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@CovidAnalysis

COVID-19 early treatment: real-time analysis of 4,583 studies

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Analysis of 84 COVID-19 early treatments, approvals in 118 countries, database of 7,902 treatments  
Recently added (more..)  Vitamin C  Paxlovid  Molnupiravir  Azvudine
Van Tin
In Vitro study showing that the SARS-CoV-2 spike protein can activate cardiac fibroblasts through ACE2-dependent mechanisms, leading to cardiac..
Nair
In Vitro study showing the persistence of an infectious form of SARS-CoV-2 after treatment with 3CLpro inhibitors nirmatrelvir and ensitrelvir,..
Shum
In Vitro and hamster study of drug associated SARS-CoV-2 mutations with several drugs including molnupiravir and favipiravir. Next-generation..
Dong
Azvudine meta analysis: 39% lower mortality (p<0.0001) and 33% lower progression (p=0.009)
$0 $1,000 $2,000+ -25+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments Donidalorsen -151% ~$2,000+ Glenzocimab -60% ~$2,000+ PPIs -46% BMS mAbs -36% ~$2,000+ Acetaminophen -28% Lufotrelvir ~$2,000+ Losartan Sargramostim ~$2,000+ Cannabidiol Vitamin B9 Conv. Plasma $5,000 Remdesivir $3,120 Acebilustat ~$2,000+ Ibuprofen Ambavirumab/r.. Aspirin Molnupiravir mutagenic/teratogenic Favipiravir Paxlovid Famotidine Vitamin C NAC Sotrovimab $2,100 Colchicine HCQ Zinc Budesonide Probiotics Azvudine Sleep Antiandro.. Metformin Nitric Oxide Bebtelovimab Vitamin A Vitamin D Sunlight H. Peroxide Fluvox. H1RAs Exercise Curcumin Tixagevimab/c.. N. Sativa NaHCO₃ Melatonin Ensovibep ~$2,000+ Bamlanivimab/e.. Casirivimab/i.. $2,100 pH+ Quercetin Diet PVP-I Thermotherapy Ivermectin Regdanvimab $2,100 Lifestyle / free No prescription Prescription required High-cost Lower risk Higher risk c19early.org August 2024 COVID-19 involves the interplay of 50+ host/viral proteins andfactors, known to be modulated by many treatments. 0.6% of7,000+ proposed treatments show efficacy with ≥3 studies.Protocols combine treatments, none are 100% effective.c19early analyzes over 4,500 studies for 84 treatments.
$0 $1,000 $2,000+ -25+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments Donidalorsen -151% Glenzocimab -60% PPIs -46% BMS mAbs -36% Acetaminophen -28% Lufotrelvir Losartan Sargramostim Cannabidiol Vitamin B9 C. Plasma Remdesivir Acebilustat Ibuprofen Ambavirumab/r.. Aspirin Molnupiravir mutagenic/teratogenic Favipiravir Paxlovid Famotidine Vitamin C NAC Sotrovimab Colchicine HCQ Zinc Budesonide Probiotics Azvudine Sleep Antiandro.. Metformin Nitric Oxide Bebtelovimab Vitamin A Vitamin D Sunlight H. Peroxide Fluvox. H1RAs Exercise Curcumin Tixagevimab/c.. N. Sativa NaHCO₃ Melatonin Ensovibep Bamlan.. Casirivim.. pH+ Quercetin Diet PVP-I Thermotherapy Ivermectin Regdanvimab Lifestyle / free No prescription Prescription required High-cost Lower risk Higher risk c19early.org August 2024 COVID-19 involves the interplay of 50+host/viral proteins/factors modulatedby many treatments. 0.6% of 7,000+treatments show efficacy. Protocolscombine treatments, none are 100%effective. c19early analyzes4,500+ studies for 84 treatments.
Azvudine Evusheld Sodium Bicarbonate Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Famotidine Molnupiravir Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide Budesonide Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Melatonin Antihistamine H1RAs Acetaminophen ↑risk Exercise Vitamin D Antiandrogens Vitamin C PPIs ↑risk Colchicine Ivermectin Metformin Zinc HCQ 2020 2021 2023 2024 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org August 2024 Time when COVID-19 studies showed efficacy
Azvudine Evusheld Sodium Bicarb.. Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Famotidine Molnupiravir Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide Budesonide Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Melatonin H1RAs Acetaminophen ↑risk Exercise Vitamin D Antiandrogens Vitamin C PPIs ↑risk Colchicine Ivermectin Metformin Zinc HCQ 2020 2021 2023 2024 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org August 2024 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations. 0.6% of treatments show efficacy.
