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% 13
16,948
Improvement, Studies, Patients Relative Risk, 95% CI With exclusions 20% 11
1,691
Mortality 59% 4
539
Ventilation 33% 2
270
ICU admission 24% 3
469
Hospitalization 13% 2
360
Progression 88% 1
70
Recovery 14% 5
1,164
Cases 35% 4
15,415
Viral clearance 4% 3
641
RCTs 29% 5
741
Peer-reviewed 15% 11
1,428
Prophylaxis 35% 4
15,415
Early 34% 2
323
Late 16% 7
1,210
Probiotics for COVID-19 c19probiotics.com Dec 3, 2021
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)
Tau​2 ​ = 0.00; I​2 ​ = 0.0%
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)
CT​1 ​
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
Tau​2 ​ = 0.02; I​2 ​ = 44.9%
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
Tau​2 ​ = 0.17; I​2 ​ = 69.5%
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 studies c19probiotics.com Dec 3, 2021
​1 ​ CT: study uses combined treatment Tau​2 ​ = 0.02; I​2 ​ = 60.0%; Z = 3.23 Effect extraction pre-specified
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 Tau​2 ​ = 0.00; I​2 ​ = 0.0%
Early treatment 35%
0.65 [0.53-0.80]
69/147
105/146
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)
CT​1 ​
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
Tau​2 ​ = 0.02; I​2 ​ = 44.9%
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
Tau​2 ​ = 2.41; I​2 ​ = 76.4%
Prophylaxis 75%
0.25 [0.03-1.91]
1/93
28/95
75% improvement All studies 20%
0.80 [0.69-0.94]
114/798
217/893
20% improvement 11 probiotics COVID-19 studies after exclusions c19probiotics.com Dec 3, 2021
​1 ​ CT: study uses combined treatment Tau​2 ​ = 0.02; I​2 ​ = 65.0%; Z = 2.76 Effect extraction pre-specified
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
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
Tau​2 ​ = 0.00; I​2 ​ = 0.0%
Late treatment 59%
0.41 [0.23-0.72]
14/255
43/284
59% improvement All studies 59%
0.41 [0.23-0.72]
14/255
43/284
59% improvement 4 probiotics COVID-19 mortality results c19probiotics.com Dec 3, 2021
Tau​2 ​ = 0.00; I​2 ​ = 0.0%; Z = 3.10
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
Tau​2 ​ = 0.00; I​2 ​ = 0.0%
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 Dec 3, 2021
Tau​2 ​ = 0.00; I​2 ​ = 0.0%; Z = 0.66
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
Tau​2 ​ = 0.00; I​2 ​ = 0.0%
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 Dec 3, 2021
Tau​2 ​ = 0.00; I​2 ​ = 0.0%; Z = 1.10
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Shah (RCT) 11%
0.89 [0.76-1.05]
hosp. time
30 (n)
30 (n)
CT​1 ​
Improvement, RR [CI] Treatment Control Zhang 14%
0.86 [0.77-0.96]
hosp. time
150 (n)
150 (n)
Tau​2 ​ = 0.00; I​2 ​ = 0.0%
Late treatment 13%
0.87 [0.80-0.96]
0/180
0/180
13% improvement All studies 13%
0.87 [0.80-0.96]
0/180
0/180
13% improvement 2 probiotics COVID-19 hospitalization results c19probiotics.com Dec 3, 2021
​1 ​ CT: study uses combined treatment Tau​2 ​ = 0.00; I​2 ​ = 0.0%; Z = 2.92 Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
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
Tau​2 ​ = 0.00; I​2 ​ = 0.0%
Late treatment 59%
0.41 [0.23-0.72]
14/255
43/284
59% improvement All studies 59%
0.41 [0.23-0.72]
14/255
43/284
59% improvement 4 probiotics COVID-19 serious outcomes c19probiotics.com Dec 3, 2021
Tau​2 ​ = 0.00; I​2 ​ = 0.0%; Z = 3.10
Effect extraction pre-specified
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 Tau​2 ​ = 0.00; I​2 ​ = 0.0%
Early treatment 35%
0.65 [0.53-0.80]
69/147
105/146
35% improvement Shah (RCT) 11%
0.89 [0.75-1.06]
