# Cod liver oil × PCR-confirmed SARS-CoV-2 — Null coprimary outcome, testing and applicability gaps

Verdict 2972 · Evidence Check

Stored-material review date: Not recorded  
Original evidence cut-off: 2026-08-26  
Review-criteria version: 1.0  
Public page/material preparation date: 2026-10-14

Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect.

## Assessment scope

- Population: 34,601 Norwegian adults not taking vitamin D supplements daily, 17,278/17,323; baseline vitamin D/age and PCR observation/testing-denominator details unverified
- Ingredient, formulation and route: Orkla Health AS Möller's Tran combination cod-liver-oil study product
- Dose: Original study exposure: 5 mL/day, vitamin D 10 µg, about 1 g n-3 and a median 164 days; no new cumulative amount or product/vitamin intake guidance
- Comparator: Flavour-matched corn-oil placebo, 17,323 adults; actual composition/concomitant exposures unverified
- Measured outcome: Selected PCR-confirmed SARS-CoV-2 infection; separated from the other coprimary serious-outcome/negative-test/self-reported-ARI endpoints
- Duration: About six winter months, a median 164 days; original registration posted 2020-10-30/start 2020-11-10 descriptions; individual observation/period details unverified
- Questions outside this scope: Repurposing effects during use as continued protection after stopping or using PCR/other coprimary outcomes as effects on each other; Adding the same reports/people/arms/periods/events/endpoints, citations, related sheets as new independent trials or participants; Mixing randomized/ITT denominators, endpoint-specific observation/testing, person/time/event denominators and other cohorts; New effects/CI/invented quantities, equivalence/zero effects, reassessment/grades or independence certification from original numbers; Cod-liver-oil/vitamin/product-use, infection-prevention/COVID-19 management or treatment-replacement instructions

