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17 lopinavir/ritonavir COVID-19 controlled studies, 10 RCTs
Supplementary Data — Lopinavir/ritonavir for COVID-19: real-time meta analysis of 17 studies
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2+ Huang (RCT) -106% 2.06 [0.20-21.6] severe case 2/32 1/33 Improvement, RR [CI] Treatment Control Huang (RCT) -6% 1.06 [0.82-1.37] hosp. time 32 (n) 33 (n) Huang (RCT) 33% 0.67 [0.30-1.47] recov. time 16 (n) 20 (n) Huang (RCT) 18% 0.82 [0.66-1.02] no improv. 29 (n) 29 (n) Huang (RCT) -15% 1.15 [0.82-1.62] viral time 32 (n) 33 (n) FLARE Lowe (DB RCT) -200% 3.00 [0.12-72.2] hosp. 1/60 0/60 FLARE Lowe (DB RCT) 7% 0.93 [0.65-1.14] viral+ 39/54 38/52 Wong (PSW) -96% 1.96 [1.43-2.63] no disch. 49 (n) 884 (n) Wong (PSW) -96% 1.96 [1.43-2.63] no recov. 49 (n) 884 (n) Zhou -10% 1.10 [1.00-1.22] viral time 29 (n) 108 (n) LOTUS China Cao (RCT) 23% 0.77 [0.45-1.30] death 19/99 25/100 LOTUS China Cao (RCT) 29% 0.71 [0.44-1.15] no improv. 21/99 30/100 LOTUS China Cao (RCT) 22% 0.78 [0.62-0.97] no improv. 54/99 70/100 LOTUS China Cao (RCT) 4% 0.96 [0.91-1.02] no improv. 93/99 98/100 LOTUS China Cao (RCT) 4% 0.96 [0.64-1.45] viral+ 24/59 30/71 LOTUS China Cao (RCT) -0% 1.00 [0.67-1.50] viral+ 25/59 30/71 LOTUS China Cao (RCT) -5% 1.05 [0.71-1.54] viral+ 27/59 31/71 LOTUS China Cao (RCT) 2% 0.98 [0.70-1.36] viral+ 30/59 37/71 LOTUS China Cao (RCT) 2% 0.98 [0.77-1.25] viral+ 39/59 48/71 Yan 40% 0.60 [0.41-0.89] viral+ 78 (n) 42 (n) Wen -4% 1.04 [0.22-4.92] severe case 3/56 3/58 Wen -21% 1.21 [1.05-1.39] viral time 59 (n) 58 (n) Ader (RCT) -36% 1.36 [0.67-2.59] death 17/147 13/149 Ader (RCT) 26% 0.74 [0.20-2.54] viral+ 4/86 5/81 SOLIDARITY SOLIDARITY .. (RCT) 0% 1.00 [0.79-1.25] death 148/1,399 146/1,372 SOLIDARITY SOLIDARITY .. (RCT) -2% 1.02 [0.80-1.29] ventilation 126/1,287 121/1,258 RECOVERY Horby (RCT) -3% 1.03 [0.91-1.17] death 374/1,616 767/3,424 RECOVERY Horby (RCT) -15% 1.15 [0.95-1.39] ventilation 152/1,556 279/3,280 RECOVERY Horby (RCT) -2% 1.02 [0.95-1.10] no disch. 1,616 (n) 3,424 (n) ELACOI Li (RCT) -100% 2.00 [0.48-8.41] progression 8/34 2/17 ELACOI Li (RCT) -400% 5.00 [0.28-88.5] no recov. 3/27 0/9 ELACOI Li (RCT) 57% 0.43 [0.16-1.12] no recov. 5/21 5/9 ELACOI Li (RCT) -250% 3.50 [0.48-25.7] no recov. 7/28 1/14 ELACOI Li (RCT) 3% 0.97 [0.71-1.31] viral time 34 (n) 17 (n) TOGETHER Reis (DB RCT) -86% 1.86 [0.17-20.4] death 2/244 1/227 TOGETHER Reis (DB RCT) -16% 1.16 [0.53-2.56] hosp. 14/244 11/227 Kokturk -118% 2.18 [0.38-9.30] death 7/55 60/1,445 CORIST Di Castelnuovo 6% 0.94 [0.78-1.13] death 1,148 (n) 1,824 (n) TREATNOW Kaizer (DB RCT) -203% 3.03 [0.12-73.9] death 1/220 0/226 TREATNOW Kaizer (DB RCT) -20% 1.20 [0.41-3.51] hosp. 7/220 6/226 TREATNOW Kaizer (DB RCT) -3% 1.03 [0.71-1.49] no recov. 220 (n) 226 (n) Değirmenci -136% 2.36 [0.29-19.1] hosp. 70 (n) 55 (n) COPEP Labhardt (RCT) -630% 7.30 [0.97-54.8] progression 14/209 1/109 COPEP Labhardt (RCT) 40% 0.60 [0.29-1.26] symp. case 35/209 13/109 Lopinavir/ritonavir COVID-19 outcomes c19 early .org July 2025 Favors lopinavir/ritonavir 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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