Top journals that accept positive studies for low cost treatments: PLOS ONE, Nutrients, International Journal of Infectious Diseases, Scientific Reports, Journal of Clinical Medicine, Frontiers in Medicine, more...
August 2024
c19early.org
Cost per life saved from NNT in
studies to date
Melatonin
9
48%
  $8
Vitamin D
69
36%
  $11
Alkalinization
8
46%
  $11
Zinc
21
30%
  $15
Sodium Bicarb..
4
41%
  $17
Vitamin C
43
19%
  $18
Colchicine
43
28%
  $26
Ivermectin
53
47%
  $26
HCQ
248
26%
  $27
Aspirin
64
11%
  $33
Vitamin A
5
30%
  $45
Curcumin
8
63%
  $59
Famotidine
21
18%
  $94
Quercetin
5
61%
  $127
Metformin
66
35%
  $133
Probiotics
9
60%
  $145
Antiandrogens
32
37%
  $179
Nigella Sativa
5
57%
  $187
Fluvoxamine
10
44%
  $411
Budesonide
12
26%
  $574
Azvudine
16
36%
  $1,248
Favipiravir
39
11%
  $1,934
Tixagev../c..
10
42%
  $74,506
Regdanvimab
7
63%
  $139,860
Casirivimab/..
9
31%
  $203,958
Paxlovid
34
25%
  $206,705
Bamlaniv../e..
13
54%
  $301,549
Sotrovimab
11
49%
  $355,740
Bebtelovimab
4
60%
  $737,601
Remdesivir
64
2%
  $1,558,440
Molnupiravir
21
17%
  $2,400,867
Conv. Plasma
47
-1%
N/A
Acetaminophen
14
-24%
N/A
PPIs
20
-40%
N/A
Treatment cost times median NNT - details and limitations. 0.6% of treatments show efficacy.
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All clinical results for selected treatments. 0.6% of treatments show efficacy.
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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% [22-95%] 1 $1 394 very limited data Cost Studies Patients Improvement Relative Risk Chlorhexidine 79% [66-87%] 3 $1 509 limited data Proxalutamide 78% [70-83%] 4 $500 1,953 limited data Indomethacin 74% [-20-94%] 4 $5 605 limited data Cetylpyridin.. 68% [-620-99%] 1 $1 23 very limited data Regdanvimab 63% [51-71%] 11 $2,100 7,430 Ivermectin 60% [52-67%] 105 $1 220,423 Chlorpheniram.. 56% [46-64%] 3 $5 806 very limited data Thermotherapy 56% [9-78%] 4 $0 217 very limited data Povidone-Iod.. 51% [38-61%] 21 $1 3,249 Diet 50% [41-58%] 28 $0 693,236 Quercetin 49% [21-68%] 11 $5 1,436 Alkalinization 49% [36-59%] 14 $1 6,383 HH-120 49% [-60-84%] 2 $500 345 very limited data Bemnifosbuvir 47% [-57-82%] 3 $500 359 very limited data Casirivimab/i.. 47% [28-61%] 29 $2,100 59,056 variant dependent Bamlaniv../e.. 47% [25-62%] 21 $1,250 35,320 variant dependent Ensovibep 46% [-173-89%] 2 $2,100 885 limited data Adintrevimab 43% [-169-88%] 2 $2,100 2,483 intramuscular Melatonin 43% [30-54%] 18 $1 14,301 Bromhexine 43% [-5-69%] 7 $5 875 very limited data Sodium Bicarb.. 43% [24-57%] 7 $1 1,092 Nigella Sativa 43% [24-57%] 14 $5 3,333 Tixagev../c.. 43% [26-56%] 17 $855 29,530 variant dependent Propolis 41% [-13-69%] 3 $1 410 very limited data Curcumin 41% [30-51%] 27 $5 14,886 Montelukast 40% [15-58%] 8 $2 2,868 limited data Exercise 39% [34-44%] 66 $0 1,936,481 H1RAs 39% [23-52%] 15 $5 71,705 Fluvoxamine 39% [21-52%] 21 $4 38,283 Hydrogen Per.. 38% [5-59%] 7 $1 835 very limited data Phthalocyanine 38% [20-51%] 4 $5 5,245 Xiannuoxin 38% [-46-73%] 2 $106 1,027 very limited data Sunlight 37% [22-50%] 5 $0 19,665 Vitamin