Tenofovir: meta-analysis of COVID-19 studies

0 0.5 1 1.5+ All studies 31% 6 1K Improvement, Studies, Patients Relative Risk Mortality 7% 2 676 Ventilation 89% 1 60 ICU admission 25% 1 60 Hospitalization 24% 2 144 Recovery 9% 2 144 Cases 66% 1 456 Viral clearance 37% 1 60 RCTs 31% 6 1K RCT mortality 7% 2 676 Prophylaxis 66% 1 456 Early 24% 2 144 Late 22% 3 736 Tenofovir for COVID-19 c19early.org September 2025 FavorsTenofovir Favorscontrol
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ AR0-CORONA Parienti (DB RCT) -100% 2.00 [0.19-20.9] hosp. 2/30 1/30 CT​1​ Improvement, RR [CI] Treatment Control Arruda (DB RCT) 80% 0.20 [0.01-3.97] hosp. 0/43 2/41 Tau​2​ = 0.80, I​2​ = 29.8%, p = 0.83 Early treatment 24% 0.76 [0.08-7.19] 2/73 3/71 24% lower risk Gaitán-Dua.. (RCT) 32% 0.68 [0.39-1.20] death 160 (n) 161 (n) CT​1​ Improvement, RR [CI] Treatment Control PANCOVID Montejano (RCT) -76% 1.76 [0.52-5.91] death 177 (n) 178 (n) Yazdan Pouri (RCT) 89% 0.11 [0.01-1.98] ventilation 0/30 4/30 Tau​2​ = 0.33, I​2​ = 44.6%, p = 0.62 Late treatment 22% 0.78 [0.30-2.03] 0/367 4/369 22% lower risk EPICOS Polo (DB RCT) 66% 0.34 [0.00-2.06] symp. case 3/233 5/223 Improvement, RR [CI] Treatment Control CoviPrep Belloso (DB RCT) unknown, >4 years late 1,378 (total) Valderr.. (DB RCT) unknown, >4 years late 950 (est. total) Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.14 Prophylaxis 66% 0.34 [0.00-2.06] 3/233 5/223 66% lower risk All studies 31% 0.69 [0.37-1.29] 5/673 12/663 31% lower risk 6 Tenofovir COVID-19 studies (+2 unreported RCTs) c19early.org September 2025 Tau​2​ = 0.12, I​2​ = 18.6%, p = 0.25 Effect extraction pre-specified(most serious outcome) ​1​ CT: study uses combined treatment Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Gaitán-Dua.. (RCT) 32% 0.68 [0.39-1.20] 160 (n) 161 (n) CT​1​ Improvement, RR [CI] Treatment Control PANCOVID Montejano (RCT) -76% 1.76 [0.52-5.91] 177 (n) 178 (n) Tau​2​ = 0.21, I​2​ = 46.2%, p = 0.87 Late treatment 7% 0.93 [0.39-2.22] 337 (n) 339 (n) 7% lower risk All studies 7% 0.93 [0.39-2.22] 337 (n) 339 (n) 7% lower risk 2 Tenofovir COVID-19 mortality results c19early.org September 2025 Tau​2​ = 0.21, I​2​ = 46.2%, p = 0.87 ​1​ CT: study uses combined treatment Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Yazdan Pouri (RCT) 89% 0.11 [0.01-1.98] 0/30 4/30 Improvement, RR [CI] Treatment Control Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.13 Late treatment 89% 0.11 [0.01-1.98] 0/30 4/30 89% lower risk All studies 89% 0.11 [0.01-1.98] 0/30 4/30 89% lower risk 1 Tenofovir COVID-19 mechanical ventilation result c19early.org September 2025 Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.13 Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Yazdan Pouri (RCT) 25% 0.75 [0.18-3.07] 3/30 4/30 Improvement, RR [CI] Treatment Control Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.7 Late treatment 25% 0.75 [0.18-3.07] 3/30 4/30 25% lower risk All studies 25% 0.75 [0.18-3.07] 3/30 4/30 25% lower risk 1 Tenofovir COVID-19 ICU result c19early.org September 2025 Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.7 Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ AR0-CORONA Parienti (DB RCT) -100% 2.00 [0.19-20.9] hosp. 2/30 1/30 CT​1​ Improvement, RR [CI] Treatment Control Arruda (DB RCT) 80% 0.20 [0.01-3.97] hosp. 0/43 2/41 Tau​2​ = 0.80, I​2​ = 29.8%, p = 0.83 Early treatment 24% 0.76 [0.08-7.19] 2/73 