Outcomes in COVID-19 probiotics studies
Outcomes in probiotics studies. The immune effects of probiotics are strain-specific and studies use different strains.
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
All studies 21% 15
17,480
Improvement, Studies, Patients Relative Risk With exclusions 20% 13
2,223
Mortality 59% 5
889
Ventilation 33% 2
270
ICU admission 24% 3
469
Hospitalization 13% 3
710
Recovery 15% 7
1,687
Cases 33% 5
15,597
Viral clearance 4% 3
641
RCTs 29% 7
1,273
RCT mortality 14% 2
550
Peer-reviewed 21% 13
16,948
Prophylaxis 31% 5
15,597
Early 34% 3
673
Late 16% 7
1,210
Probiotics for COVID-19 c19probiotics.com Jan 26, 2022
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Haran (RCT) 67%
0.33 [0.01-8.16]
death
0/174
1/176
Improvement, RR [CI] Treatment Control Gutiérre.. (DB RCT) 35%
0.65 [0.53-0.80]
no recov.
69/147
105/146
Veterini 29%
0.71 [0.41-1.22]
viral time
15 (n)
15 (n)
Tau2 = 0.00, I2 = 0.0%, p < 0.0001
Early treatment 34%
0.66 [0.55-0.79]
69/336
106/337
34% improvement d'Ettorre 87%
0.13 [0.01-2.33]
death
0/28
4/42
Improvement, RR [CI] Treatment Control Ceccarelli 64%
0.36 [0.18-0.68]
death
10/88
34/112
Shah (RCT) 11%
0.89 [0.75-1.06]
recov. time
30 (n)
30 (n)
CT1
Li -12%
1.12 [0.74-1.69]
no disch.
30/123
41/188
Zhang 14%
0.86 [0.77-0.96]
hosp. time
150 (n)
150 (n)
Ceccarelli 70%
0.30 [0.01-7.02]
death
0/40
1/29
Ivashkin (RCT) -2%
1.02 [0.26-3.97]
death
4/99
4/101
Tau2 = 0.02, I2 = 44.9%, p = 0.08
Late treatment 16%
0.84 [0.69-1.02]
44/558
84/652
16% improvement Louca 8%
0.92 [0.85-0.99]
cases
Improvement, RR [CI] Treatment Control Di Pierro (RCT) 98%
0.02 [0.00-0.33]
cases
0/64
24/64
Holt 30%
0.70 [0.45-1.10]
cases
20/909
426/14,318
Ahanchian (DB RCT) 73%
0.27 [0.03-2.25]
symp. case
1/29
4/31
Wischme.. (DB RCT) 33%
0.67 [0.38-1.17]
m/s case
16/91
24/91
Tau2 = 0.11, I2 = 63.4%, p = 0.085
Prophylaxis 31%
0.69 [0.45-1.05]
37/1,093
478/14,504
31% improvement All studies 21%
0.79 [0.69-0.90]
150/1,987
668/15,493
21% improvement 15 probiotics COVID-19 studies c19probiotics.com Jan 26, 2022
Tau2 = 0.02, I2 = 55.1%, p = 0.00051
Effect extraction pre-specified (most serious outcome) 1 CT: study uses combined treatment Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Haran (RCT) 67%
0.33 [0.01-8.16]
death
0/174
1/176
Improvement, RR [CI] Treatment Control Gutiérre.. (DB RCT) 35%
0.65 [0.53-0.80]
no recov.
69/147
105/146
Tau2 = 0.00, I2 = 0.0%, p < 0.0001
Early treatment 35%
0.65 [0.53-0.79]
69/321
106/322
35% improvement d'Ettorre 87%
0.13 [0.01-2.33]
death
0/28
4/42
Improvement, RR [CI] Treatment Control Ceccarelli 64%
0.36 [0.18-0.68]
death
10/88
34/112
Shah (RCT) 11%
0.89 [0.75-1.06]
recov. time
30 (n)
30 (n)
CT1
Li -12%
1.12 [0.74-1.69]
no disch.