## Checklist items

### N01 · Which existing PCR-infection claim is being presented?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The selected claim is reduced PCR-confirmed SARS-CoV-2 infection. Its original subclaim grade is D and its note records a null result, RR 1.00 (CI 0.82–1.22). Missing subclaim score/status/axes are distinguished from the parent D with 34 points and its axes.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: PCR-infection definition, population/exposure, prespecified endpoint/estimand, period/denominator and existing question-boundary review. Parent values are not used to fill missing subclaim fields.
- Required materials and conditions: Selected wording, subclaim grade and parent context
- Materials to obtain first: PCR-infection definition, population/exposure, prespecified endpoint/estimand, period/denominator and existing question-boundary review. Parent values are not used to fill missing subclaim fields.
- Further research: Materials needed: PCR-infection definition, population/exposure, prespecified endpoint/estimand, period/denominator and existing question-boundary review. Parent values are not used to fill missing subclaim fields. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for selected wording, subclaim grade and parent context together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect selected wording, subclaim grade and parent context with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N02 · Which adults were studied during winter?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The original population was 34,601 Norwegian adults not taking vitamin D supplements daily. Exact age range, baseline vitamin D status/deficiency, conditions, testing/vaccination and concomitant exposures are not established from the summary.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Eligibility/exclusions, baseline vitamin D/health, vaccination/infection history and actual exposure/behaviour/medication data. Do not extend to deficient patients or populations in every period.
- Required materials and conditions: Norwegian adults not taking vitamin D daily
- Materials to obtain first: Eligibility/exclusions, baseline vitamin D/health, vaccination/infection history and actual exposure/behaviour/medication data. Do not extend to deficient patients or populations in every period.
- Further research: Materials needed: Eligibility/exclusions, baseline vitamin D/health, vaccination/infection history and actual exposure/behaviour/medication data. Do not extend to deficient patients or populations in every period. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for norwegian adults not taking vitamin D daily together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect norwegian adults not taking vitamin D daily with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N03 · What is known about winter, the period and duration?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The original materials record about six winter months, a median 164 days of use, registration posted 2020-10-30 and start 2020-11-10. Actual end/individual follow-up and variant/vaccination/testing-policy details remain unverified. No new end date or observation time is calculated.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Actual recruitment/exposure/follow-up dates, season/variant/vaccination/testing policies and discontinuation/loss data. Do not turn this into current COVID-19 or other-period prevention guidance.
- Required materials and conditions: About six winter months, a median 164 days and the stated start
- Materials to obtain first: Actual recruitment/exposure/follow-up dates, season/variant/vaccination/testing policies and discontinuation/loss data. Do not turn this into current COVID-19 or other-period prevention guidance.
- Further research: Materials needed: Actual recruitment/exposure/follow-up dates, season/variant/vaccination/testing policies and discontinuation/loss data. Do not turn this into current COVID-19 or other-period prevention guidance. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for about six winter months, a median 164 days and the stated start together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect about six winter months, a median 164 days and the stated start with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N04 · Was the study product vitamin D or omega-3 alone?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The original study used cod liver oil 5 mL/day, supplying vitamin D 10 µg and about 1 g of n-3 fatty acids. This was a combination product; it does not extend to deficiency treatment, high-dose vitamin D or omega-3 alone. No new total ingredient amounts or other vitamin values are created.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Exact product/composition/manufacture, actual intake/adherence and concomitant supplement source data. No cod-liver-oil/vitamin/product-use or treatment-replacement instructions.
- Required materials and conditions: Möller's Tran combination cod liver oil
- Materials to obtain first: Exact product/composition/manufacture, actual intake/adherence and concomitant supplement source data. No cod-liver-oil/vitamin/product-use or treatment-replacement instructions.
- Further research: Materials needed: Exact product/composition/manufacture, actual intake/adherence and concomitant supplement source data. No cod-liver-oil/vitamin/product-use or treatment-replacement instructions. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for möller's Tran combination cod liver oil together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect möller's Tran combination cod liver oil with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N05 · Is the flavour-matched corn-oil comparator preserved?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The original 34,601 adults were assigned to cod liver oil, 17,278, or flavour-matched corn-oil placebo, 17,323. Actual placebo composition, sensory features/masking, other supplements/diet and concomitant exposures remain unverified. Do not substitute no intervention or a different oil product.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Actual active/placebo products, contact/sensory features, concomitant intake, adherence and exposure data. Do not generalize this particular comparison to all cod-liver-oil/vitamin effects.
- Required materials and conditions: 17,278 assigned cod liver oil versus 17,323 assigned corn oil
- Materials to obtain first: Actual active/placebo products, contact/sensory features, concomitant intake, adherence and exposure data. Do not generalize this particular comparison to all cod-liver-oil/vitamin effects.
- Further research: Materials needed: Actual active/placebo products, contact/sensory features, concomitant intake, adherence and exposure data. Do not generalize this particular comparison to all cod-liver-oil/vitamin effects. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for 17,278 assigned cod liver oil versus 17,323 assigned corn oil together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect 17,278 assigned cod liver oil versus 17,323 assigned corn oil with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N06 · Are a median 164 days and complete observation/adherence distinguished?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The original duration of use was a median 164 days. This does not mean identical duration/exposure or complete adherence for everyone. Distributions, discontinuation/withdrawal and observation by time remain unverified; cumulative amounts/person-time are not calculated.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Actual exposure/adherence, discontinuation, follow-up distributions by arm and endpoint-specific observation periods/missing data. No product-use or COVID-19 management guidance.
- Required materials and conditions: Duration distribution and actual exposure/discontinuation
- Materials to obtain first: Actual exposure/adherence, discontinuation, follow-up distributions by arm and endpoint-specific observation periods/missing data. No product-use or COVID-19 management guidance.
- Further research: Materials needed: Actual exposure/adherence, discontinuation, follow-up distributions by arm and endpoint-specific observation periods/missing data. No product-use or COVID-19 management guidance. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for duration distribution and actual exposure/discontinuation together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect duration distribution and actual exposure/discontinuation with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N07 · What were the original PCR-infection events and effect?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Selected PCR infection was null: 227 versus 228, RR 1.00 (adjusted 95% CI 0.82–1.22). No new proportions, risk differences, NNT or P values are calculated from randomized arm sizes; no new verdict of exactly zero effect, equivalence or exclusion of every benefit is made.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Original PCR events/denominators, estimand/test, adjusted interval/plan and clinical threshold. No new calculations or invented examples beyond the original effect/CI.
- Required materials and conditions: 227 versus 228, RR 1.00 and adjusted 95% CI
- Materials to obtain first: Original PCR events/denominators, estimand/test, adjusted interval/plan and clinical threshold. No new calculations or invented examples beyond the original effect/CI.
- Further research: Materials needed: Original PCR events/denominators, estimand/test, adjusted interval/plan and clinical threshold. No new calculations or invented examples beyond the original effect/CI. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for 227 versus 228, RR 1.00 and adjusted 95% CI together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect 227 versus 228, RR 1.00 and adjusted 95% CI with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N08 · What is the exact event unit for a positive PCR result?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The original endpoint was PCR-confirmed SARS-CoV-2 infection with 227/228 events. Positive tests, people with a first infection, repeated infections/tests, specimens and confirmation rules remain unverified. Tests/repeated time points are not added as new participants/events.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Original test/event definitions, person identifiers, first/repeated positives, baseline infection/diagnosis and aggregation/timing data. No new unique-infection or test totals.
- Required materials and conditions: Confirmed infection, people/tests and repeated events
- Materials to obtain first: Original test/event definitions, person identifiers, first/repeated positives, baseline infection/diagnosis and aggregation/timing data. No new unique-infection or test totals.
- Further research: Materials needed: Original test/event definitions, person identifiers, first/repeated positives, baseline infection/diagnosis and aggregation/timing data. No new unique-infection or test totals. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for confirmed infection, people/tests and repeated events together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect confirmed infection, people/tests and repeated events with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N09 · How do testing selection and opportunities affect the comparison?

