Spironolactone for COVID-19: real-time meta analysis of 11 studies

• Statistically significant improvements are seen for mortality, progression, and recovery. 10 studies from 9 independent teams in 8 different countries show statistically significant improvements in isolation (8 for the most serious outcome).• Meta analysis using the most serious outcome reported shows 36% [17‑51%] improvement. Results are similar for Randomized Controlled Trials, similar after exclusions, and slightly worse for peer-reviewed studies. Early treatment is more effective than late treatment. • 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. None of the spironolactone studies show zero events with treatment. • All data to reproduce this paper and sources are in the appendix.

Percentage improvement with spironolactone (more)

	Early treatment	Late treatment	All studies	Studies	Patients	Authors
All studies	77% [34‑92%]**	52% [21‑71%]**	36% [17‑51%]**	11	28,019	97
Randomized Controlled TrialsRCTs	-	44% [-14‑73%]	44% [-14‑73%]	3	324	49
Mortality	-	48% [24‑64%]***	34% [5‑54%]*	3	25,206	20
HospitalizationHosp.	-	52% [-95‑88%]	52% [-95‑88%]	2	272	29
Cases	-	-	51% [-92‑87%]	2	0	12