• 98% of the 53 studies to date report positive effects (25 statistically significant in isolation).
• Random effects meta-analysis with pooled effects shows 81% and 85% improvement for early treatment and prophylaxis (RR 0.19 [0.10-0.39] and 0.15 [0.09-0.25]). Results are similar after exclusion based sensitivity analysis, with 83% and 87% improvement (RR 0.17 [0.11-0.25] and 0.13 [0.07-0.25]).
• 76% and 80% lower mortality is observed for all treatment delays and for early treatment (RR 0.24 [0.14-0.42] and 0.20 [0.06-0.60]).
• 96% of the 27 Randomized Controlled Trials (RCTs) report positive effects, with an estimated improvement of 74% and 83% for early treatment and prophylaxis (RR 0.26 [0.16-0.42] and 0.17 [0.05-0.61]).
• The probability that an ineffective treatment generated results as positive as the 53 studies to date is estimated to be 1 in 167 trillion (p
= 0.000000000000006). It is extremely unlikely that the observed results could have occurred by chance.
• Heterogeneity arises from many factors including treatment delay, patient population, the effect measured, variants, and treatment regimens. The consistency of positive results across a wide variety of cases is remarkable. Heterogeneity is low when looking at specific cases, for example early treatment mortality.
• All data to reproduce this paper and the sources are in the appendix. See [Bryant
] for other meta analyses, all with similar results confirming effectiveness.