Supplementary Data — Antihistamine H1RAs reduce COVID-19 risk: real-time meta-analysis of 17 studies

October 2026

Antihistamine H1RA COVID-19 outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk
Valerio-.. (DB RCT)61%0.39 · 0.24–0.63no recov.61 (n)40 (n)ACCROS-Ichlorpheniramine Valerio-.. (DB RCT)67%0.33 · 0.09–1.24no recov.3/616/40ACCROS-Ichlorpheniramine Valerio-.. (DB RCT)89%0.11 · 0.01–0.87no recov.1/616/40ACCROS-Ichlorpheniramine Valerio-.. (DB RCT)53%0.47 · 0.23–0.95no recov.10/6114/40ACCROS-Ichlorpheniramine Valerio-.. (DB RCT)67%0.33 · 0.06–1.71no recov.2/614/40ACCROS-Ichlorpheniramine Valerio-.. (DB RCT)59%0.41 · 0.14–1.16no recov.5/618/40ACCROS-Ichlorpheniramine Valerio-.. (DB RCT)74%0.26 · 0.12–0.58PASC55 (n)46 (n)ACCROS-Ichlorpheniramine Valerio-Pascua54%0.46 · 0.36–0.58recov. time330 (n)330 (n)ACCROS-IIchlorpheniramine Sanchez-.. (DB RCT)87%0.13 · 0.01–2.46hosp.0/322/13chlorpheniramine Klussmann (DB RCT)66%0.34 · 0.01–7.95no recov.0/291/30CARVINazelastine Klussmann (DB RCT)67%0.33 · 0.01–7.79no recov.0/311/30CARVINazelastine Klussmann (DB RCT)13%0.87 · 0.57–1.33no recov.29 (n)30 (n)CARVINazelastine Klussmann (DB RCT)−33%1.33 · 0.81–2.17no recov.31 (n)30 (n)CARVINazelastine Klussmann (DB RCT)14%0.86 · 0.67–1.09viral load29 (n)30 (n)CARVINazelastine Klussmann (DB RCT)7%0.93 · 0.74–1.16viral load31 (n)30 (n)CARVINazelastine Klussmann (DB RCT)22%0.78 · 0.62–0.99viral+29 (n)30 (n)CARVINazelastine Klussmann (DB RCT)6%0.94 · 0.77–1.15viral+31 (n)30 (n)CARVINazelastine Mura (PSM)25%0.75 · 0.39–1.46death88 (n)88 (n) Salvucci29%0.71 · 0.51–1.01PASC10/1413/13LONG COVID Meiser (DB RCT)12%0.88 · 0.64–1.20recovery122 (n)129 (n)CARVIN-IIazelastine Meiser (DB RCT)6%0.94 · 0.91–0.96viral load122 (n)129 (n)CARVIN-IIazelastine Meiser (DB RCT)2%0.98 · 0.97–0.99viral load122 (n)129 (n)CARVIN-IIazelastine Meiser (DB RCT)1%0.99 · 0.98–1.00viral load122 (n)129 (n)CARVIN-IIazelastine Meiser (DB RCT)3%0.97 · 0.96–0.98viral+122 (n)129 (n)CARVIN-IIazelastine Vila-Corcoles61%0.39 · 0.12–1.21cases Hoertel58%0.42 · 0.25–0.71death138 (n)7,207 (n)hydroxyzine Vila-Córcoles53%0.47 · 0.22–1.01cases Reznikov34%0.66 · 0.58–0.75casesn/an/a Reznikov37%0.63 · 0.44–0.90casesn/an/a Reznikov17%0.83 · 0.62–1.12casesn/an/a Reznikov48%0.52 · 0.16–1.64casesn/an/a Reznikov52%0.48 · 0.34–0.67casesn/an/a Reznikov43%0.57 · 0.42–0.78casesn/an/a Reznikov62%0.38 · 0.11–1.32casesn/an/a Reznikov−33%1.33 · 0.50–3.57casesn/an/a Reznikov34%0.66 · 0.48–0.89casesn/an/a Reznikov26%0.74 · 0.55–0.99casesn/an/a Reznikov35%0.65 · 0.52–0.79casesn/an/a Reznikov14%0.86 · 0.71–1.05casesn/an/a Reznikov74%0.26 · 0.07–1.01casesn/an/a Reznikov78%0.22 · 0.05–1.00casesn/an/a Reznikov36%0.64 · 0.33–1.25casesn/an/a Reznikov8%0.92 · 0.47–1.75casesn/an/a Reznikov59%0.41 · 0.25–0.68casesn/an/a Reznikov29%0.71 · 0.44–1.15casesn/an/a McKeigue−30%1.30 · 1.13–1.51severe casecase-control study Sánchez-Rico46%0.54 · 0.31–0.89death18/1641,571/14,939hydroxyzine Monserrat .. (PSM)80%0.20 · 0.02–0.93deathn/an/aloratadine Hunt43%0.57 · 0.49–0.66death260/7,6001,352/18,908 Loucera40%0.60 · 0.43–0.84death251 (n)15,717 (n) Loucera30%0.70 · 0.48–1.00death251 (n)15,717 (n) Loucera51%0.49 · 0.32–0.77death233 (n)15,735 (n) Hoertel−7%1.07 · 0.88–1.31death962 (n)4,810 (n)desloratadine/hydroxyzine Hoertel8%0.92 · 0.49–1.76death11/9462/470desloratadine/hydroxyzine Hoertel−9%1.09 · 0.89–1.35death104/962591/4,810desloratadine/hydroxyzine
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← Antihistamine
H1RAs reduce
risk
Antihistamine
H1RAs increase
risk →
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.