Verification status: Unverified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The original materials record PCR-confirmed infection and negative SARS-CoV-2 tests as separate coprimary outcomes. Testing selection, frequency, access, omissions, asymptomatic testing and opportunities/behaviour by arm are not established from the summary.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Testing/selection criteria, policies/access, opportunities in both arms, missingness/confirmation and prespecified analysis/sensitivity data. Do not repurpose negative tests as absence of infection or a prevention effect.
- Required materials and conditions: Detailed gaps in access, symptoms/screening and missed testing
- Materials to obtain first: Testing/selection criteria, policies/access, opportunities in both arms, missingness/confirmation and prespecified analysis/sensitivity data. Do not repurpose negative tests as absence of infection or a prevention effect.
- Further research: Materials needed: Testing/selection criteria, policies/access, opportunities in both arms, missingness/confirmation and prespecified analysis/sensitivity data. Do not repurpose negative tests as absence of infection or a prevention effect. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for detailed gaps in access, symptoms/screening and missed testing together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect detailed gaps in access, symptoms/screening and missed testing with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N10 · Are ITT for 34,601 adults and endpoint-specific observation denominators separated?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: All original 34,601 randomized adults were included in ITT; missingness in key variables was 0.05%. This does not establish identical denominators for all PCR observations/tests/analyses or zero missingness in every variable. Actual missing/observed/censored counts remain unverified.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Original participant flow by arm, PCR observation/analysis/testing denominators, missing variables/handling and duration/withdrawal/censoring data. No new missing counts/rates or confirmation that everyone completed follow-up.
- Required materials and conditions: All randomized adults in ITT and the scope of 0.05% missingness
- Materials to obtain first: Original participant flow by arm, PCR observation/analysis/testing denominators, missing variables/handling and duration/withdrawal/censoring data. No new missing counts/rates or confirmation that everyone completed follow-up.
- Further research: Materials needed: Original participant flow by arm, PCR observation/analysis/testing denominators, missing variables/handling and duration/withdrawal/censoring data. No new missing counts/rates or confirmation that everyone completed follow-up. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for all randomized adults in ITT and the scope of 0.05% missingness together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect all randomized adults in ITT and the scope of 0.05% missingness with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N11 · Are the four coprimary outcomes and multiplicity plan preserved?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The original materials record four prespecified coprimary outcomes—PCR infection, serious COVID-19, negative tests and self-reported ARI—and fallback multiplicity control. Plan details, allocation and decision rules were not confirmed through new registration/SAP reading.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Exact endpoints, fallback procedure/intervals/significance levels, amendments/hierarchy in registration/protocol/SAP and original results. No new adjusted P values, calculations or grades.
- Required materials and conditions: Prespecified fallback, adjusted intervals and null outcomes
- Materials to obtain first: Exact endpoints, fallback procedure/intervals/significance levels, amendments/hierarchy in registration/protocol/SAP and original results. No new adjusted P values, calculations or grades.
- Further research: Materials needed: Exact endpoints, fallback procedure/intervals/significance levels, amendments/hierarchy in registration/protocol/SAP and original results. No new adjusted P values, calculations or grades. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for prespecified fallback, adjusted intervals and null outcomes together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect prespecified fallback, adjusted intervals and null outcomes with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N12 · Is serious COVID-19 distinguished from the overall PCR-infection effect?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Original serious COVID-19 was null: 121 versus 101, RR 1.20 (CI 0.87–1.65). The exact serious-outcome definition, overlap/denominators and model remain unverified; PCR numerators 227/228 or RR 1.00 are not copied here. No new verdict of a confirmed risk increase is made.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Serious-outcome definition, relation to test-confirmed infection, denominators/timing/follow-up, original effect/CI and aggregation data. No new clinical components/event totals or effects.
- Required materials and conditions: 121 versus 101, RR 1.20 and CI 0.87–1.65
- Materials to obtain first: Serious-outcome definition, relation to test-confirmed infection, denominators/timing/follow-up, original effect/CI and aggregation data. No new clinical components/event totals or effects.
- Further research: Materials needed: Serious-outcome definition, relation to test-confirmed infection, denominators/timing/follow-up, original effect/CI and aggregation data. No new clinical components/event totals or effects. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for 121 versus 101, RR 1.20 and CI 0.87–1.65 together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect 121 versus 101, RR 1.20 and CI 0.87–1.65 with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N13 · Does a negative test independently establish infection prevention?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Original negative SARS-CoV-2 tests were null: 8,546 versus 8,565, RR 1.00 (CI 0.97–1.04). Testing selection/negative-event definition and person/test overlap remain unverified. Do not repurpose this as people with negative PCR/no infection or a reduction in all infection incidence.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Negative-test definition, aggregation/repetition, denominators, testing opportunities, prespecified model and original results. Positives/negatives are not summed into new test totals or unique people.
- Required materials and conditions: 8,546 versus 8,565, RR 1.00 and CI 0.97–1.04
- Materials to obtain first: Negative-test definition, aggregation/repetition, denominators, testing opportunities, prespecified model and original results. Positives/negatives are not summed into new test totals or unique people.
- Further research: Materials needed: Negative-test definition, aggregation/repetition, denominators, testing opportunities, prespecified model and original results. Positives/negatives are not summed into new test totals or unique people. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for 8,546 versus 8,565, RR 1.00 and CI 0.97–1.04 together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect 8,546 versus 8,565, RR 1.00 and CI 0.97–1.04 with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N14 · Is self-reported ARI confirmed SARS-CoV-2 infection?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Original self-reported acute respiratory infection was null: 3,964 versus 3,834, RR 1.04 (CI 0.97–1.11). Questionnaire/period/definition, other pathogens and test-confirmation details remain unverified. Do not combine this with PCR-confirmed infection/serious events.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Original ARI questions/definition, people/repeated symptoms, actual testing/timing, denominators/model. Do not upgrade self-reports to pathogen-confirmed infection.
- Required materials and conditions: 3,964 versus 3,834, RR 1.04 and CI 0.97–1.11
- Materials to obtain first: Original ARI questions/definition, people/repeated symptoms, actual testing/timing, denominators/model. Do not upgrade self-reports to pathogen-confirmed infection.
- Further research: Materials needed: Original ARI questions/definition, people/repeated symptoms, actual testing/timing, denominators/model. Do not upgrade self-reports to pathogen-confirmed infection. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for 3,964 versus 3,834, RR 1.04 and CI 0.97–1.11 together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect 3,964 versus 3,834, RR 1.04 and CI 0.97–1.11 with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N15 · Were coprimary outcomes or repeated tests in the same people added together?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Original event counts for all four endpoints are preserved separately. The overlap between PCR/serious outcomes/negative tests/ARI and repeated time points in the same people remains unverified. Events/denominators are not added into new participant counts, independent trials or infection totals.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Person/test/event identifiers, overlap/repetition handling and endpoint-specific denominator/observation data. Overall unique-trial/participant totals remain unrecorded.
- Required materials and conditions: Endpoint/event overlap and unique people
- Materials to obtain first: Person/test/event identifiers, overlap/repetition handling and endpoint-specific denominator/observation data. Overall unique-trial/participant totals remain unrecorded.
