Budesonide for COVID-19: real-time meta analysis of 12 studies

• Statistically significant improvements are seen for mortality, progression, and recovery. 8 studies from 8 independent teams in 7 different countries show statistically significant improvements in isolation (4 for the most serious outcome).• Meta analysis using the most serious outcome reported shows 30% [16‑42%] improvement. Results are similar for Randomized Controlled Trials, similar after exclusions, and similar for peer-reviewed studies. Early treatment is more effective than late treatment. • Results are robust — in exclusion sensitivity analysis 8 of 12 studies must be excluded to avoid finding statistically significant efficacy in pooled analysis.• 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 budesonide studies show zero events with treatment. • All data to reproduce this paper and sources are in the appendix.

Percentage improvement with budesonide (more)

	Early treatment	All studies	Prophylaxis	Studies	Patients	Authors
All studies	49% [-617‑96%]	30% [16‑42%]***	28% [12‑41%]**	12	27,682	191
Randomized Controlled TrialsRCTs	49% [-617‑96%]	33% [-38‑67%]	-	5	3,332	115
Mortality	-200% [-7253‑88%]	27% [13‑39%]***	32% [0‑54%]*	10	20,517	162
HospitalizationHosp.	12% [-140‑68%]	44% [-52‑80%]	-	2	1,578	41