30/123
41/188
Zhang 14%
0.86 [0.77-0.96]
hosp. time
150 (n)
150 (n)
Ceccarelli 70%
0.30 [0.01-7.02]
death
0/40
1/29
Ivashkin (RCT) -2%
1.02 [0.26-3.97]
death
4/99
4/101
Tau2 = 0.02, I2 = 44.9%, p = 0.08
Late treatment 16%
0.84 [0.69-1.02]
44/558
84/652
16% improvement Louca 8%
0.92 [0.85-0.99]
cases
Improvement, RR [CI] Treatment Control Di Pierro (RCT) 98%
0.02 [0.00-0.33]
cases
0/64
24/64
Ahanchian (DB RCT) 73%
0.27 [0.03-2.25]
symp. case
1/29
4/31
Wischme.. (DB RCT) 33%
0.67 [0.38-1.17]
m/s case
16/91
24/91
Tau2 = 0.25, I2 = 68.8%, p = 0.14
Prophylaxis 40%
0.60 [0.30-1.18]
17/184
52/186
40% improvement All studies 20%
0.80 [0.69-0.92]
130/1,063
242/1,160
20% improvement 13 probiotics COVID-19 studies after exclusions c19probiotics.com Jan 26, 2022
Tau2 = 0.02, I2 = 59.7%, p = 0.0024
Effect extraction pre-specified (most serious outcome) 1 CT: study uses combined treatment Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Haran (RCT) 67%
0.33 [0.01-8.16]
0/174
1/176
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.51
Early treatment 67%
0.33 [0.01-8.16]
0/174
1/176
67% improvement d'Ettorre 87%
0.13 [0.01-2.33]
0/28
4/42
Improvement, RR [CI] Treatment Control Ceccarelli 64%
0.36 [0.18-0.68]
10/88
34/112
Ceccarelli 70%
0.30 [0.01-7.02]
0/40
1/29
Ivashkin (RCT) -2%
1.02 [0.26-3.97]
4/99
4/101
Tau2 = 0.00, I2 = 0.0%, p = 0.002
Late treatment 59%
0.41 [0.23-0.72]
14/255
43/284
59% improvement All studies 59%
0.41 [0.23-0.71]
14/429
44/460
59% improvement 5 probiotics COVID-19 mortality results c19probiotics.com Jan 26, 2022
Tau2 = 0.00, I2 = 0.0%, p = 0.0016
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
d'Ettorre 77%
0.23 [0.01-4.63]
0/28
2/42
Improvement, RR [CI] Treatment Control Ivashkin (RCT) 18%
0.82 [0.23-2.95]
4/99
5/101
Tau2 = 0.00, I2 = 0.0%, p = 0.52
Late treatment 33%
0.67 [0.21-2.19]
4/127
7/143
33% improvement All studies 33%
0.67 [0.21-2.19]
4/127
7/143
33% improvement 2 probiotics COVID-19 mechanical ventilation results c19probiotics.com Jan 26, 2022
Tau2 = 0.00, I2 = 0.0%, p = 0.52
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Ceccarelli 15%
0.85 [0.48-1.50]
16/88
24/112
Improvement, RR [CI] Treatment Control Ceccarelli 82%
0.18 [0.02-1.54]
1/40
4/29
Ivashkin (RCT) 27%
0.73 [0.24-2.22]
5/99
7/101
Tau2 = 0.00, I2 = 0.0%, p = 0.28
Late treatment 24%
0.76 [0.46-1.24]
22/227
35/242
24% improvement All studies 24%
0.76 [0.46-1.24]
22/227
35/242
24% improvement 3 probiotics COVID-19 ICU results c19probiotics.com Jan 26, 2022
Tau2 = 0.00, I2 = 0.0%, p = 0.28
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Haran (RCT) 60%
0.40 [0.08-2.06]
hosp.
