Supplementary Data — Lopinavir/ritonavir for COVID-19: real-time meta-analysis of 18 studies

@CovidAnalysis, October 2026, Version 8V8 (V1 2025)

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October 2026

Lopinavir/ritonavir COVID-19 outcomes

StudyImprovementRR · 95% CIOutcomeTreatmentControlRelative Risk

Huang (RCT)−106%2.06 · 0.20–21.64severe case2/321/33 Huang (RCT)−6%1.06 · 0.82–1.37hosp. time32 (n)33 (n) Huang (RCT)33%0.67 · 0.30–1.47recov. time16 (n)20 (n) Huang (RCT)18%0.82 · 0.66–1.02no improv.29 (n)29 (n) Huang (RCT)−15%1.15 · 0.82–1.62viral time32 (n)33 (n) Lowe (DB RCT)−200%3.00 · 0.12–72.21hosp.1/600/60FLARE Lowe (DB RCT)7%0.93 · 0.65–1.14viral+39/5438/52FLARE Wong (PSW)−96%1.96 · 1.43–2.63no disch.49 (n)884 (n) Wong (PSW)−96%1.96 · 1.43–2.63no recov.49 (n)884 (n) Strub-Wour.. (RCT)−20%1.20 · 0.15–8.65progression1/779/817ANTICOVOT¹ Strub-Wour.. (RCT)12%0.88 · 0.12–6.71hosp.1/7712/817ANTICOVOT¹ Zhou−10%1.10 · 1.00–1.22viral time29 (n)108 (n) Cao (RCT)23%0.77 · 0.45–1.30death19/9925/100LOTUS China Cao (RCT)29%0.71 · 0.44–1.15no improv.21/9930/100LOTUS China Cao (RCT)22%0.78 · 0.62–0.97no improv.54/9970/100LOTUS China Cao (RCT)4%0.96 · 0.91–1.02no improv.93/9998/100LOTUS China Cao (RCT)4%0.96 · 0.64–1.45viral+24/5930/71LOTUS China Cao (RCT)0%1.00 · 0.67–1.50viral+25/5930/71LOTUS China Cao (RCT)−5%1.05 · 0.71–1.54viral+27/5931/71LOTUS China Cao (RCT)2%0.98 · 0.70–1.36viral+30/5937/71LOTUS China Cao (RCT)2%0.98 · 0.77–1.25viral+39/5948/71LOTUS China Yan40%0.60 · 0.41–0.89viral+78 (n)42 (n) Wen−4%1.04 · 0.22–4.92severe case3/563/58 Wen−21%1.21 · 1.05–1.39viral time59 (n)58 (n) Ader (RCT)−36%1.36 · 0.67–2.59death17/14713/149 Ader (RCT)26%0.74 · 0.20–2.54viral+4/865/81 SOLIDARITY .. (RCT)0%1.00 · 0.79–1.25death148/1,399146/1,372SOLIDARITY SOLIDARITY .. (RCT)−2%1.02 · 0.80–1.29ventilation126/1,287121/1,258SOLIDARITY Horby (RCT)−7%1.07 · 0.95–1.19death451/1,616932/3,424RECOVERY Horby (RCT)−3%1.03 · 0.91–1.17death374/1,616767/3,424RECOVERY Horby (RCT)−15%1.15 · 0.95–1.39ventilation152/1,556279/3,280RECOVERY Horby (RCT)−2%1.02 · 0.95–1.10no disch.1,616 (n)3,424 (n)RECOVERY Li (RCT)−100%2.00 · 0.48–8.41progression8/342/17ELACOI Li (RCT)−400%5.00 · 0.28–88.53no recov.3/270/9ELACOI Li (RCT)57%0.43 · 0.16–1.12no recov.5/215/9ELACOI Li (RCT)−250%3.50 · 0.48–25.72no recov.7/281/14ELACOI Li (RCT)3%0.97 · 0.71–1.31viral time34 (n)17 (n)ELACOI Reis (DB RCT)−86%1.86 · 0.17–20.38death2/2441/227TOGETHER Reis (DB RCT)−16%1.16 · 0.53–2.56hosp.14/24411/227TOGETHER Kokturk−118%2.18 · 0.38–9.30death7/5560/1,445 Di Castelnuovo6%0.94 · 0.78–1.13death1,148 (n)1,824 (n)CORIST Kaizer (DB RCT)−203%3.03 · 0.12–73.92death1/2200/226TREATNOW Kaizer (DB RCT)−20%1.20 · 0.41–3.51hosp.7/2206/226TREATNOW Kaizer (DB RCT)−3%1.03 · 0.71–1.49no recov.220 (n)226 (n)TREATNOW Değirmenci−136%2.36 · 0.29–19.11hosp.70 (n)55 (n) Labhardt (RCT)−630%7.30 · 0.97–54.80progression14/2091/109COPEP Labhardt (RCT)40%0.60 · 0.29–1.26symp. case35/20913/109COPEP

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¹ OT: comparison with other treatment

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← Lopinavir/
ritonavir
reduces riskLopinavir/
ritonavir
increases 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.