Ramipril: meta-analysis of COVID-19 studies

0 0.5 1 1.5+ All studies -144% 1 114 Improvement, Studies, Patients Relative Risk Mortality -144% 1 114 Ventilation -289% 1 114 ICU admission -289% 1 114 RCTs -144% 1 114 Late -144% 1 114 Ramipril for COVID-19 c19early.org December 2025 Favorsramipril Favorscontrol
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (DB RCT) -144% 2.44 [0.10-58.5] death 1/79 0/35 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Late treatment -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk All studies -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk 1 ramipril COVID-19 study c19early.org December 2025 Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Effect extraction pre-specified(most serious outcome) Favors ramipril Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (DB RCT) -144% 2.44 [0.10-58.5] 1/79 0/35 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Late treatment -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk All studies -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk 1 ramipril COVID-19 mortality result c19early.org December 2025 Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Favors ramipril Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (DB RCT) -289% 3.89 [0.19-78.9] 2/79 0/35 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.38 Late treatment -289% 3.89 [0.19-78.9] 2/79 0/35 289% higher risk All studies -289% 3.89 [0.19-78.9] 2/79 0/35 289% higher risk 1 ramipril COVID-19 mechanical ventilation result c19early.org December 2025 Tau​2 = 0.00, I​2 = 0.0%, p = 0.38 Favors ramipril Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (DB RCT) -289% 3.89 [0.19-78.9] 2/79 0/35 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.38 Late treatment -289% 3.89 [0.19-78.9] 2/79 0/35 289% higher risk All studies -289% 3.89 [0.19-78.9] 2/79 0/35 289% higher risk 1 ramipril COVID-19 ICU result c19early.org December 2025 Tau​2 = 0.00, I​2 = 0.0%, p = 0.38 Favors ramipril Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (DB RCT) -144% 2.44 [0.10-58.5] no disch. 1/79 0/35 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Late treatment -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk All studies -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk 1 ramipril COVID-19 recovery result c19early.org December 2025 Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Favors ramipril Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (DB RCT) -144% 2.44 [0.10-58.5] death 1/79 0/35 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Late treatment -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk All studies -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk 1 ramipril COVID-19 Randomized Controlled Trial c19early.org December 2025 Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Effect extraction pre-specified(most serious outcome) Favors ramipril Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (DB RCT) -144% 2.44 [0.10-58.5] 1/79 0/35 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Late treatment -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk All studies -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk 1 ramipril COVID-19 RCT mortality result c19early.org December 2025 Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Favors ramipril Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (DB RCT) -144% 2.44 [0.10-58.5] death 1/79 0/35 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Late treatment -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk All studies -144% 2.44 [0.10-58.5] 1/79 0/35 144% higher risk 1 ramipril COVID-19 peer reviewed studies c19early.org December 2025 Tau​2 = 0.00, I​2 = 0.0%, p = 0.59 Effect extraction pre-specified(most serious outcome) Favors ramipril Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huang (DB RCT) -144% 2.44 [0.10-58.5] death 1/79 0/35 Improvement, RR [CI] Treatment Control Huang (DB RCT) -289% 3.89 [0.19-78.9] ventilation 2/79 0/35 Huang (DB RCT) -289% 3.89 [0.19-78.9] ICU 2/79 0/35 Huang (DB RCT) -144% 2.44 [0.10-58.5] no disch. 1/79 0/35 Ramipril COVID-19 outcomes c19early.org December 2025 Favors ramipril Favors control