2/174
5/176
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.28
Early treatment 60%
0.40 [0.08-2.06]
2/174
5/176
60% improvement Shah (RCT) 11%
0.89 [0.76-1.05]
hosp. time
30 (n)
30 (n)
CT1
Improvement, RR [CI] Treatment Control Zhang 14%
0.86 [0.77-0.96]
hosp. time
150 (n)
150 (n)
Tau2 = 0.00, I2 = 0.0%, p = 0.0035
Late treatment 13%
0.87 [0.80-0.96]
0/180
0/180
13% improvement All studies 13%
0.87 [0.80-0.95]
2/354
5/356
13% improvement 3 probiotics COVID-19 hospitalization results c19probiotics.com Jan 26, 2022
Tau2 = 0.00, I2 = 0.0%, p = 0.0029
1 CT: study uses combined treatment Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Haran (RCT) 67%
0.33 [0.01-8.16]
death
0/174
1/176
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.51
Early treatment 67%
0.33 [0.01-8.16]
0/174
1/176
67% improvement d'Ettorre 87%
0.13 [0.01-2.33]
death
0/28
4/42
Improvement, RR [CI] Treatment Control Ceccarelli 64%
0.36 [0.18-0.68]
death
10/88
34/112
Ceccarelli 70%
0.30 [0.01-7.02]
death
0/40
1/29
Ivashkin (RCT) -2%
1.02 [0.26-3.97]
death
4/99
4/101
Tau2 = 0.00, I2 = 0.0%, p = 0.002
Late treatment 59%
0.41 [0.23-0.72]
14/255
43/284
59% improvement Wischme.. (DB RCT) 33%
0.67 [0.38-1.17]
m/s case
16/91
24/91
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.16
Prophylaxis 33%
0.67 [0.38-1.17]
16/91
24/91
33% improvement All studies 48%
0.52 [0.35-0.77]
30/520
68/551
48% improvement 6 probiotics COVID-19 serious outcomes c19probiotics.com Jan 26, 2022
Tau2 = 0.00, I2 = 0.0%, p = 0.0012
Effect extraction pre-specified (most serious outcome) Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Haran (RCT) 20%
0.80 [0.61-1.04]
recov. time
169 (n)
172 (n)
Improvement, RR [CI] Treatment Control Gutiérre.. (DB RCT) 35%
0.65 [0.53-0.80]
no recov.
69/147
105/146
Tau2 = 0.01, I2 = 26.7%, p = 0.0004
Early treatment 29%
0.71 [0.58-0.86]
69/316
105/318
29% improvement Shah (RCT) 11%
0.89 [0.75-1.06]
recov. time
30 (n)
30 (n)
CT1
Improvement, RR [CI] Treatment Control Li -12%
1.12 [0.74-1.69]
no disch.
30/123
41/188
Zhang 14%
0.86 [0.75-0.98]
recov. time
150 (n)
150 (n)
Ivashkin (RCT) 5%
0.95 [0.84-1.08]
recov. time
99 (n)
101 (n)
Tau2 = 0.00, I2 = 0.0%, p = 0.019
Late treatment 9%
0.91 [0.84-0.98]
30/402
41/469
9% improvement Wischme.. (DB RCT) 27%
0.73 [0.37-1.45]
recov. time
91 (n)
91 (n)
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.37
Prophylaxis 27%
0.73 [0.37-1.45]
0/91
0/91
27% improvement All studies 15%
0.85 [0.76-0.95]
99/809
146/878
15% improvement 7 probiotics COVID-19 recovery results c19probiotics.com Jan 26, 2022
Tau2 = 0.01, I2 = 49.9%, p = 0.0047
1 CT: study uses combined treatment Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Louca 8%
0.92 [0.85-0.99]
cases
Improvement, RR [CI] Treatment Control Di Pierro (RCT) 98%
0.02 [0.00-0.33]
cases
0/64
24/64
Holt 30%
0.70 [0.45-1.10]
cases
20/909
426/14,318
Ahanchian (DB RCT) 73%
0.27 [0.03-2.25]
symp. case
1/29
4/31
Wischme.. (DB RCT) 38%
0.62 [0.41-0.93]
symp. case
24/91
39/91
Tau2 = 0.11, I2 = 69.2%, p = 0.059
Prophylaxis 33%
0.67 [0.45-1.02]
45/1,093
493/14,504
33% improvement All studies 33%
0.67 [0.45-1.02]
45/1,093
493/14,504
33% improvement 5 probiotics COVID-19 case results c19probiotics.com Jan 26, 2022
Tau2 = 0.11, I2 = 69.2%, p = 0.059
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Veterini 29%
0.71 [0.41-1.22]
viral time
15 (n)
15 (n)
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.22
Early treatment 29%
0.71 [0.41-1.22]
0/15
0/15
29% improvement Li -35%
1.35 [1.13-1.62]
viral time
123 (n)
188 (n)
Improvement, RR [CI] Treatment Control Zhang 17%
0.83 [0.75-0.93]
viral time
150 (n)
150 (n)
Tau2 = 0.11, I2 = 95.1%, p = 0.83
Late treatment -6%
1.06 [0.66-1.70]
0/273
0/338
-6% improvement All studies 4%
0.96 [0.65-1.43]
0/288
0/353
4% improvement 3 probiotics COVID-19 viral clearance results c19probiotics.com Jan 26, 2022
Tau2 = 0.10, I2 = 90.7%, p = 0.86
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Haran (RCT) 67%
0.33 [0.01-8.16]
death
0/174
1/176
Improvement, RR [CI] Treatment Control Gutiérre.. (DB RCT) 35%
0.65 [0.53-0.80]
no recov.
