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16 antihistamine H1RA COVID-19 controlled studies, 3 RCTs
56% improvement
for early treatment, RR
0.44
[0.36-0.54]
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
ACCROS-I
Valerio-.. (DB RCT)
61%
0.39 [0.24-0.63]
no recov.
61 (n)
40 (n)
chlorpheniramine
Improvement, RR [CI]
Treatment
Control
ACCROS-I
Valerio-.. (DB RCT)
67%
0.33 [0.09-1.24]
no recov.
3/61
6/40
chlorpheniramine
ACCROS-I
Valerio-.. (DB RCT)
89%
0.11 [0.01-0.87]
no recov.
1/61
6/40
chlorpheniramine
ACCROS-I
Valerio-.. (DB RCT)
53%
0.47 [0.22-1.02]
no recov.
10/61
14/40
chlorpheniramine
ACCROS-I
Valerio-.. (DB RCT)
67%
0.33 [0.06-1.71]
no recov.
2/61
4/40
chlorpheniramine
ACCROS-I
Valerio-.. (DB RCT)
59%
0.41 [0.14-1.16]
no recov.
5/61
8/40
chlorpheniramine
ACCROS-I
Valerio-.. (DB RCT)
74%
0.26 [0.12-0.58]
PASC
55 (n)
46 (n)
chlorpheniramine
ACCROS-II
Valerio-Pascua
54%
0.46 [0.36-0.58]
recov. time
330 (n)
330 (n)
chlorpheniramine
Sanchez-.. (DB RCT)
87%
0.13 [0.01-2.46]
hosp.
0/32
2/13
chlorpheniramine
Mura (PSM)
25%
0.75 [0.39-1.46]
death
88 (n)
88 (n)
Salvucci
29%
0.71 [0.51-1.01]
PASC
10/14
13/13
LONG COVID
CARVIN-II
Meiser (DB RCT)
12%
0.88 [0.64-1.20]
no recov.
122 (n)
129 (n)
CARVIN-II
Meiser (DB RCT)
6%
0.94 [0.91-0.96]
viral load
122 (n)
129 (n)
CARVIN-II
Meiser (DB RCT)
2%
0.98 [0.97-0.99]
viral load
122 (n)
129 (n)
CARVIN-II
Meiser (DB RCT)
1%
0.99 [0.98-1.00]
viral load
122 (n)
129 (n)
CARVIN-II
Meiser (DB RCT)
3%
0.97 [0.96-0.98]
viral+
122 (n)
129 (n)
Vila‐Corcoles
61%
0.39 [0.12-1.21]
cases
Hoertel
58%
0.42 [0.25-0.71]
death
138 (n)
7,207 (n)
hydroxyzine
Vila-Córcoles
53%
0.47 [0.22-1.01]
cases
Reznikov
34%
0.66 [0.58-0.75]
cases
n/a
n/a
Reznikov
37%
0.63 [0.44-0.90]
cases
n/a
n/a
Reznikov
17%
0.83 [0.62-1.12]
cases
n/a
n/a
Reznikov
48%
0.52 [0.16-1.64]
cases
n/a
n/a
Reznikov
52%
0.48 [0.34-0.67]
cases
n/a
n/a
Reznikov
43%
0.57 [0.42-0.78]
cases
n/a
n/a
Reznikov
62%
0.38 [0.11-1.32]
cases
n/a
n/a
Reznikov
-33%
1.33 [0.50-3.57]
cases
n/a
n/a
Reznikov
34%
0.66 [0.48-0.89]
cases
n/a
n/a
Reznikov
26%
0.74 [0.55-0.99]
cases
n/a
n/a
Reznikov
35%
0.65 [0.52-0.79]
cases
n/a
n/a
Reznikov
14%
0.86 [0.71-1.05]
cases
n/a
n/a
Reznikov
74%
0.26 [0.07-1.01]
cases
n/a
n/a
Reznikov
78%
0.22 [0.05-1.00]
cases
n/a
n/a
Reznikov
36%
0.64 [0.33-1.25]
cases
n/a
n/a
Reznikov
8%
0.92 [0.47-1.75]
cases
n/a
n/a
Reznikov
59%
0.41 [0.25-0.68]
cases
n/a
n/a
Reznikov
29%
0.71 [0.44-1.15]
cases
n/a
n/a
McKeigue
-30%
1.30 [1.13-1.51]
severe case
case control
Sánchez-Rico
46%
0.54 [0.31-0.89]
death
18/164
1,571/14,939
hydroxyzine
Monserrat .. (PSM)
80%
0.20 [0.02-0.93]
death
n/a
n/a
loratadine
Hunt
43%
0.57 [0.49-0.66]
death
260/7,600
1,352/18,908
Loucera
40%
0.60 [0.43-0.84]
death
251 (n)
15,717 (n)
Loucera
30%
0.70 [0.48-1.00]
death
251 (n)
15,717 (n)
Loucera
51%
0.49 [0.32-0.77]
death
233 (n)
15,735 (n)
Hoertel
-7%
1.07 [0.88-1.31]
death
962 (n)
4,810 (n)
desloratadine/hydroxyzine
Hoertel
8%
0.92 [0.49-1.76]
death
11/94
62/470
desloratadine/hydroxyzine
Hoertel
-9%
1.09 [0.89-1.35]
death
104/962
591/4,810
desloratadine/hydroxyzine
Antihistamine H1RA COVID-19 outcomes
c19 early .org
December 2024
Favors H1RAs
Favors control
Figure 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.
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