recov. time
30 (n)
30 (n)
CT​1 ​
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)
Tau​2 ​ = 0.00; I​2 ​ = 0.0%
Late treatment 9%
0.91 [0.84-0.98]
30/402
41/469
9% improvement All studies 14%
0.86 [0.75-0.99]
99/549
146/615
14% improvement 5 probiotics COVID-19 recovery results c19probiotics.com Dec 3, 2021
​1 ​ CT: study uses combined treatment Tau​2 ​ = 0.01; I​2 ​ = 64.9%; Z = 2.16 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]
Improvement, RR [CI] Treatment Control Di Pierro (RCT) 98%
0.02 [0.00-0.33]
0/64
24/64
Holt 30%
0.70 [0.45-1.10]
20/909
426/14,318
Ahanchian (DB RCT) 85%
0.15 [0.01-2.73]
0/29
3/31
Tau​2 ​ = 0.18; I​2 ​ = 70.2%
Prophylaxis 35%
0.65 [0.36-1.18]
20/1,002
453/14,413
35% improvement All studies 35%
0.65 [0.36-1.18]
20/1,002
453/14,413
35% improvement 4 probiotics COVID-19 case results c19probiotics.com Dec 3, 2021
Tau​2 ​ = 0.18; I​2 ​ = 70.2%; Z = 1.41
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 Tau​2 ​ = 0.00; I​2 ​ = 0.0%
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)
Tau​2 ​ = 0.11; I​2 ​ = 95.1%
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 Dec 3, 2021
Tau​2 ​ = 0.10; I​2 ​ = 90.7%; Z = 0.18
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 Tau​2 ​ = 0.00; I​2 ​ = 0.0%
Early treatment 35%
0.65 [0.53-0.80]
69/147
105/146
35% improvement Shah (RCT) 11%
0.89 [0.75-1.06]
recov. time
30 (n)
30 (n)
CT​1 ​
Improvement, RR [CI] Treatment Control Ivashkin (RCT) -2%
1.02 [0.26-3.97]
death
4/99
4/101
Tau​2 ​ = 0.00; I​2 ​ = 0.0%
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
Tau​2 ​ = 1.71; I​2 ​ = 51.7%
Prophylaxis 91%
0.09 [0.01-1.06]
1/93
28/95
91% improvement All studies 29%
0.71 [0.48-1.04]
74/369
137/372
29% improvement 5 probiotics COVID-19 Randomized Controlled Trials c19probiotics.com Dec 3, 2021
​1 ​ CT: study uses combined treatment Tau​2 ​ = 0.08; I​2 ​ = 69.4%; Z = 1.77 Effect extraction pre-specified
Favors probiotics
Favors control
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
Ivashkin (RCT) -2%
1.02 [0.26-3.97]
4/99
4/101
Improvement, RR [CI] Treatment Control Tau​2 ​ = 0.00; I​2 ​ = 0.0%
Late treatment -2%
1.02 [0.26-3.97]
4/99
4/101
-2% improvement All studies -2%
1.02 [0.26-3.97]
4/99
4/101
-2% improvement 1 probiotics COVID-19 RCT mortality result c19probiotics.com Dec 3, 2021
Tau​2 ​ = 0.00; I​2 ​ = 0.0%; Z = 0.03
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 Tau​2 ​ = 0.00; I​2 ​ = 0.0%
Early treatment 29%
0.71 [0.41-1.22]
0/15
0/15
29% 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)
CT​1 ​
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
Tau​2 ​ = 0.02; I​2 ​ = 44.9%
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
Tau​2 ​ = 2.41; I​2 ​ = 76.4%
Prophylaxis 75%
0.25 [0.03-1.91]
1/93
28/95
75% improvement All studies 15%
0.85 [0.73-0.98]
45/666
112/762
15% improvement 11 probiotics COVID-19 peer reviewed trials c19probiotics.com Dec 3, 2021
​1 ​ CT: study uses combined treatment Tau​2 ​ = 0.02; I​2 ​ = 51.7%; Z = 2.31 Effect extraction pre-specified
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)
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)
CT​1 ​
Shah (RCT) 11%
0.89 [0.76-1.05]
hosp. time
30 (n)
30 (n)
CT​1 ​
Shah (RCT) 83%
0.17 [0.04-0.68]
no recov.
2/30
12/30
CT​1 ​
Shah (RCT) 4%
0.96 [0.80-1.16]
no recov.
26/30
27/30
CT​1 ​
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
probiotics COVID-19 outcomes c19probiotics.com Dec 3, 2021
Favors probiotics
Favors control
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