Supplementary Data — Azvudine reduces COVID-19 risk: real-time meta analysis of 39 studies

@CovidAnalysis, December 2025, Version 40V40
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Chen -12% 1.12 [0.05-23.9] recov. time 66 (n) 41 (n) Improvement, RR [CI] Treatment Control Chen 32% 0.68 [0.47-0.99] viral+ 166 (n) 41 (n) Han (PSM) 37% 0.63 [0.40-1.00] death 428 (n) 428 (n) Han (PSM) 3% 0.97 [0.83-1.14] no improv. 428 (n) 428 (n) Yang 91% 0.09 [0.01-1.62] death 0/317 6/487 Yang (PSW) 75% 0.25 [0.06-0.98] hosp. 317 (n) 487 (n) Yang (PSW) 16% 0.84 [0.65-1.09] no recov. 317 (n) 487 (n) Wang 20% 0.80 [0.46-1.40] death 128 (n) 55 (n) Wang 3% 0.97 [0.58-1.61] progression 128 (n) 55 (n) Jin -1% 1.01 [0.91-1.12] recov. time 33 (n) 33 (n) Wu (PSM) 81% 0.19 [0.07-0.50] death 90 (n) 90 (n) Wu 57% 0.43 [0.25-0.74] death 106 (n) 245 (n) Zou 9% 0.91 [0.54-1.53] viral+ 14/91 96/569 Guo (PSM) 56% 0.44 [0.25-0.78] death 703 (n) 703 (n) Guo (PSM) 62% 0.38 [0.28-0.51] progression 703 (n) 703 (n) Guo (PSM) 34% 0.66 [0.54-0.80] viral+ 703 (n) 703 (n) Ren (RCT) 38% 0.62 [0.40-0.98] recov. time 10 (n) 10 (n) Ren (RCT) 54% 0.46 [0.26-0.82] viral time 10 (n) 10 (n) Shen (PSM) 74% 0.26 [0.07-0.94] death 3/226 10/226 Shen (PSM) 91% 0.09 [0.01-1.63] ventilation 0/226 5/226 Shen (PSM) 75% 0.25 [0.03-2.22] ICU 1/226 4/226 Shen (PSM) 57% 0.43 [0.18-0.99] progression 8/226 17/226 Chen (PSM) 6% 0.94 [0.61-1.43] death 29/99 31/99 Chen (PSM) 63% 0.37 [0.18-0.77] death 99 (n) 99 (n) Sun 54% 0.46 [0.15-1.34] death 5/245 9/245 Sun 0% 1.00 [0.14-7.04] ventilation 2/245 2/245 Sun -100% 2.00 [0.18-21.9] ICU 2/245 1/245 Sun 38% 0.62 [0.34-1.12] oxygen 16/245 26/245 Sun 48% 0.52 [0.30-0.90] progression 17/245 31/245 Zong (PSM) 62% 0.38 [0.23-0.62] death 195 (n) 390 (n) Shao 56% 0.44 [0.24-0.79] death 177 (n) 509 (n) Dian (PSM) 64% 0.36 [0.12-1.13] death 4/228 11/228 OT​1​ Dian (PSM) 67% 0.33 [0.07-1.63] ventilation 2/228 6/228 OT​1​ Dian (PSM) 0% 1.00 [0.06-15.9] ICU 1/228 1/228 OT​1​ Dian (PSM) 48% 0.52 [0.29-0.92] progression 16/228 31/228 OT​1​ Dian (PSM) 44% 0.56 [0.30-1.02] progression 15/228 27/228 OT​1​ Zhou 22% 0.78 [0.56-1.09] death 37/131 69/191 Wei -0% 1.00 [0.68-1.47] death 63/461 36/264 OT​1​ Wei 28% 0.72 [0.54-0.98] ventilation 77/461 61/264 OT​1​ Wei 55% 0.45 [0.20-1.02] ICU 11/461 14/264 OT​1​ Wei 22% 0.78 [0.60-1.01] progression 98/461 72/264 OT​1​ de Souza (DB RCT) 27% 0.73 [0.17-3.15] ICU 3/91 4/88 de Souza (DB RCT) 42% 0.58 [0.14-2.36] no disch. 3/91 5/88 de Souza (DB RCT) 82% 0.18 [0.05-0.71] no recov. 