- Further research: Materials needed: Person/test/event identifiers, overlap/repetition handling and endpoint-specific denominator/observation data. Overall unique-trial/participant totals remain unrecorded. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for endpoint/event overlap and unique people together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect endpoint/event overlap and unique people with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N16 · Were between-arm estimates replaced by within-arm changes?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Original effects are endpoint-specific randomized between-arm RRs/intervals. Individual/within-arm changes in infection exposure, testing behaviour and model adjustment remain unverified. Changes across periods within an arm are not newly calculated as product-specific effects.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Original estimand/denominators, between-arm model, period/testing/concomitant exposures and variable/missing-data handling. No new differences, ratios or time-series effects.
- Required materials and conditions: Randomized between-arm RRs and exposure/testing changes
- Materials to obtain first: Original estimand/denominators, between-arm model, period/testing/concomitant exposures and variable/missing-data handling. No new differences, ratios or time-series effects.
- Further research: Materials needed: Original estimand/denominators, between-arm model, period/testing/concomitant exposures and variable/missing-data handling. No new differences, ratios or time-series effects. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for randomized between-arm RRs and exposure/testing changes together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect randomized between-arm RRs and exposure/testing changes with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N17 · Were original allocation and masking descriptions treated as certification?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Original materials record allocation by the hospital research-support department without investigator involvement, and masking of participants, investigators, care providers, collectors, assessors and analysts. The original term quadruple-blinded and parent B0 are retained; no new procedural comparison or formal risk-of-bias assessment was performed.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Actual concealment/implementation, masking success/unmasking, exposure/deviations and measurement/missing-data source materials. Design strengths and manufacturer support are recorded separately.
- Required materials and conditions: Independent research-support allocation and masked roles
- Materials to obtain first: Actual concealment/implementation, masking success/unmasking, exposure/deviations and measurement/missing-data source materials. Design strengths and manufacturer support are recorded separately.
- Further research: Materials needed: Actual concealment/implementation, masking success/unmasking, exposure/deviations and measurement/missing-data source materials. Design strengths and manufacturer support are recorded separately. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for independent research-support allocation and masked roles together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect independent research-support allocation and masked roles with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N18 · Was the CI range or null result extended into a clinical-threshold conclusion?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Original PCR RR 1.00 (CI 0.82–1.22) and subclaim grade D are preserved. No new confirmation is made of a prespecified clinical threshold, exclusion of every benefit, equivalence, high-dose single-ingredient effects or deficiency treatment.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Original estimand, adjusted CI/plan, clinical threshold, scope and question-specific direct materials. No new precision/efficacy verdict based only on sample size.
- Required materials and conditions: PCR RR/adjusted CI and unverified clinical importance
- Materials to obtain first: Original estimand, adjusted CI/plan, clinical threshold, scope and question-specific direct materials. No new precision/efficacy verdict based only on sample size.
- Further research: Materials needed: Original estimand, adjusted CI/plan, clinical threshold, scope and question-specific direct materials. No new precision/efficacy verdict based only on sample size. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for pCR RR/adjusted CI and unverified clinical importance together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect pCR RR/adjusted CI and unverified clinical importance with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N19 · Was the result generalized to current prevention or other ingredients?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The existing counterview/ad interpretation limits scope to about six winter months of combination cod liver oil in adults not taking vitamin D daily. It does not address deficiency treatment, high-dose vitamin D or omega-3 alone. Do not turn it into current COVID-19 prevention/management or treatment-replacement instructions.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Direct population/period/ingredient/dose, intervention/comparator, PCR/clinical endpoint, duration/effect/CI and harm materials. No recommendations or intake guidance.
- Required materials and conditions: Combination-product, period and population boundaries
- Materials to obtain first: Direct population/period/ingredient/dose, intervention/comparator, PCR/clinical endpoint, duration/effect/CI and harm materials. No recommendations or intake guidance.
- Further research: Materials needed: Direct population/period/ingredient/dose, intervention/comparator, PCR/clinical endpoint, duration/effect/CI and harm materials. No recommendations or intake guidance. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for combination-product, period and population boundaries together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect combination-product, period and population boundaries with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N20 · What is the scope of the low-grade side-effect description?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The existing safety description records only low-grade side effects in both arms and limits scope to the tested dose/participants. Event types/counts by arm, actual exposure/denominators, discontinuation and causality remain unverified. Do not extend to zero adverse events or long-term safety.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Adverse-event collection/grading, events/exposure/harm denominators by arm, discontinuation/causality and long-term materials. No cod-liver-oil/vitamin/infection-management instructions.
- Required materials and conditions: Reports in both arms and tested dose/population safety
- Materials to obtain first: Adverse-event collection/grading, events/exposure/harm denominators by arm, discontinuation/causality and long-term materials. No cod-liver-oil/vitamin/infection-management instructions.
- Further research: Materials needed: Adverse-event collection/grading, events/exposure/harm denominators by arm, discontinuation/causality and long-term materials. No cod-liver-oil/vitamin/infection-management instructions. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for reports in both arms and tested dose/population safety together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect reports in both arms and tested dose/population safety with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N21 · What materials were actually read or acquired?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The complete parent summary was read for production and preserved in its original form. Summary reading concerns preserved materials; external abstracts/full texts/registrations/protocols/SAP remain unread. Original citations/URLs do not establish external reading here.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Records of actual acquisition/reading scope, versions and dates. No external-link/click/access testing.
- Required materials and conditions: Preserved summary and external original materials
- Materials to obtain first: Records of actual acquisition/reading scope, versions and dates. No external-link/click/access testing.
- Further research: Materials needed: Records of actual acquisition/reading scope, versions and dates. No external-link/click/access testing. Only material requests/research needs are recorded; no search or research was performed in that production.
- Conditions for verification: Show original materials for preserved summary and external original materials together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect preserved summary and external original materials with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N22 · Are historical registration/plans distinguished from current reading?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Existing evidence/Korean text records NCT04609423, posted 2020-10-30 before the 2020-11-10 start, as prospective registration with four matching coprimary endpoints. Official registration URL/version/plan were not newly compared externally; URLs are not guessed.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Actual registration versions/publication, recruitment/start/amendments, endpoints/models/analysis intervals and original report links. Preserve historical descriptions without new certification of plans or prospective specification.
- Required materials and conditions: Original registration identifier and detailed comparison
- Materials to obtain first: Actual registration versions/publication, recruitment/start/amendments, endpoints/models/analysis intervals and original report links. Preserve historical descriptions without new certification of plans or prospective specification.
- Further research: Materials needed: Actual registration versions/publication, recruitment/start/amendments, endpoints/models/analysis intervals and original report links. Preserve historical descriptions without new certification of plans or prospective specification. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for original registration identifier and detailed comparison together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect original registration identifier and detailed comparison with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N23 · Have protocol/SAP and analysis/missing-data plans been acquired?

