0.09 [0.03-0.27] hosp. 3/134 35/134 censored, see details CS​3 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) OT​1 Vicenzi 81% 0.19 [0.07-0.53] death/int. 30 (n) 39 (n) OT​1 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) CT​2 Mareev (RCT) 39% 0.61 [0.14-0.97] no recov. 14/24 20/21 CT​2 Mareev (RCT) 8% 0.92 [0.77-1.09] hosp. time 33 (n) 33 (n) CT​2 Mareev (RCT) 87% 0.13 [0.01-2.25] viral+ 0/17 3/13 CT​2 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 CT​2 Davarpanah 67% 0.33 [0.16-0.71] progression 8/103 24/103 CT​2 Davarpanah 64% 0.36 [0.21-0.60] recov. time 103 (n) 103 (n) CT​2 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 CT​2 Gomaa (DB RCT) 91% 0.09 [0.01-1.56] ventilation 0/25 5/25 CT​2 Gomaa (DB RCT) 44% 0.56 [0.40-0.79] recov. time 25 (n) 25 (n) CT​2 Gomaa (DB RCT) 33% 0.67 [0.52-0.85] no recov. 25 (n) 25 (n) CT​2 Hsieh 88% 0.12 [0.01-2.22] death 0/117 4/143 CT​2 Hsieh 51% 0.49 [0.10-2.47] ventilation 2/117 5/143 CT​2 Hsieh 30% 0.70 [0.21-2.33] ICU 4/117 7/143 CT​2 Hsieh 88% 0.12 [0.01-2.22] no recov. 0/117 4/143 CT​2 Hsieh 36% 0.64 [0.51-0.80] viral load 117 (n) 143 (n) CT​2 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 c19early.org November 2025 1 OT: comparison with other treatment3 CS: censored, see details 2 CT: study uses combined treatment Favors antiandrogens Favors control
Fig. S1. All outcomes.
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Fig. 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.