D 37% [31-42%] 122 $1 195,710 Vitamin A 36% [6-56%] 14 $2 22,297 Nitazoxanide 35% [-8-61%] 14 $4 3,632 Selenium 34% [-40-69%] 4 $1 21,452 Bebtelovimab 34% [-24-65%] 6 $1,200 13,329 intravenous Azvudine 32% [18-44%] 21 $25 12,504 Spironolactone 31% [15-44%] 12 $5 28,019 Nitric Oxide 31% [-1-52%] 12 $11 2,236 Metformin 30% [26-34%] 93 $10 282,079 Antiandrogens 30% [21-38%] 49 $5 120,172 Sleep 30% [22-38%] 15 $0 429,001 Vitamin B12 30% [5-48%] 4 $1 11,407 Probiotics 28% [18-37%] 27 $5 19,448 Budesonide 28% [18-36%] 15 $4 28,194 Zinc 28% [18-36%] 45 $1 55,380 Hydroxychlor.. 28% [24-31%] 419 $1 536,791 Colchicine 27% [18-36%] 56 $1 33,066 Andrographol.. 27% [-8-50%] 7 $5 1,245 Ensitrelvir 26% [-14-52%] 3 $500 1,450 very limited data Sotrovimab 26% [10-39%] 24 $2,100 54,452 variant dependent N-acetylcys.. 25% [14-35%] 24 $1 26,243 Lactoferrin 24% [-24-53%] 8 $5 1,419 Vitamin C 21% [14-27%] 72 $1 88,913 Leritrelvir 21% [3-35%] 2 $1,000 1,399 very limited data Camostat 17% [-3-34%] 15 $1 1,920 Famotidine 17% [8-24%] 30 $5 114,119 Paxlovid 16% [12-20%] 65 $1,390 125,492 independent trials refused UDCA 16% [4-26%] 15 $15 37,452 Favipiravir 14% [4-23%] 69 $20 30,778 worse w/longer followup Vitamin K 14% [0-25%] 2 $1 7,806 very limited data Molnupiravir 12% [3-20%] 43 $707 137,606 mutagenic/teratogenic Aspirin 11% [5-16%] 73 $1 186,700 Deuremidevir 11% [-1-21%] 2 $112 1,432 very limited data Ambavir../r.. 11% [-154-69%] 3 $1,380 1,531 intravenous Peg.. Lambda 7% [-138-63%] 4 $500 2,143 subcutaneous Ibuprofen 0% [-9-9%] 13 $1 54,707 Acebilustat 0% [-1462-94%] 1 $2,000 120 very limited data Remdesivir -0% [-9-8%] 76 $3,120 202,278 worse w/longer followup Conv. Plasma -1% [-5-3%] 48 $5,000 30,004 intravenous Vitamin B9 -11% [-47-15%] 11 $1 54,354 Cannabidiol -12% [-86-33%] 8 $25 16,883 Sargramostim -13% [-85-31%] 4 $2,000 870 very limited data Losartan -15% [-127-42%] 5 $5 665 very limited data Lufotrelvir -22% [-198-50%] 1 $2,000 58 intravenous Acetaminoph.. -28% [-41--17%] 27 $1 543,459 BMS mAbs -36% [-492-69%] 1 $2,100 210 subcutaneous PPIs -46% [-68--27%] 37 $5 221,083 Glenzocimab -60% [-236-24%] 1 $2,000 62 intravenous Donidalorsen -151% [-602-11%] 1 $2,000 103 intravenous/subcutaneous All studies (pooled effects, all stages) c19early.org August 2024 Favors treatment Favors control
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% 1 very limited data Studies, Improvement Relative Risk Chlorhexidine 79% 3 limited data Proxalutamide 78% 4 limited data Indomethacin 74% 4 limited data Cetylpyridin.. 68% 1 very limited data Regdanvimab 63% 11 Ivermectin 60% 105 Chlorphenira.. 56% 3 very limited data Thermotherapy 56% 4 very limited data Povidone-Iod.. 51% 21 Diet 50% 28 Quercetin 49% 11 Alkalinization 49% 14 HH-120 49% 2 very limited data Bemnifosbuvir 47% 3 very limited data Casirivimab/.. 47% 29 variant dependent Bamlaniv../e.. 47% 21 variant dependent Ensovibep 46% 2 limited data Adintrevimab 43% 2 intramuscular Melatonin 43% 18 Bromhexine 43% 7 very limited data Sodium Bicar.. 