Verification status: Unverified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Original primary-outcome/ITT/registration descriptions and historical cross-checking are preserved. Actual protocol/SAP versions/timing, interval/endpoint-specific models/censoring/missingness and hierarchy/multiplicity were not newly read.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Protocol, SAP, amendments, estimands/denominators/analyses, all endpoints and publication timing. Unread materials are not assumed absent.
- Required materials and conditions: Separate materials for prespecified plans/changes
- Materials to obtain first: Protocol, SAP, amendments, estimands/denominators/analyses, all endpoints and publication timing. Unread materials are not assumed absent.
- Further research: Materials needed: Protocol, SAP, amendments, estimands/denominators/analyses, all endpoints and publication timing. Unread materials are not assumed absent. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for separate prespecified-plan and amendment materials together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect separate prespecified-plan and amendment materials with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N24 · Are sponsorship, funding, products, authors and research involvement separated?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Orkla Health AS funding and cod-liver-oil/placebo supply, plus Oslo University Hospital/University of Oslo support, are preserved. Outside relationships of KBH with Olympic Seafood/Amgen/Sanofi and SMU with Olympic Seafood, and AS/KTK employment at Age Laboratories AS, are separately recorded. Do not confuse these with newly confirmed product-manufacturer employee authors or design/analysis roles.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Separate original materials on company cash funding, product support, employee authors/outside relationships, design/analysis/data control and nonprofit/institutional support. Original independence-axis values are not new certification of all items or independence.
- Required materials and conditions: Four company-involvement items and nonprofit/public/academic support
- Materials to obtain first: Separate original materials on company cash funding, product support, employee authors/outside relationships, design/analysis/data control and nonprofit/institutional support. Original independence-axis values are not new certification of all items or independence.
- Further research: Materials needed: Separate original materials on company cash funding, product support, employee authors/outside relationships, design/analysis/data control and nonprofit/institutional support. Original independence-axis values are not new certification of all items or independence. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for four company-involvement items and nonprofit/public/academic support together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect four company-involvement items and nonprofit/public/academic support with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N25 · Are results by interval/endpoint distinguished from information gaps?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Null findings for PCR infection, serious outcomes, negative tests and self-reported ARI are distinguished from unverified event definitions/testing opportunities/denominators and unread details.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Direct measurements, original interval/endpoint tables, plans, observations/denominators and actual access records. Do not substitute unread with unreported or null with exactly zero effect/equivalence.
- Required materials and conditions: Direct results, unverified details and access status
- Materials to obtain first: Direct measurements, original interval/endpoint tables, plans, observations/denominators and actual access records. Do not substitute unread with unreported or null with exactly zero effect/equivalence.
- Further research: Materials needed: Direct measurements, original interval/endpoint tables, plans, observations/denominators and actual access records. Do not substitute unread with unreported or null with exactly zero effect/equivalence. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for direct results, unverified details and access status together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect direct results, unverified details and access status with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N26 · Are reports, trials, people, intervals, events and related sheets separated?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Parent 2972 and existing s0/s1/s2 share the same Brunvoll 2022 report, trial of 34,601 people and four-coprimary-outcome context. The same people/arms/periods/tests/events/endpoints, citations, related sheets are not added as new independent trials or participants. Linked-report counts do not certify unique-trial/participant totals.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Original reports/registration, cohorts/intervals, events/repetition/observation and overlap relationships. Unique-trial/participant totals remain unrecorded.
- Required materials and conditions: Linked records versus unique trials/participants
- Materials to obtain first: Original reports/registration, cohorts/intervals, events/repetition/observation and overlap relationships. Unique-trial/participant totals remain unrecorded.
- Further research: Materials needed: Original reports/registration, cohorts/intervals, events/repetition/observation and overlap relationships. Unique-trial/participant totals remain unrecorded. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for linked records and unique trials/participants together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect linked records and unique trials/participants with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N27 · Are the original single trial and separate independent replication distinguished?

