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All Studies   Meta Analysis   Recent: 
0 0.5 1 1.5 2+ Mortality 76% Improvement Relative Risk Improvement 76% Case -75% c19bromhexine.com Tolouian et al. Bromhexine for COVID-19 RCT LATE Favors bromhexine Favors control
Tolouian, 100 patient bromhexine late treatment RCT: 76% lower mortality [p=0.43], 76% better improvement [p=0.43], and 75% more cases [p=0.02] https://c19p.org/tolouian
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Effect of bromhexine in hospitalized patients with COVID-19
Tolouian et al., J. Investig. Med., doi:10.1136/jim-2020-001747
15 Mar 2021    Source   PDF   Share   Tweet
Small RCT with 100 patients, 48 with bromhexine added to SOC, showing slower viral- conversion but lower mortality and greater clinical improvement with bromhexine (not statistically significant with few deaths and very high recovery). The very large difference between unadjusted and adjusted results is due to much higher risk for patients with renal disease and the much higher prevalence of renal disease in the bromhexine group.
The study also shows 90% of patients in the control group had BMI>=30 compared to 0% in the treatment group, suggesting a possible problem with randomization. Due to the imbalance between groups, results were adjusted for BMI>30, smoking, and renal disease.
11 patients were lost to followup in the treatment group compared to zero in the control group, perhaps in part due to faster recovery in the treatment group. 9 patients were excluded from the treatment group because they did not want to take bromhexine after discharge. Therefore up to 29% of treatment patients may have been excluded because they recovered quickly.
Bromhexine may be less effective for omicron due to the entry process moving towards TMPRSS2-independent fusion.
risk of death, 76.0% lower, OR 0.24, p = 0.43, treatment 48, control 52, Table 3, adjusted, RR approximated with OR.
risk of no improvement, 75.9% lower, OR 0.24, p = 0.43, treatment 48, control 52, Table 2, adjusted, RR approximated with OR.
risk of case, 74.5% higher, RR 1.75, p = 0.02, treatment 29 of 48 (60.4%), control 18 of 52 (34.6%), mid-recovery day 7.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Tolouian et al., 3/15/2021, Randomized Controlled Trial, Iran, Middle East, peer-reviewed, 7 authors.
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