43% 7 Nigella Sativa 43% 14 Tixagev../c.. 43% 17 variant dependent Propolis 41% 3 very limited data Curcumin 41% 27 Montelukast 40% 8 limited data Exercise 39% 66 H1RAs 39% 15 Fluvoxamine 39% 21 Hydrogen Per.. 38% 7 very limited data Phthalocyanine 38% 4 Xiannuoxin 38% 2 very limited data Sunlight 37% 5 Vitamin D 37% 122 Vitamin A 36% 14 Nitazoxanide 35% 14 Selenium 34% 4 Bebtelovimab 34% 6 intravenous Azvudine 32% 21 Spironolactone 31% 12 Nitric Oxide 31% 12 Metformin 30% 93 Antiandrogens 30% 49 Sleep 30% 15 Vitamin B12 30% 4 Probiotics 28% 27 Budesonide 28% 15 Zinc 28% 45 Hydroxychlor.. 28% 419 Colchicine 27% 56 Andrographol.. 27% 7 Ensitrelvir 26% 3 very limited data Sotrovimab 26% 24 variant dependent N-acetylcys.. 25% 24 Lactoferrin 24% 8 Vitamin C 21% 72 Leritrelvir 21% 2 very limited data Camostat 17% 15 Famotidine 17% 30 Paxlovid 16% 65 independent trials refused UDCA 16% 15 Favipiravir 14% 69 worse w/longer followup Vitamin K 14% 2 very limited data Molnupiravir 12% 43 mutagenic/teratogenic Aspirin 11% 73 Deuremidevir 11% 2 very limited data Ambavir../r.. 11% 3 intravenous Peg.. Lambda 7% 4 subcutaneous Ibuprofen 0% 13 Acebilustat 0% 1 very limited data Remdesivir -0% 76 worse w/longer followup Conv. Plasma -1% 48 intravenous Vitamin B9 -11% 11 Cannabidiol -12% 8 Sargramostim -13% 4 very limited data Losartan -15% 5 very limited data Lufotrelvir -22% 1 intravenous Acetaminoph.. -28% 27 BMS mAbs -36% 1 subcutaneous PPIs -46% 37 Glenzocimab -60% 1 intravenous Donidalorsen -151% 1 intravenous/subcutaneous All studies (pooled effects, all stages) c19early.org August 2024 Rotate device for details Favors treatment Favors control
Random effects meta-analysis of all studies (pooled effects, all stages). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all stages and outcomes depend on the distribution of stages and outcomes tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage and outcome analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of early treatment studies (pooled effects). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all outcomes are affected by the distribution of outcomes tested, please see detail pages for specific outcome analysis. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of all mortality results (all stages). Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Pooled results across all stages depend on the distribution of stages tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of early treatment mortality results. Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of prophylaxis studies (pooled effects). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all outcomes are affected by the distribution of outcomes tested, please see detail pages for specific outcome analysis. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of prophylaxis mortality results. Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
LATE TREATMENT
Physician / TeamLocationPatients HospitalizationHosp. MortalityDeath
Dr. David Uip (*) Brazil 2,200 38.6% (850) Ref. 2.5% (54) Ref.
EARLY TREATMENT - 40 physicians/teams
Physician / TeamLocationPatients HospitalizationHosp. ImprovementImp. MortalityDeath ImprovementImp.