Verification status: Unverified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Parent R1/I0 are preserved. Intervals/endpoints/related sheets for the same participants are not certified as new independent replication; researcher relationships and manufacturer support remain separately recorded.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Separate prespecified confirmation matching the question, with direct population/intervention/comparator/endpoint/duration, denominators/effects/CI and funding/author relationships. No new search or independence verdict.
- Required materials and conditions: Parent R1, independence axis and direct replication
- Materials to obtain first: Separate prespecified confirmation matching the question, with direct population/intervention/comparator/endpoint/duration, denominators/effects/CI and funding/author relationships. No new search or independence verdict.
- Further research: Materials needed: Separate prespecified confirmation matching the question, with direct population/intervention/comparator/endpoint/duration, denominators/effects/CI and funding/author relationships. No new search or independence verdict. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for parent R1, independence axis and direct replication together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect parent R1, independence axis and direct replication with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N28 · Are the subclaim grade and parent score/axes preserved?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: The selected grade/note and bilingual question are preserved; absent subclaim score/status/axes remain unrecorded. Parent D with 34 points, safety and axes remain parent context. They are not repurposed as the selected score and no new grade/RoB2/GRADE certification is created.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Existing subclaim/parent-boundary review and actual correction materials. Distinguish absent/original axis values and their history.
- Required materials and conditions: Selected D, missing score/status/axes and parent context
- Materials to obtain first: Existing subclaim/parent-boundary review and actual correction materials. Distinguish absent/original axis values and their history.
- Further research: Materials needed: Existing subclaim/parent-boundary review and actual correction materials. Distinguish absent/original axis values and their history. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for selected D, missing score/status/axes and parent context together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect selected D, missing score/status/axes and parent context with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N29 · Are both languages, citations and absent fields preserved?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Preserve parent Korean/English citations/descriptions, evidence/citation lists, axes and selected-subclaim records in the complete summary. Separate classification information in both languages is absent; originals are not filled with new fields. No external English full-text comparison.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Materials for reviewing bilingual terminology, time/event/effect units, selected scope and absent fields. Production explanations are distinguished from original records.
- Required materials and conditions: Both original languages and absent separate classification information
- Materials to obtain first: Materials for reviewing bilingual terminology, time/event/effect units, selected scope and absent fields. Production explanations are distinguished from original records.
- Further research: Materials needed: Materials for reviewing bilingual terminology, time/event/effect units, selected scope and absent fields. Production explanations are distinguished from original records. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for both original languages and absent classification fields together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect both original languages and absent classification fields with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N30 · Are source dates/corrections/history separated from production dates?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: Original evidence date 2026-08-26, empty corrections/deliberation and grade-decision cross-checking are preserved. Historical citation/registration descriptions differ from current production, condition freezing/application and completed content review.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Update materials separating originals, events, conditions/observations and verdict decisions when new evidence/corrections arise. Historical wording is not completed clinical content review here.
- Required materials and conditions: Original 2026-08-26 and new conditions/application
- Materials to obtain first: Update materials separating originals, events, conditions/observations and verdict decisions when new evidence/corrections arise. Historical wording is not completed clinical content review here.
- Further research: Materials needed: Update materials separating originals, events, conditions/observations and verdict decisions when new evidence/corrections arise. Historical wording is not completed clinical content review here. Only material requests/research needs are recorded; no search or research was performed in that production.
- Conditions for verification: Show original materials for original 2026-08-26 and new conditions/application together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect original 2026-08-26 and new conditions/application with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N31 · What direct materials would fill the selected gaps?

