Supplementary Data — Acetaminophen increases COVID-19 risk: real-time meta-analysis of 28 studies

October 2026

Acetaminophen COVID-19 outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk
Rinott−473%5.73 · 0.30–109death3/850/49OT1 Rinott−534%6.34 · 0.84–47.65oxygen11/851/49OT1 Lapi (ES)−15%1.15 · 0.92–1.43death/hosp.n/an/a Lapi (ES)−29%1.29 · 0.61–2.73death/hosp.n/an/a Sharif−77%1.77 · 0.39–8.09death9/3612/142 Chen−32%1.32 · 0.98–1.78PASC98/23239/122LONG COVID Chen−1%1.01 · 0.67–1.52PASC16/41121/313LONG COVID Rahman−23%1.23 · 0.96–1.56hosp.84/244100/356 Vasilkova−60%1.60 · 0.60–4.29ICU8/285/28OT1 Vasilkova−19%1.19 · 0.90–1.56progression28 (n)28 (n)OT1 Ravichandran (PSM)−2700%28.00 · 3.91–200oxygen28/721/72OT1 Ravichandran−75%1.75 · 1.48–2.06recov. time72 (n)72 (n)OT1 Ravichandran−117%2.17 · 1.72–2.72recov. time72 (n)72 (n)OT1 Ravichandran−167%2.67 · 2.00–3.56recov. time72 (n)72 (n)OT1 Manjani−220%3.20 · 1.51–6.82death64/3887/136 Manjani−434%5.34 · 1.98–14.45ventilation388 (n)136 (n) Manjani−244%3.44 · 1.49–8.54progression132 (n)136 (n) Manjani−201%3.01 · 1.40–7.07progression256 (n)136 (n) Manjani−100%2.00 · 1.33–3.02hosp. time388 (n)136 (n) Lerner−27%1.27 · 0.96–1.68death5,783 (all patients) Ravichandran (RCT)−43%1.43 · 1.14–1.78no recov.77/10752/103OT1 Ravichandran (RCT)−3925%40.25 · 2.47–657progression20/1070/103OT1 Ravichandran (RCT)−133%2.33 · 1.82–3.00recov. time107 (n)103 (n)OT1 Ravichandran (RCT)−75%1.75 · 1.48–2.06recov. time107 (n)103 (n)OT1 Ravichandran (RCT)−75%1.75 · 1.48–2.06recov. time107 (n)103 (n)OT1 Ravichandran (RCT)−20%1.20 · 0.93–1.56viral+43/6037/62OT1 Lapi−75%1.75 · 1.40–2.18death/hosp.n/an/a Abolhassani−56%1.56 · 0.58–4.18death3/68/25 Baldia (ICU)12%0.88 · 0.72–1.07death1,166 (n)1,480 (n)ICU patients Baldia (ICU)14%0.86 · 0.72–1.03death1,166 (n)1,480 (n)ICU patients Stufano−19%1.19 · 0.70–2.02PASC11/2323/57 Sobhy (DB RCT)−110%2.10 · 1.05–4.20ICU21/9010/90OT1 Sobhy (DB RCT)−110%2.10 · 1.05–4.20oxygen21/9010/90OT1 Sobhy (DB RCT)−36%1.36 · 1.07–1.73hosp. time90 (n)90 (n)OT1 Sobhy (DB RCT)−33%1.33 · 0.31–5.79no recov.4/903/90OT1 Sobhy (DB RCT)−75%1.75 · 0.77–3.97no recov.14/908/90OT1 Sobhy (DB RCT)−92%1.92 · 1.05–3.52no recov.25/9013/90OT1 Sobhy (DB RCT)−70%1.70 · 1.06–2.72no recov.34/9020/90OT1 Blanc−51%1.51 · 0.82–2.84cases60 (n)119 (n) Kolin−23%1.23 · 1.05–1.43cases397,064 (all patients) Park (PSM)25%0.75 · 0.35–1.59death12/39716/397OT1 Park (PSM)38%0.62 · 0.19–1.89ventilation5/3978/397OT1 Gálvez-Barrón−47%1.47 · 0.66–3.33death43 (n)60 (n) Gálvez-Barrón23%0.77 · 0.35–1.71severe case43 (n)60 (n) Reese (PSM)−61%1.61 · 1.40–1.84death20,826 (n)20,826 (n) Reese (PSM)−816%9.16 · 8.72–9.63severe case20,826 (n)20,826 (n) Chandan (PSM)−18%1.18 · 0.83–1.64death71/8,59579/8,595OT1 CT2 Chandan (PSM)−27%1.27 · 0.90–1.75cases8,595 (n)8,595 (n)OT1 CT2 Oh2%0.98 · 0.38–2.49death58 (n)7,655 (n) Leal7%0.93 · 0.91–0.96casesn/an/a Moreno-Martos−29%1.29 · 1.27–1.32hosp. Moreno-Martos−52%1.52 · 1.28–1.79hosp.103/178196/514 Moreno-Martos−5%1.05 · 0.91–1.22hosp.87/144360/626 Moreno-Martos22%0.78 · 0.63–0.98hosp.64/3191,585/6,181 Moreno-Martos−16%1.16 · 1.13–1.20hosp. Moreno-Martos−57%1.57 · 1.50–1.65hosp.1,090/1,8683,414/9,188 Moreno-Martos−47%1.47 · 1.40–1.54hosp.1,397/2,8753,214/9,735 MacFadden−48%1.48 · 1.44–1.51casesn/an/a Campbell (PSW)−1%1.01 · 0.99–1.02death2,074 (n)20,311 (n) Campbell (PSW)0%1.00 · 0.99–1.02death2,074 (n)20,311 (n) Xie−5%1.05 · 0.70–1.56hosp.population-based cohortOT1 Xie3%0.97 · 0.72–1.29casespopulation-based cohortOT1 Kim (PSM)−71%1.71 · 0.69–4.24death12/1627/162OT1 Kim (PSM)−14%1.14 · 0.42–3.08ventilation8/1627/162OT1 Kim (PSM)40%0.60 · 0.15–2.47ICU3/1625/162OT1 Kim (PSM)−9%1.09 · 0.64–1.86oxygen24/16222/162OT1 Ritsinger−21%1.21 · 1.17–1.25death24,641 (n)20,225 (n)
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1 OT: comparison with other treatment
2 CT: study uses combined treatment
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← Acetaminophen
reduces risk
Acetaminophen
increases risk →
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.