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Safety and efficacy of probiotic supplements as adjunctive therapies in patients with COVID-19: A systematic review and meta-analysis

Zhu et al., PLOS ONE, doi:10.1371/journal.pone.0278356, PROSPERO CRD42022328256
Mar 2023  
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Probiotics for COVID-19
18th treatment shown to reduce risk in March 2021
*, now known with p = 0.0000013 from 26 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Systematic review and meta-analysis of 8 RCTs with 1,027 patients showing that early probiotic supplements in COVID-19 patients reduced risk of a composite clinical endpoint of escalation or mortality (ow certainty), diarrhea, and cough/dyspnea respiratory symptoms, and are associated with reduced adverse events.
The immune effects of probiotics are strain-specific.
2 meta analyses show significant improvements with probiotics for hospitalization Tian and recovery Neris Almeida Viana, Tian.
Currently there are 26 probiotics for COVID-19 studies, showing 61% lower mortality [37‑76%], 38% lower ventilation [-87‑79%], 21% lower ICU admission [-20‑48%], 13% lower hospitalization [5‑21%], and 40% fewer cases [10‑60%].
Zhu et al., 31 Mar 2023, peer-reviewed, 5 authors, trial PROSPERO CRD42022328256. Contact:
This PaperProbioticsAll
Safety and efficacy of probiotic supplements as adjunctive therapies in patients with COVID-19: A systematic review and meta-analysis
Julie Zhu, Tyler Pitre, Carmen Ching, Dena Zeraatkar, Steven Gruchy
PLOS ONE, doi:10.1371/journal.pone.0278356
Background and aims Oral probiotic supplementation may be a beneficial adjunctive therapy for patients with symptomatic COVID-19. However, its safety and efficacy are unclear. We aimed to investigate how probiotic supplementation impacts COVID-19 symptom trajectory and patient outcomes by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods RCTs randomizing patients with COVID-19 to probiotics were searched in PubMed Central, Embase, CINAHL, and Cochrane Library from inception to July 31, 2022. We performed a random-effects pairwise meta-analysis for all outcomes using the restricted maximum likelihood (REML) estimator. We used the GRADE approach to assess the certainty of the evidence.
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