Verification status: Unverified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: PCR-infection accuracy/applicability could be clarified by direct testing selection/definition, endpoint denominator/model, adjustment-plan and winter/period/baseline-state materials. Do not extend to other-ingredient treatment or broad prevention.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Original tables/plans, interval/endpoint definitions, estimands/CI, observation/censoring/denominators, exposure/adherence, independent confirmation and long-term harms. Only the need is recorded; no new lookup/research.
- Required materials and conditions: Direct interval/endpoint effects, denominators/CI and follow-up
- Materials to obtain first: Original tables/plans, interval/endpoint definitions, estimands/CI, observation/censoring/denominators, exposure/adherence, independent confirmation and long-term harms. Only the need is recorded; no new lookup/research.
- Further research: Materials needed: Original tables/plans, interval/endpoint definitions, estimands/CI, observation/censoring/denominators, exposure/adherence, independent confirmation and long-term harms. Only the need is recorded; no new lookup/research. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for direct interval/endpoint effects, denominators/CI and follow-up together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect direct interval/endpoint effects, denominators/CI and follow-up with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

### N32 · Are applicability records separated from content review and instructions?

Verification status: Partly verified  
Reading scope: Preserved summary read; external abstracts/full texts/registrations/protocols/SAP remain unread

- Current findings: These are summary-based applicability records. Existing content/question-boundary review remains incomplete; candidate pending/eligible markers are preserved as history.
- Why unverified: Production observation distinguishing selected/parent, report and interval/endpoint materials in the preserved summary. Detailed original materials remain unverified and existing content review is incomplete; this does not establish completed clinical review or certification.
- Reason for missing information: Existing content review and later actual materials/corrections. The original production did not perform clinical-source comparisons, external access, new calculations, grade changes or product-use/COVID-19 management/infection-prevention/treatment-replacement instructions.
- Required materials and conditions: Applicability records, existing candidate history and content review
- Materials to obtain first: Existing content review and later actual materials/corrections. The original production did not perform clinical-source comparisons, external access, new calculations, grade changes or product-use/COVID-19 management/infection-prevention/treatment-replacement instructions.
- Further research: Materials needed: Existing content review and later actual materials/corrections. The original production did not perform clinical-source comparisons, external access, new calculations, grade changes or product-use/COVID-19 management/infection-prevention/treatment-replacement instructions. Only the material request/research need is recorded; no lookup or research is performed now.
- Conditions for verification: Show original materials for condition records, historical candidates and content review together with selected-subclaim/parent boundaries, direct endpoints/estimands/denominators and the scope of external reading.
- Why this condition is needed: Needed to connect condition records, historical candidates and content review with the selected question, actual population/intervention/comparator, endpoints/estimands, denominators/tests/follow-up and reports/harms.
- Application exceptions: Distinguish PCR-confirmed infection, testing selection/repetition, serious outcomes/negative tests/self-reported ARI, four coprimary endpoints/fallback, all randomized participants in ITT/missingness/denominators, winter/period/population, combination product/comparator/exposure, sponsorship/company involvement and harms. Only original numbers are preserved; no new calculations, invented quantities, effects/CI, grades/reassessment, independence certification or cod-liver-oil/vitamin/product-use/infection-prevention/COVID-19 management/treatment-replacement instructions.
- Remaining uncertainty: External original materials remain unread and existing content review is incomplete. Original grades/scores/axes and historical verification/independence descriptions are not upgraded to new verdicts/certification.
- Referenced methods: Existing C/E/H distinctions of questions, populations, interventions, comparisons, reports/trials, endpoints/denominators and harms referenced for production
- Related sources: R01