Dr. Roberto Alfonso Accinelli
0/360 deaths for treatment within 3 days		 Peru 1,265 0.6% (7) 77.5%
Dr. Mohammed Tarek Alam
patients up to 84 years old		 Bangladesh 100 0.0% (0) 100.0%
Dr. Oluwagbenga Alonge Nigeria 310 0.0% (0) 100.0%
Dr. Raja Bhattacharya
up to 88yo, 81% comorbidities		 India 148 1.4% (2) 44.9%
Dr. Flavio Cadegiani Brazil 3,450 0.1% (4) 99.7% 0.0% (0) 100.0%
Dr. Alessandro Capucci Italy 350 4.6% (16) 88.2%
Dr. Shankara Chetty South Africa 8,000 0.0% (0) 100.0%
Dr. Deborah Chisholm USA 100 0.0% (0) 100.0%
Dr. Ryan Cole USA 400 0.0% (0) 100.0% 0.0% (0) 100.0%
Dr. Marco Cosentino
vs. 3-3.8% mortality during period; earlier treatment better		 Italy 392 6.4% (25) 83.5% 0.3% (1) 89.6%
Dr. Jeff Davis USA 6,000 0.0% (0) 100.0%
Dr. Dhanajay India 500 0.0% (0) 100.0%
Dr. Bryan Tyson & Dr. George Fareed USA 20,000 0.0% (6) 99.9% 0.0% (4) 99.2%
Dr. Raphael Furtado Brazil 170 0.6% (1) 98.5% 0.0% (0) 100.0%
Rabbi Yehoshua Gerzi Israel 860 0.1% (1) 99.7% 0.0% (0) 100.0%
Dr. Heather Gessling USA 1,500 0.1% (1) 97.3%
Dr. Ellen Guimarães Brazil 500 1.6% (8) 95.9% 0.4% (2) 83.7%
Dr. Syed Haider USA 4,000 0.1% (5) 99.7% 0.0% (0) 100.0%
Dr. Mark Hancock USA 24 0.0% (0) 100.0%
Dr. Sabine Hazan USA 1,000 0.0% (0) 100.0%
Dr. Mollie James USA 3,500 1.1% (40) 97.0% 0.0% (1) 98.8%
Dr. Roberta Lacerda Brazil 550 1.5% (8) 96.2% 0.4% (2) 85.2%
Dr. Katarina Lindley USA 100 5.0% (5) 87.1% 0.0% (0) 100.0%
Dr. Ben Marble USA 150,000 0.0% (4) 99.9%
Dr. Edimilson Migowski Brazil 2,000 0.3% (7) 99.1% 0.1% (2) 95.9%
Dr. Abdulrahman Mohana Saudi Arabia 2,733 0.0% (0) 100.0%
Dr. Carlos Nigro Brazil 5,000 0.9% (45) 97.7% 0.5% (23) 81.3%
Dr. Benoit Ochs Luxembourg 800 0.0% (0) 100.0%
Dr. Ortore Italy 240 1.2% (3) 96.8% 0.0% (0) 100.0%
Dr. Valerio Pascua
one death for a patient presenting on the 5th day in need of supplemental oxygen		 Honduras 415 6.3% (26) 83.8% 0.2% (1) 90.2%
Dr. Sebastian Pop Romania 300 0.0% (0) 100.0%
Dr. Brian Proctor USA 869 2.3% (20) 94.0% 0.2% (2) 90.6%
Dr. Anastacio Queiroz Brazil 700 0.0% (0) 100.0%
Dr. Didier Raoult France 8,315 2.6% (214) 93.3% 0.1% (5) 97.6%
Dr. Karin Ried
up to 99yo, 73% comorbidities, av. age 63		 Turkey 237 0.4% (1) 82.8%
Dr. Roman Rozencwaig
patients up to 86 years old		 Canada 80 0.0% (0) 100.0%
Dr. Vipul Shah India 8,000 0.1% (5) 97.5%
Dr. Silvestre Sobrinho Brazil 116 8.6% (10) 77.7% 0.0% (0) 100.0%
Dr. Unknown Brazil 957 1.7% (16) 95.7% 0.2% (2) 91.5%
Dr. Vladimir Zelenko USA 2,200 0.5% (12) 98.6% 0.1% (2) 96.3%
Mean improvement with early treatment protocols 238,381 HospitalizationHosp. 94.4% MortalityDeath 94.9%
Physician results with early treatment protocols compared to no early treatment. These results are subject to selection and ascertainment bias and more accurate analysis requires details of the patient populations and followup, however results are consistently better across many teams, and consistent with the extensive controlled trial evidence that shows a significant reduction in risk with many early treatments, and improved results with the use of multiple treatments in combination.
Vitamin C
Van Tin
In Vitro study showing that the SARS-CoV-2 spike protein can activate cardiac fibroblasts through ACE2-dependent mechanisms, leading to cardiac..
N-acetylcysteine
Van Tin
In Vitro study showing that the SARS-CoV-2 spike protein can activate cardiac fibroblasts through ACE2-dependent mechanisms, leading to cardiac..
Curcumin
Van Tin
In Vitro study showing that the SARS-CoV-2 spike protein can activate cardiac fibroblasts through ACE2-dependent mechanisms, leading to cardiac..
