Supplementary Data — Azithromycin for COVID-19: real-time meta analysis of 29 studies

@CovidAnalysis, November 2025, Version 16V16
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Q-PROTECT Omrani (DB RCT) -33% 1.33 [0.30-5.86] hosp. 4/152 3/152 Improvement, RR [CI] Treatment Control Q-PROTECT Omrani (DB RCT) 67% 0.33 [0.04-3.17] progression 1/152 3/152 Q-PROTECT Omrani (DB RCT) -100% 2.00 [0.51-7.85] no recov. 6/152 3/152 Q-PROTECT Omrani (DB RCT) -4% 1.04 [0.89-1.22] viral load 152 (n) 152 (n) Rashad (RCT) 26% 0.74 [0.53-1.04] no improv. 37/107 46/99 Rashad (RCT) 34% 0.66 [0.58-0.75] viral time 107 (n) 99 (n) Madamombe 40% 0.60 [0.40-0.98] death 672 (all patients) Lounnas (PSM) 27% 0.73 [0.61-0.87] death/ICU n/a n/a Kuderer -27% 1.27 [0.67-2.32] death 12/93 41/486 Kuderer -152% 2.52 [1.68-3.63] death 45/181 41/486 COALITION I Cavalcanti (RCT) 57% 0.43 [0.13-1.45] death 5/172 7/159 COALITION I Cavalcanti (RCT) 45% 0.55 [0.13-2.28] death 3/172 5/159 COALITION I Cavalcanti (RCT) -54% 1.54 [0.71-3.35] ventilation 19/172 12/159 COALITION I Cavalcanti (RCT) 18% 0.82 [0.47-1.43] 7-point status 172 (n) 159 (n) COALITION II Furtado (RCT) -8% 1.08 [0.79-1.47] death 90/214 73/183 COALITION II Furtado (RCT) -3% 1.03 [0.76-1.38] death 66/214 55/183 COALITION II Furtado (RCT) 30% 0.70 [0.47-1.04] misc. 214 (n) 183 (n) COALITION II Furtado (RCT) 26% 0.74 [0.51-1.06] misc. 214 (n) 183 (n) Sekhavati (RCT) 67% 0.33 [0.01-7.96] death 0/56 1/55 Sekhavati (RCT) 86% 0.14 [0.01-2.68] ventilation 0/56 3/55 Sekhavati (RCT) 72% 0.28 [0.06-1.29] ICU 2/56 7/55 Sekhavati (RCT) 23% 0.77 [0.62-0.96] hosp. time 56 (n) 55 (n) Yeramaneni 7% 0.93 [0.49-1.78] death 4,003 (n) 3,155 (n) RECOVERY Horby (RCT) 2% 0.98 [0.90-1.08] death 705/2,582 1,440/5,181 RECOVERY Horby (RCT) 3% 0.97 [0.87-1.07] death 561/2,582 1,162/5,181 RECOVERY Horby (RCT) 8% 0.92 [0.79-1.07] ventilation 211/2,430 461/4,881 PRINCIPLE Butler (RCT) 50% 0.50 [0.10-2.59] ventilation 2/496 5/625 PRINCIPLE Butler (RCT) 24% 0.76 [0.18-3.15] ICU 3/495 5/625 PRINCIPLE Butler (RCT) 16% 0.84 [0.38-1.85] oxygen 10/497 15/625 PRINCIPLE Butler (RCT) 9% 0.91 [0.49-1.72] hosp. 16/500 22/629 PRINCIPLE Butler (RCT) 7% 0.93 [0.81-1.05] no recov. 500 (n) 823 (n) Corradini -12% 1.12 [0.86-1.46] death 222 (n) 1,479 (n) Kokturk -50% 1.50 [0.49-4.25] death 34/738 33/762 ACTION Oldenburg (DB RCT) -788% 8.88 [0.50-158] hosp. 5/125 0/72 ACTION Oldenburg (DB RCT) -418% 5.18 [1.24-21.7] misc. 18/125 2/72 ACTION Oldenburg (DB RCT) 1% 0.99 [0.74-1.33] no recov. 65/131 35/70 ACTION Oldenburg (DB RCT) 12% 0.88 [0.51-1.50] transmission 33/522 20/278 Ghanei (RCT) 19% 0.81 [0.30-2.17] death 10/226 6/110 Ghanei (RCT) 51% 0.49 [0.10-2.37] ventilation 3/226 3/110 Ghanei (RCT) 24% 0.76 [0.30-1.92] ICU 11/226 7/110 ATOMIC2 Hinks (RCT) -1% 1.01 [0.06-16.1] death 1/145 1/147 ATOMIC2 Hinks (RCT) 1% 0.99 [0.49-2.00] death/hosp. 15/145 17/147 ATOMIC2 Hinks (RCT) 8% 0.92 [0.45-1.77] death/hosp. 15/145 17/147 ATOMIC2 Hinks (RCT) 80% 0.20 [0.01-4.05] progression 0/119 2/114 Gyselinck (RCT) -11% 1.11 [0.34-3.63] death 119 (n) 64 (n) Gyselinck (RCT) 26% 0.74 [0.31-1.74] ventilation 119 (n) 64 (n) Gyselinck (RCT) -7% 1.07 [0.57-1.99] ICU 119 (n) 64 (n) Gyselinck (RCT) 2% 0.98 [0.73-1.32] no recov. 119 (n) 64 (n) AlQadheeb (ICU) -22% 1.22 [0.96-1.55] death 467/775 36/73 ICU patients Yilgwan 67% 0.33 [0.19-0.58] death 1,619 (n) 1,843 (n) Atefi 85% 0.15 [0.01-2.63] death 0/18 4/42 Mehrizi 32% 0.68 [0.66-0.70] death population-based cohort Donida 7% 0.93 [0.56-1.57] death 180/548 101/175 Traore 69% 0.31 [0.10-0.97] death n/a n/a Dinoi 28% 0.72 [0.50-1.04] death case control Alqahtani (ICU) 9% 0.91 [0.38-2.19] death 159 (n) 26 (n) ICU patients Piñana 58% 0.42 [0.20-0.89] death n/a n/a Huh -54% 1.54 [0.48-2.65] progression 3/6 875/2,799 Huh 42% 0.58 [0.30-1.12] cases case control Loucera 15% 0.85 [0.76-0.95] death 2,465 (n) 13,503 (n) Dugot 12% 0.88 [0.83-0.94] cases case control Azithromycin COVID-19 outcomes c19early.org November 2025 Favors azithromycin 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.