## Evidence and sources

### R01

Brunvoll SH, et al. Prevention of covid-19 and other acute respiratory infections with cod liver oil supplementation. BMJ. 2022;378:e071245. PMID: 36215222.

[PubMed](https://pubmed.ncbi.nlm.nih.gov/36215222/)

Materials actually read: Preserved summary read; external abstracts/full texts/registrations/plans remain unread  
Findings recorded in the summary: 227 vs 228, RR 1.00 (0.82–1.22); 121 vs 101, RR 1.20 (0.87–1.65); 8,546 vs 8,565, RR 1.00 (0.97–1.04); 3,964 vs 3,834, RR 1.04 (0.97–1.11)  
Record level: Parent endpoint summary in the original evidence list; boundaries between the selected interval/PCR result and other outcomes are distinguished in condition rows/roles  
Independent replication: Separate PCR/other coprimary results from the same Brunvoll trial; no extension to current/single-ingredient prevention. Parent 2972 and existing s0/s1/s2 share the Brunvoll 2022 report, trial of 34,601 people and four-coprimary-outcome context. The same people/arms/periods/tests/events/endpoints, citations, related sheets are not added as new independent trials/participants. Citation-based provisional links do not certify unique trials/participants or independence.

| Material | Public availability | Access status | Actually read | Notes |
|---|---|---|---|---|
| Stored summary | Local preserved copy of the complete parent summary | Stored summary read | Summary read | Only original PubMed URL/citation and registration identifier are preserved; absent full-text/registration/plan URLs or registration for other reports are not guessed. No new external reading/access or certification that conditions are met. |
| External abstract | Original identifier/bibliography or required-material entry; public availability/access details remain unverified | Unread; access testing not performed | Not read | Only original PubMed URL/citation and registration identifier are preserved; absent full-text/registration/plan URLs or registration for other reports are not guessed. No new external reading/access or certification that conditions are met. |
| External full text | Original identifier/bibliography or required-material entry; public availability/access details remain unverified | Unread; access testing not performed | Not read | Only original PubMed URL/citation and registration identifier are preserved; absent full-text/registration/plan URLs or registration for other reports are not guessed. No new external reading/access or certification that conditions are met. |
| Registration material | Original identifier/bibliography or required-material entry; public availability/access details remain unverified | Unread; access testing not performed | Not read | Only original PubMed URL/citation and registration identifier are preserved; absent full-text/registration/plan URLs or registration for other reports are not guessed. No new external reading/access or certification that conditions are met. |
| Protocol/SAP | Original identifier/bibliography or required-material entry; public availability/access details remain unverified | Unread; access testing not performed | Not read | Only original PubMed URL/citation and registration identifier are preserved; absent full-text/registration/plan URLs or registration for other reports are not guessed. No new external reading/access or certification that conditions are met. |

## Review criteria and methods

These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score.

- M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed.
- M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed.
- M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed.
- M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed.
- M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Link preserved methodological application records; no current clinical-content reassessment or external-link verification was performed.

## What the statuses mean

- Partly verified: Some information exists in the preserved review summary; detailed original materials remain unverified. This does not certify a passed review or clinical efficacy.
- Unverified: Detailed materials for the selected condition could not be established within the stored scope; this does not mean zero effect, zero studies or safety
- Review incomplete: Review of existing content incomplete
- Met: Use only within the relevant conditions after existing content review; no automatic designation in this preparation
- Not reported: Distinguish only within materials actually read; do not turn unread external materials into unreported findings
- Inaccessible: Not applied during this preparation because actual access was not tested
- Not applicable: Use with a reason for non-applicability based on an explicit question boundary
- Conflicting data: Judge after actual material comparison; review was not performed during this preparation
- Insufficient evidence for the conditions: Do not use as a clinical grade encompassing currently unread materials

## Change history

2026-10-14 · Public page/materials 1.0. Public pages and materials were prepared from the existing 32 items. No new clinical search, verification-status change or scoring was performed.