Colchicine
Van Tin
In Vitro study showing that the SARS-CoV-2 spike protein can activate cardiac fibroblasts through ACE2-dependent mechanisms, leading to cardiac..
Paxlovid
Nair
In Vitro study showing the persistence of an infectious form of SARS-CoV-2 after treatment with 3CLpro inhibitors nirmatrelvir and ensitrelvir,..
Ensitrelvir
Nair
In Vitro study showing the persistence of an infectious form of SARS-CoV-2 after treatment with 3CLpro inhibitors nirmatrelvir and ensitrelvir,..
Molnupiravir
Shum
In Vitro and hamster study of drug associated SARS-CoV-2 mutations with several drugs including molnupiravir and favipiravir. Next-generation..
Favipiravir
Shum
In Vitro and hamster study of drug associated SARS-CoV-2 mutations with several drugs including molnupiravir and favipiravir. Next-generation..
Azvudine
Dong
Meta analysis: 39% lower mortality (p<0.0001) and 33% lower progression (p=0.009)
HCQ
Asaba
Review suggesting that the SARS-CoV-2 spike protein interacts with TLR4 to induce hyperinflammation and severe COVID-19. The spike protein binds..
Probiotics
Vaishnani
Bioinformatics analysis of oral microbiome data from 244 healthy subjects across 8 countries showing an association between higher levels of..
Li
Mendelian randomization study based on large-scale GWAS data from 18,340 individuals showing a causal relationship between 14 gut microbiota taxa..
Vitamin D
Pietzner
Sufficiency: 55% lower mortality (p<0.0001), 53% lower hospitalization (p<0.0001), 25% lower ARDS (p=0.05), and 56% lower PASC (p<0.0001)
Zinc
Al-Fartusie
Retrospective 78 hospitalized COVID-19 patients and 40 healthy controls, showing significantly lower zinc levels in COVID-19 patients. There was no..
Sleep
Zhou
Meta analysis: 31% lower mortality (p=0.0003), 20% lower hospitalization (p<0.0001), 11% fewer cases (p<0.0001), and 26% lower PASC (p<0.0001)
Miscellaneous
Goldswain
Longitudinal sequencing study of 16 immunocompetent individuals in a closed SARS-CoV-2 transmission chain showing genomic diversity over the course..
Recent studies (see the individual treatment pages for all studies):
Aug 12
 Nair et al., The Journal of Infectious Diseases, doi:10.1093/infdis/jiae385 Persistence of an infectious form of SARS-CoV-2 post protease inhibitor treatment of permissive cells in vitro
In Vitro study showing the persistence of an infectious form of SARS-CoV-2 after treatment with 3CLpro inhibitors nirmatrelvir and ensitrelvir, which may explain the rebound often seen with paxlovid. 3CLpro is crucial for processing viral..
Aug 11
 Van Tin et al., Cells, doi:10.3390/cells13161331 Spike Protein of SARS-CoV-2 Activates Cardiac Fibrogenesis through NLRP3 Inflammasomes and NF-κB Signaling
In Vitro study showing that the SARS-CoV-2 spike protein can activate cardiac fibroblasts through ACE2-dependent mechanisms, leading to cardiac fibrosis via the NLRP3 inflammasome and NF-κB signaling pathways. The results suggest that COV..
Aug 8
 Casadevall et al., Clinical Infectious Diseases, doi:10.1093/cid/ciae408 Single monoclonal antibodies should not be used for COVID-19 therapy: a call for antiviral stewardship
Review arguing against use of single monoclonal antibodies for COVID-19 treatment, particularly in immunosuppressed patients, due to the risk of rapidly selecting for resistant viral variants. Authors suggest that while monoclonal antibod..
Aug 8
 Vaishnani et al., medRxiv, doi:10.1101/2024.08.07.24311606 Hydrogen Sulfide (H₂S)-Producing Oral Bacteria May Protect Against COVID-19
Bioinformatics analysis of oral microbiome data from 244 healthy subjects across 8 countries showing an association between higher levels of hydrogen sulfide-producing oral bacteria and lower COVID-19 mortality rates. Authors hypothesize ..
Aug 6
 Al-Fartusie et al., Indian Journal of Clinical Biochemistry, doi:10.1007/s12291-024-01254-4 Comparison of Serum Zn, Cu, Mg, Mn, Cr, and Fe Levels in Iraqi COVID-19 Patients and their Association with Infection Severity
Retrospective 78 hospitalized COVID-19 patients and 40 healthy controls, showing significantly lower zinc levels in COVID-19 patients. There was no significant difference for moderate vs. severe patients.