69/147
105/146
Tau2 = 0.00, I2 = 0.0%, p < 0.0001
Early treatment 35%
0.65 [0.53-0.79]
69/321
106/322
35% improvement Shah (RCT) 11%
0.89 [0.75-1.06]
recov. time
30 (n)
30 (n)
CT1
Improvement, RR [CI] Treatment Control Ivashkin (RCT) -2%
1.02 [0.26-3.97]
death
4/99
4/101
Tau2 = 0.00, I2 = 0.0%, p = 0.2
Late treatment 11%
0.89 [0.75-1.06]
4/129
4/131
11% improvement Di Pierro (RCT) 98%
0.02 [0.00-0.33]
cases
0/64
24/64
Improvement, RR [CI] Treatment Control Ahanchian (DB RCT) 73%
0.27 [0.03-2.25]
symp. case
1/29
4/31
Wischme.. (DB RCT) 33%
0.67 [0.38-1.17]
m/s case
16/91
24/91
Tau2 = 1.73, I2 = 68.2%, p = 0.11
Prophylaxis 77%
0.23 [0.04-1.41]
17/184
52/186
77% improvement All studies 29%
0.71 [0.52-0.96]
90/634
162/639
29% improvement 7 probiotics COVID-19 Randomized Controlled Trials c19probiotics.com Jan 26, 2022
Tau2 = 0.06, I2 = 55.9%, p = 0.025
Effect extraction pre-specified (most serious outcome) 1 CT: study uses combined treatment Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Haran (RCT) 67%
0.33 [0.01-8.16]
0/174
1/176
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.51
Early treatment 67%
0.33 [0.01-8.16]
0/174
1/176
67% improvement Ivashkin (RCT) -2%
1.02 [0.26-3.97]
4/99
4/101
Improvement, RR [CI] Treatment Control Tau2 = 0.00, I2 = 0.0%, p = 0.98
Late treatment -2%
1.02 [0.26-3.97]
4/99
4/101
-2% improvement All studies 14%
0.86 [0.25-3.00]
4/273
5/277
14% improvement 2 probiotics COVID-19 RCT mortality results c19probiotics.com Jan 26, 2022
Tau2 = 0.00, I2 = 0.0%, p = 0.82
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Gutiérre.. (DB RCT) 35%
0.65 [0.53-0.80]
no recov.
69/147
105/146
Improvement, RR [CI] Treatment Control Veterini 29%
0.71 [0.41-1.22]
viral time
15 (n)
15 (n)
Tau2 = 0.00, I2 = 0.0%, p < 0.0001
Early treatment 34%
0.66 [0.55-0.80]
69/162
105/161
34% improvement d'Ettorre 87%
0.13 [0.01-2.33]
death
0/28
4/42
Improvement, RR [CI] Treatment Control Ceccarelli 64%
0.36 [0.18-0.68]
death
10/88
34/112
Shah (RCT) 11%
0.89 [0.75-1.06]
recov. time
30 (n)
30 (n)
CT1
Li -12%
1.12 [0.74-1.69]
no disch.
30/123
41/188
Zhang 14%
0.86 [0.77-0.96]
hosp. time
150 (n)
150 (n)
Ceccarelli 70%
0.30 [0.01-7.02]
death
0/40
1/29
Ivashkin (RCT) -2%
1.02 [0.26-3.97]
death
4/99
4/101
Tau2 = 0.02, I2 = 44.9%, p = 0.08
Late treatment 16%
0.84 [0.69-1.02]
44/558
84/652
16% improvement Louca 8%
0.92 [0.85-0.99]
cases
Improvement, RR [CI] Treatment Control Di Pierro (RCT) 98%
0.02 [0.00-0.33]
cases
0/64
24/64
Holt 30%
0.70 [0.45-1.10]
cases
20/909
426/14,318
Ahanchian (DB RCT) 73%
0.27 [0.03-2.25]
symp. case
1/29
4/31
Tau2 = 0.17, I2 = 69.5%, p = 0.15
Prophylaxis 35%
0.65 [0.37-1.16]
21/1,002
454/14,413
35% improvement All studies 21%
0.79 [0.69-0.91]
134/1,722
643/15,226
21% improvement 13 probiotics COVID-19 peer reviewed trials c19probiotics.com Jan 26, 2022
Tau2 = 0.02, I2 = 60.0%, p = 0.0013
Effect extraction pre-specified (most serious outcome) 1 CT: study uses combined treatment Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Haran (RCT) 67%
0.33 [0.01-8.16]
death
0/174
1/176
Improvement, RR [CI] Treatment Control Haran (RCT) 60%
0.40 [0.08-2.06]
hosp.