3/71 24% lower risk All studies 24% 0.76 [0.08-7.19] 2/73 3/71 24% lower risk 2 Tenofovir COVID-19 hospitalization results c19early.org September 2025 Tau​2​ = 0.80, I​2​ = 29.8%, p = 0.83 ​1​ CT: study uses combined treatment Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ AR0-CORONA Parienti (DB RCT) -100% 2.00 [0.19-20.9] hosp. 2/30 1/30 CT​1​ Improvement, RR [CI] Treatment Control Arruda (DB RCT) 80% 0.20 [0.01-3.97] hosp. 0/43 2/41 Tau​2​ = 0.80, I​2​ = 29.8%, p = 0.83 Early treatment 24% 0.76 [0.08-7.19] 2/73 3/71 24% lower risk Gaitán-Dua.. (RCT) 32% 0.68 [0.39-1.20] death 160 (n) 161 (n) CT​1​ Improvement, RR [CI] Treatment Control PANCOVID Montejano (RCT) -76% 1.76 [0.52-5.91] death 177 (n) 178 (n) Yazdan Pouri (RCT) 89% 0.11 [0.01-1.98] ventilation 0/30 4/30 Tau​2​ = 0.33, I​2​ = 44.6%, p = 0.62 Late treatment 22% 0.78 [0.30-2.03] 0/367 4/369 22% lower risk All studies 21% 0.79 [0.38-1.62] 2/440 7/440 21% lower risk 5 Tenofovir COVID-19 serious outcomes c19early.org September 2025 Tau​2​ = 0.16, I​2​ = 20.7%, p = 0.53 Effect extraction pre-specified(most serious outcome) ​1​ CT: study uses combined treatment Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ AR0-CORONA Parienti (DB RCT) 11% 0.89 [0.72-1.10] no recov. 24/30 27/30 CT​1​ Improvement, RR [CI] Treatment Control Arruda (DB RCT) -9% 1.09 [0.61-1.94] no recov. 16/43 14/41 Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.37 Early treatment 9% 0.91 [0.75-1.11] 40/73 41/71 9% lower risk All studies 9% 0.91 [0.75-1.11] 40/73 41/71 9% lower risk 2 Tenofovir COVID-19 recovery results c19early.org September 2025 Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.37 ​1​ CT: study uses combined treatment Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ EPICOS Polo (DB RCT) 66% 0.34 [0.00-2.06] symp. case 3/233 5/223 Improvement, RR [CI] Treatment Control CoviPrep Belloso (DB RCT) unknown, >4 years late 1,378 (total) Valderr.. (DB RCT) unknown, >4 years late 950 (est. total) Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.14 Prophylaxis 66% 0.34 [0.00-2.06] 3/233 5/223 66% lower risk All studies 66% 0.34 [0.00-2.06] 3/233 5/223 66% lower risk 1 Tenofovir COVID-19 case result c19early.org September 2025 Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.14 Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ AR0-CORONA Parienti (DB RCT) 37% 0.63 [0.36-1.10] viral+ 30 (n) 30 (n) CT​1​ Improvement, RR [CI] Treatment Control Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.1 Early treatment 37% 0.63 [0.36-1.10] 30 (n) 30 (n) 37% lower risk All studies 37% 0.63 [0.36-1.10] 30 (n) 30 (n) 37% lower risk 1 Tenofovir COVID-19 viral clearance result c19early.org September 2025 Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.1 ​1​ CT: study uses combined treatment Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ AR0-CORONA Parienti (DB RCT) -100% 2.00 [0.19-20.9] hosp. 2/30 1/30 CT​1​ Improvement, RR [CI] Treatment Control Arruda (DB RCT) 80% 0.20 [0.01-3.97] hosp. 0/43 2/41 Tau​2​ = 0.80, I​2​ = 29.8%, p = 0.83 Early treatment 24% 0.76 [0.08-7.19] 2/73 3/71 24% lower risk Gaitán-Dua.. (RCT) 32% 0.68 [0.39-1.20] death 160 (n) 161 (n) CT​1​ Improvement, RR [CI] Treatment Control PANCOVID Montejano (RCT) -76% 1.76 [0.52-5.91] death 177 (n) 178 (n) Yazdan Pouri (RCT) 89% 0.11 [0.01-1.98] ventilation 0/30 4/30 Tau​2​ = 0.33, I​2​ = 44.6%, p = 0.62 Late treatment 22% 0.78 [0.30-2.03] 0/367 4/369 22% lower risk EPICOS Polo (DB RCT) 66% 0.34 [0.00-2.06] symp. case 3/233 5/223 Improvement, RR [CI] Treatment Control CoviPrep Belloso (DB RCT) unknown, >4 years late 1,378 (total) Valderr.. (DB RCT) unknown, >4 years late 950 (est. total) Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.14 Prophylaxis 66% 0.34 [0.00-2.06] 3/233 5/223 66% lower risk All studies 31% 0.69 [0.37-1.29] 5/673 12/663 31% lower risk 6 Tenofovir COVID-19 Randomized Controlled Trials c19early.org September 2025 Tau​2​ = 0.12, I​2​ = 18.6%, p = 0.25 Effect extraction pre-specified(most serious outcome) ​1​ CT: study uses combined treatment Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Gaitán-Dua.. (RCT) 32% 0.68 [0.39-1.20] 160 (n) 161 (n) CT​1​ Improvement, RR [CI] Treatment Control PANCOVID Montejano (RCT) -76% 1.76 [0.52-5.91] 177 (n) 178 (n) Tau​2​ = 0.21, I​2​ = 46.2%, p = 0.87 Late treatment 7% 0.93 [0.39-2.22] 337 (n) 339 (n) 7% lower risk All studies 7% 0.93 [0.39-2.22] 337 (n) 339 (n) 7% lower risk 2 Tenofovir COVID-19 RCT mortality results c19early.org September 2025 Tau​2​ = 0.21, I​2​ = 46.2%, p = 0.87 ​1​ CT: study uses combined treatment Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ AR0-CORONA Parienti (DB RCT) -100% 2.00 [0.19-20.9] hosp. 2/30 1/30 CT​1​ Improvement, RR [CI] Treatment Control Arruda (DB RCT) 80% 0.20 [0.01-3.97] hosp. 0/43 2/41 Tau​2​ = 0.80, I​2​ = 29.8%, p = 0.83 Early treatment 24% 0.76 [0.08-7.19] 2/73 3/71 24% lower risk Gaitán-Dua.. (RCT) 32% 0.68 [0.39-1.20] death 160 (n) 161 (n) CT​1​ Improvement, RR [CI] Treatment Control PANCOVID Montejano (RCT) -76% 1.76 [0.52-5.91] death 177 (n) 178 (n) Yazdan Pouri (RCT) 89% 0.11 [0.01-1.98] ventilation 0/30 4/30 Tau​2​ = 0.33, I​2​ = 44.6%, p = 0.62 Late treatment 22% 0.78 [0.30-2.03] 0/367 4/369 22% lower risk EPICOS Polo (DB RCT) 66% 0.34 [0.00-2.06] symp. case 3/233 5/223 Improvement, RR [CI] Treatment Control Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.14 Prophylaxis 66% 0.34 [0.00-2.06] 3/233 5/223 66% lower risk All studies 31% 0.69 [0.37-1.29] 5/673 12/663 31% lower risk 6 Tenofovir COVID-19 peer reviewed studies c19early.org September 2025 Tau​2​ = 0.12, I​2​ = 18.6%, p = 0.25 Effect extraction pre-specified(most serious outcome) ​1​ CT: study uses combined treatment Favors Tenofovir Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ AR0-CORONA Parienti (DB RCT) -100% 2.00 [0.19-20.9] hosp. 2/30 1/30 CT​1​ Improvement, RR [CI] Treatment Control AR0-CORONA Parienti (DB RCT) 11% 0.89 [0.72-1.10] no recov. 24/30 27/30 CT​1​ AR0-CORONA Parienti (DB RCT) 37% 0.63 [0.36-1.10] viral+ 30 (n) 30 (n) CT​1​ AR0-CORONA Parienti (DB RCT) 25% 0.75 [0.56-1.01] viral+ 30 (n) 30 (n) CT​1​ Arruda (DB RCT) 80% 0.20 [0.01-3.97] hosp. 0/43 2/41 Arruda (DB RCT) -9% 1.09 [0.61-1.94] no recov. 16/43 14/41 Gaitán-Dua.. (RCT) 32% 0.68 [0.39-1.20] death 160 (n) 161 (n) CT​1​ PANCOVID Montejano (RCT) -76% 1.76 [0.52-5.91] death 177 (n) 178 (n) PANCOVID Montejano (RCT) 6% 0.94 [0.66-1.35] progression 177 (n) 178 (n) Yazdan Pouri (RCT) 89% 0.11 [0.01-1.98] ventilation 0/30 4/30 Yazdan Pouri (RCT) 25% 0.75 [0.18-3.07] ICU 3/30 4/30 EPICOS Polo (DB RCT) 66% 0.34 [0.00-2.06] symp. case 3/233 5/223 EPICOS Polo (DB RCT) 19% 0.81 [0.44-1.49] cases 20/233 23/223 Tenofovir COVID-19 outcomes c19early.org September 2025 ​1​ CT: study uses combined treatment Favors Tenofovir Favors control