Aug 5
 Li et al., BMC Microbiology, doi:10.1186/s12866-024-03423-0 Large-scale genetic correlation studies explore the causal relationship and potential mechanism between gut microbiota and COVID-19-associated risks
Mendelian randomization study based on large-scale GWAS data from 18,340 individuals showing a causal relationship between 14 gut microbiota taxa and reduced or increased risk of COVID-19 severity, hospitalization, or susceptibility. The ..
Aug 4
 Babulic et al., Pharmaceuticals, doi:10.3390/ph17081021 Lactoferrin Binds through Its N-Terminus to the Receptor-Binding Domain of the SARS-CoV-2 Spike Protein
In Vitro study showing that lactoferrin directly binds to the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein, potentially explaining lactoferrin's observed protective effects against SARS-CoV-2 infection. Authors found that..
Aug 3
 Zampieri et al., Journal of Critical Care, doi:10.1016/j.jcrc.2024.154892 Antisense therapy to block the Kallikrein-kinin pathway in COVID-19: The ASKCOV randomized controlled trial
151% higher mortality (p=0.08), 81% higher ventilation (p=0.08), and 35% higher progression (p=0.03). RCT 111 hospitalized COVID-19 patients in Brazil showing no clinical benefit with antisense therapy to block the kallikrein-kinin pathway using ISIS 721744 (donidalorsen). Treatment was associated with a significantly higher SOFA score at..
Aug 1
 Sunita et al., Asian Journal of Microbiology and Biotechnology, doi:10.56557/ajmab/2024/v9i28800 Characterization of Phytochemical Inhibitors of the COVID-19 Primary Protease Using Molecular Modelling Approach
In Silico study showing that quercetin, gallic acid, lactucin, and rutin may inhibit the SARS-CoV-2 main protease (Mpro). Quercetin and rutin demonstrated strong binding affinity to Mpro and favorable drug-likeness, bioactivity scores, an..
Jul 31
 Pavlyshyn et al., La Rivista Italiana della Medicina di Laboratorio, doi:10.23736/S1825-859X.24.00247-0 Potential role of vitamins B (B6, B9, B12) in the severity of COVID-19 in children
Retrospective 112 pediatric COVID-19 patients in Ukraine showing lower levels of vitamins B6, B9, and B12 associated with COVID-19 severity.
Jul 31
 Asaba et al., Journal of Inflammation Research, doi:10.2147/jir.s474707 Interplay of TLR4 and SARS-CoV-2: Unveiling the Complex Mechanisms of Inflammation and Severity in COVID-19 Infections
Review suggesting that the SARS-CoV-2 spike protein interacts with TLR4 to induce hyperinflammation and severe COVID-19. The spike protein binds TLR4 with high affinity, triggering inflammatory signaling cascades. SARS-CoV-2 infection may..
Jul 30
 Shum, C., The University of Hong Kong, PhD Thesis An investigational study into the drug-associated mutational signature in SARS-CoV-2 viruses
In Vitro and hamster study of drug associated SARS-CoV-2 mutations with several drugs including molnupiravir and favipiravir. Next-generation sequencing was used to identify de novo mutational spectra and single base substitution mutation..
Jul 30
 Değirmenci et al., Journal of Controversies in Obstetrics & Gynecology and Pediatrics, doi:10.51271/JCOGP-0035 Is vitamin D level important in pregnant women with COVID-19?
43% lower hospitalization (p=0.76). Retrospective 125 pregnant women hospitalized with COVID-19 in Turkey, showing no significant difference in hospitalization length with HCQ, and longer hospitalization with lopinavir/ritonavir use.
Jul 28
 Charoenporn et al., Psychiatry and Clinical Neurosciences, doi:10.1111/pcn.13716 Effects of an 8‐week high‐dose vitamin D supplementation on fatigue and neuropsychiatric manifestations in post‐COVID syndrome: A randomized controlled trial
RCT 80 long COVID patients showing benefits with high-dose vitamin D treatment. Participants received 60,000 IU vitamin D weekly or placebo for 8 weeks. The vitamin D group showed significant improvements in fatigue (CFQ score), anxiety..
