Bromhexine for COVID-19: real-time meta analysis of 7 studies

• Statistically significant improvements are seen for ventilation and ICU admission. 3 studies from 3 independent teams in 2 different countries show statistically significant improvements in isolation (not for the most serious outcome).• Meta analysis using the most serious outcome reported shows 43% [-5‑69%] improvement, without reaching statistical significance. Results are similar for peer-reviewed studies. Early treatment is more effective than late treatment. Currently all studies are RCTs.• Currently there is limited data, with only 875 patients and only 13 control events for the most serious outcome in trials to date.• Bromhexine efficacy may vary depending on the degree of TMPRSS-dependent fusion for different variants [Peacock, Willett]. • No treatment, vaccine, or intervention is 100% effective and available. All practical, effective, and safe means should be used based on risk/benefit analysis. Multiple treatments are typically used in combination, and other treatments may be more effective. Only 57% of bromhexine studies show zero events with treatment. • All data to reproduce this paper and sources are in the appendix.

Percentage improvement with bromhexine (more)

	All studies	Prophylaxis	Early treatment	Studies	Patients	Authors
All studies	43% [-5‑69%]	65% [-212‑96%]	78% [30‑93%]*	7	875	110
Randomized Controlled TrialsRCTs	43% [-5‑69%]	65% [-212‑96%]	78% [30‑93%]*	7	875	110
Mortality	77% [-39‑96%]	33% [-946‑96%]	91% [-59‑99%]	3	550	34
Cases	62% [-11‑87%]	62% [-11‑87%]	-	2	422	24
RCT mortality	77% [-39‑96%]	33% [-946‑96%]	91% [-59‑99%]	3	550	34