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Supplementary Data — Nitazoxanide for COVID-19: real-time meta analysis of 14 studies

@CovidAnalysis, July 2025, Version 28V28
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Rocco (RCT) -404% 5.04 [0.24-104] ICU 2/194 0/198 Improvement, RR [CI] Treatment Control Rocco (RCT) -2% 1.02 [0.30-3.47] hosp. 5/194 5/198 Rocco (RCT) -16% 1.16 [0.84-1.59] no recov. 59/194 52/198 Rocco (RCT) 12% 0.88 [0.80-0.96] viral+ 194 (n) 198 (n) Rocco (RCT) 14% 0.86 [0.77-0.96] viral+ 136/194 162/198 Cadegiani 88% 0.12 [0.01-2.52] death 0/357 2/137 Cadegiani 97% 0.03 [0.00-0.51] ventilation 0/357 9/137 Cadegiani 99% 0.01 [0.00-0.17] hosp. 0/357 27/137 Elalfy 87% 0.13 [0.06-0.27] viral+ 7/62 44/51 CT​2 Elalfy 58% 0.42 [0.31-0.56] viral+ 26/62 51/51 CT​2 Silva (SB RCT) 26% 0.74 [0.38-1.41] viral+ 23 (n) 13 (n) Silva (SB RCT) 38% 0.62 [0.36-1.05] viral+ 12/23 11/13 Rossignol (DB RCT) -206% 3.06 [0.13-74.6] death 1/184 0/195 Rossignol (DB RCT) 79% 0.21 [0.02-1.80] hosp. 1/184 5/195 Rossignol (DB RCT) 85% 0.15 [0.02-1.22] severe case 1/184 7/195 Rossignol (DB RCT) 84% 0.16 [0.02-1.29] severe case 1/112 7/126 Rossignol (DB RCT) -7% 1.07 [0.46-2.49] recov. time 184 (n) 195 (n) ANTICOV ANTICOV (RCT) -188% 2.88 [1.05-7.85] progression 15/462 5/443 OT​1 CT​2 Medhat (RCT) 56% 0.44 [0.22-0.88] viral+ 77 (n) 73 (n) Chandiwana (RCT) -13% 1.13 [0.23-5.46] progression 37 (n) 39 (n) CT​2 Chandiwana (RCT) -23% 1.23 [0.73-2.08] recov. time 37 (n) 39 (n) CT​2 Chandiwana (RCT) -67% 1.67 [0.85-3.23] viral+ 27/37 25/38 CT​2 Blum (DB RCT) 67% 0.33 [0.07-1.50] death 2/25 6/25 Blum (DB RCT) 62% 0.38 [0.11-1.25] ventilation 3/25 8/25 Blum (DB RCT) 56% 0.44 [0.22-0.89] hosp. time 25 (n) 25 (n) Blum (DB RCT) 90% 0.10 [0.01-0.85] viral+ 0/23 4/19 Calderón 68% 0.32 [0.04-2.49] death 1/17 5/27 OT​1 Calderón 87% 0.13 [0.01-2.33] ventilation 0/17 4/27 OT​1 Calderón 59% 0.41 [0.25-0.59] ICU 0/17 16/27 OT​1 Calderón 52% 0.48 [0.29-0.82] hosp. time 17 (n) 27 (n) OT​1 Fowotade (RCT) -11% 1.11 [0.61-2.03] no recov. 31 (n) 26 (n) CT​2 Fowotade (RCT) -87% 1.87 [0.88-3.98] no recov. 31 (n) 26 (n) CT​2 Fowotade (RCT) 5% 0.95 [0.34-2.64] viral load 31 (n) 26 (n) CT​2 Rocco (DB RCT) -5% 1.05 [0.30-3.50] death 6/202 5/203 Rocco (DB RCT) 31% 0.69 [0.40-1.17] ICU 20/202 30/203 Rocco (DB RCT) 40% 0.60 [0.35-1.02] oxygen 22/202 33/203 Rocco (DB RCT) 64% 0.36 [0.29-0.45] no improv. 202 (n) 203 (n) Rocco (DB RCT) 34% 0.66 [0.38-1.15] no improv. 202 (n) 203 (n) Rocco (DB RCT) 27% 0.73 [0.58-0.90] no disch. 202 (n) 203 (n) Rocco (DB RCT) 8% 0.92 [0.55-1.52] no disch. 202 (n) 203 (n) COVER Sokhela (RCT) 66% 0.34 [0.01-8.41] death 0/240 1/265 COVER Sokhela (RCT) 79% 0.21 [0.01-4.31] hosp. 0/240 2/265 COVER Sokhela (RCT) 17% 0.83 [0.50-1.40] symp. case 23/240 37/265 COVER Sokhela (RCT) -21% 1.21 [0.29-1.58] cases 23/240 37/265 Romark (DB RCT) 43% 0.57 [0.35-0.92] progression 13 (n) 13 (n) Romark (DB RCT) 50% 0.50 [0.22-1.13] no recov. 13 (n) 13 (n) Romark (DB RCT) 32% 0.68 [0.32-1.45] no recov. 13 (n) 13 (n) Romark (DB RCT) 28% 0.72 [0.29-1.78] no recov. 13 (n) 13 (n) Romark (DB RCT) 3% 0.97 [0.46-2.09] cases 13/629 13/613 Nitazoxanide COVID-19 outcomes c19early.org July 2025 1 OT: comparison with other treatment2 CT: study uses combined treatment Favors nitazoxanide Favors control
Figure S1. All outcomes.
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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.
Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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