91 (n) 88 (n) de Souza (DB RCT) 13% 0.87 [0.77-0.99] viral time 91 (n) 88 (n) Liu 24% 0.76 [0.42-1.37] progression 12/126 56/446 Li (PSM) 29% 0.71 [0.52-0.97] death 1,103 (n) 1,103 (n) Peng -13% 1.13 [0.32-3.99] death 42 (n) 124 (n) Li 50% 0.50 [0.10-2.58] ICU 2/42 4/42 Li 11% 0.89 [0.73-1.09] hosp. time 42 (n) 42 (n) Li 50% 0.50 [0.27-0.94] viral+ 42 (n) 42 (n) Li 32% 0.68 [0.41-1.12] viral+ 15/42 22/42 Zhong (PSW) 35% 0.65 [0.42-1.00] death 1,490 (n) 1,373 (n) Zhong (PSW) 52% 0.48 [0.31-0.75] death 1,490 (n) 1,373 (n) Zhong (PSW) 87% 0.13 [0.06-0.25] death 1,490 (n) 1,373 (n) Liu (PSM) 45% 0.55 [0.15-1.96] progression 148 (all patients) Lv -42% 1.42 [0.39-5.15] death 2/11 40/313 Zhang -32% 1.32 [0.89-1.97] death 49/303 37/303 Zhang -62% 1.62 [0.82-3.17] ventilation 21/303 13/303 Zhang -7% 1.07 [0.66-1.75] ICU 30/303 28/303 Zhang 9% 0.91 [0.83-1.00] hosp. time 303 (n) 303 (n) Zhang 19% 0.81 [0.71-0.92] hosp. time 165 (n) 181 (n) Xu (PSM) 75% 0.25 [0.08-0.81] death 132 (n) 132 (n) Xu (PSM) 63% 0.37 [0.16-0.84] progression 132 (n) 132 (n) Ren (PSM) 32% 0.68 [0.60-0.78] death 5,735 (n) 5,735 (n) Ren (PSM) 12% 0.88 [0.80-0.98] progression 5,735 (n) 5,735 (n) Zhang 43% 0.57 [0.35-0.95] progression 28/165 13/44 Zhang 14% 0.86 [0.75-0.97] viral time 165 (n) 44 (n) Zhu (PSM) 22% 0.78 [0.67-0.90] death 265/1,999 341/1,999 Zhu (PSM) 13% 0.87 [0.76-0.99] no disch. 323/1,999 372/1,999 Zhu 1% 0.99 [0.95-1.02] hosp. time 1,676 (n) 1,623 (n) Zhu 10% 0.90 [0.86-0.93] viral time 1,676 (n) 1,623 (n) Yuan 9% 0.91 [0.83-0.99] viral time 121 (n) 123 (n) Zhong (PSW) 35% 0.65 [0.42-1.00] death 1,490 (n) 1,372 (n) Zhong (PSM) 43% 0.57 [0.39-0.83] death 920 (n) 920 (n) Zhong (PSW) 52% 0.48 [0.31-0.75] death 1,490 (n) 1,372 (n) Zhong (PSM) 56% 0.44 [0.28-0.68] death 920 (n) 920 (n) Zhong (PSW) 87% 0.13 [0.06-0.25] death 1,490 (n) 1,372 (n) Zhong (PSM) 88% 0.12 [0.05-0.32] death 920 (n) 920 (n) Sun (PSM) 27% 0.73 [0.55-0.96] death 1,462 (n) 1,462 (n) Sun (PSM) -15% 1.15 [0.95-1.38] progression 1,462 (n) 1,462 (n) Zhou (PSM) 26% 0.74 [0.58-0.94] death 1,417 (n) 1,417 (n) Zhou (PSM) 9% 0.91 [0.75-1.11] progression 1,417 (n) 1,417 (n) He -48% 1.48 [1.23-1.78] death 165/865 214/1,655 He -55% 1.55 [1.28-1.87] death 158/832 198/1,612 He 43% 0.57 [0.27-1.22] death 7/33 16/43 Yu (PSM) 38% 0.62 [0.48-0.77] death 831 (n) 831 (n) Yu (PSM) 21% 0.79 [0.64-0.98] progression 831 (n) 831 (n) Zhang (PSM) 20% 0.80 [0.70-0.92] hosp. time 48 (n) 48 (n) Zhang (PSM) 0% 1.00 [0.67-1.50] viral time 48 (n) 48 (n) Wang 45% 0.55 [0.30-1.00] death 302 (n) 302 (n) Wang 69% 0.31 [0.10-0.91] death 126 (n) 302 (n) Wang 32% 0.68 [0.36-1.31] death 176 (n) 302 (n) Han (PSM) 27% 0.73 [0.57-0.94] death 90/901 123/901 Han (PSM) 18% 0.82 [0.67-1.00] ventilation 139/901 170/901 Han (PSM) 21% 0.79 [0.65-0.97] ICU 140/901 177/901 Han (PSM) 20% 0.80 [0.67-0.95] progression 182/901 230/910 Azvudine COVID-19 outcomes c19early.org December 2025 ​1​ OT: comparison with other treatment Favors azvudine 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.