2/174
5/176
Haran (RCT) 50%
0.50 [0.21-1.20]
hosp./ER/UC
7/169
15/181
Haran (RCT) 20%
0.80 [0.61-1.04]
recov. time
169 (n)
172 (n)
Gutiérre.. (DB RCT) 35%
0.65 [0.53-0.80]
no recov.
69/147
105/146
Veterini 29%
0.71 [0.41-1.22]
viral time
15 (n)
15 (n)
d'Ettorre 87%
0.13 [0.01-2.33]
death
0/28
4/42
d'Ettorre 77%
0.23 [0.01-4.63]
ventilation
0/28
2/42
d'Ettorre 88%
0.12 [0.02-0.61]
progression
28 (n)
42 (n)
Ceccarelli 64%
0.36 [0.18-0.68]
death
10/88
34/112
Ceccarelli 15%
0.85 [0.48-1.50]
ICU
16/88
24/112
Shah (RCT) 11%
0.89 [0.75-1.06]
recov. time
30 (n)
30 (n)
CT1
Shah (RCT) 11%
0.89 [0.76-1.05]
hosp. time
30 (n)
30 (n)
CT1
Shah (RCT) 83%
0.17 [0.04-0.68]
no recov.
2/30
12/30
CT1
Shah (RCT) 4%
0.96 [0.80-1.16]
no recov.
26/30
27/30
CT1
Li -12%
1.12 [0.74-1.69]
no disch.
30/123
41/188
Li -60%
1.60 [1.21-2.11]
no disch.
123 (n)
188 (n)
Li -35%
1.35 [1.13-1.62]
viral time
123 (n)
188 (n)
Zhang 14%
0.86 [0.77-0.96]
hosp. time
150 (n)
150 (n)
Zhang 14%
0.86 [0.75-0.98]
recov. time
150 (n)
150 (n)
Zhang 17%
0.83 [0.75-0.93]
viral time
150 (n)
150 (n)
Ceccarelli 70%
0.30 [0.01-7.02]
death
0/40
1/29
Ceccarelli 82%
0.18 [0.02-1.54]
ICU
1/40
4/29
Ivashkin (RCT) -2%
1.02 [0.26-3.97]
death
4/99
4/101
Ivashkin (RCT) 18%
0.82 [0.23-2.95]
ventilation
4/99
5/101
Ivashkin (RCT) 27%
0.73 [0.24-2.22]
ICU
5/99
7/101
Ivashkin (RCT) 5%
0.95 [0.84-1.08]
recov. time
99 (n)
101 (n)
Louca 8%
0.92 [0.85-0.99]
cases
Di Pierro (RCT) 98%
0.02 [0.00-0.33]
cases
0/64
24/64
Holt 30%
0.70 [0.45-1.10]
cases
20/909
426/14,318
Ahanchian (DB RCT) 73%
0.27 [0.03-2.25]
symp. case
1/29
4/31
Ahanchian (DB RCT) 85%
0.15 [0.01-2.73]
cases
0/29
3/31
Wischme.. (DB RCT) 33%
0.67 [0.38-1.17]
m/s case
16/91
24/91
Wischme.. (DB RCT) 38%
0.62 [0.41-0.93]
symp. case
24/91
39/91
Wischme.. (DB RCT) 27%
0.73 [0.37-1.45]
recov. time
91 (n)
91 (n)
Wischme.. (DB RCT) 43%
0.57 [0.25-1.30]
cases
8/91
14/91
probiotics COVID-19 outcomes c19probiotics.com Jan 26, 2022
1 CT: study uses combined treatment Favors probiotics
Favors control
Please send us
corrections, updates, or comments. Vaccines and treatments are both
valuable and complementary. All practical, effective, and safe means
should be used. Elimination of COVID-19 is a race against viral evolution. No
treatment, vaccine, or intervention is 100% available and effective for all
current and future variants. Denying the efficacy of any method increases
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