Jul 26
 Wolak et al., Scientific Reports, doi:10.1038/s41598-024-68055-w A safety evaluation of intermittent high-dose inhaled nitric oxide in viral pneumonia due to COVID-19: a randomised clinical study
64% lower need for oxygen therapy (p=0.03) and 41% shorter hospitalization (p=0.24). RCT 35 hospitalized patients with viral pneumonia (34 with COVID-19) showing improved recovery with high-dose inhaled nitric oxide (iNO) treatment. The treatment group received intermittent inhalations of 150 ppm iNO for 40 minutes, 4 tim..
Jul 25
 Jia et al., Journal of Clinical Hepatology, doi:10.12449/JCH240714 Effect of ursodeoxycholic acid on symptoms after severe acute respiratory syndrome coronavirus 2 infection in patients with primary biliary cholangitis and their family members
Retrospective 171 primary biliary cholangitis (PBC) patients taking ursodeoxycholic acid (UDCA) and 128 family members, showing no reduction in SARS-CoV-2 infection rates but milder symptoms in PBC patients. All PBC patients and family me..
Jul 24
 Ferreira et al., Bioscience Reports, doi:10.1042/BSR20240617 Boosting Immunity: Synergistic Antiviral Effects of Luteolin, Vitamin C, Magnesium, and Zinc Against SARS-CoV-2 3CLpro
In Vitro and In Silico study showing synergistic antiviral effects of luteolin, vitamin C, magnesium, and zinc against SARS-CoV-2 3CLpro. Authors found that luteolin inhibited SARS-CoV-2 3CLpro with an IC50 of 78 μM, which decreased 10-fo..
Jul 24
 Hitti et al., Immunology, doi:10.1111/imm.13835 Hydroxychloroquine attenuates double-stranded RNA-stimulated hyper-phosphorylation of tristetraprolin/ZFP36 and AU-rich mRNA stabilization
In Vitro study showing that HCQ reduces inflammation by inhibiting the double-stranded RNA-stimulated phosphorylation of tristetraprolin (TTP) and decreasing the stability of AU-rich mRNAs. This suggests that HCQ could mitigate excessive ..
Jul 22
 Sebghatollahi et al., Avicenna Journal of Phytomedicine, doi:10.22038/ajp.2024.24633 The adjuvant therapy of edible herbal product including colchicum bulb, olive leaf, black cumin seeds, lavender flower, and ginger rhizome on the outcome of patients with severe and critical COVID-19: A double-blind randomized controlled clinical trial
73% lower mortality (p=0.001), 77% lower ICU admission (p=0.0005), and 41% shorter hospitalization (p<0.0001). RCT 150 severe and critical COVID-19 patients showing lower mortality, lower ICU admission, and improved recovery with a treatment including nigella sativa, colchicum autumnal, olea europaea, lavandula angustifolia, and zingiber officinal..
Jul 22
 Wijewickrema et al., BMC Infectious Diseases, doi:10.1186/s12879-024-09563-y Efficacy and safety of oral ivermectin in the treatment of mild to moderate Covid-19 patients: a multi-centre double-blind randomized controlled clinical trial
51% improved viral clearance (p=0.03). RCT 249 hospitalized patients with mild to moderate COVID-19 in Sri Lanka, showing statistically significant lower viral load. There was no significant difference in clinical outcomes. Only one patient had a serious outcome. Mid-recovery ..
Jul 22
 Siami et al., Health Science Reports, doi:10.1002/hsr2.2252 Clinical outcomes and considerations in outpatient with COVID‐19 receiving remdesivir therapy
70% higher hospitalization (p=0.2). Retrospective 514 COVID-19 outpatients showing no significant benefit with remdesivir therapy.
Jul 21
 Sugimoto et al., medRxiv, doi:10.1101/2024.07.20.24310736 Biguanides Associate with Decreased Early Mortality and Risk of Acute Kidney Injury In Hospitalized COVID-19 Patients: a nationwide retrospective cohort study in Japan
40% lower mortality (p<0.0001). Retrospective 168,370 hospitalized COVID-19 patients with diabetes in Japan showing lower mortality and reduced risk of acute kidney injury with biguanide (likely primarily or only metformin) use. Authors hypothesize that metformin's acti..
Jul 18
 Wu et al., Elsevier BV, doi:10.2139/ssrn.4897774 Biomarkers Prediction and Immune Landscape in Covid-19 and “Brain Fog”
In Silico study identifying key genes and potential therapeutic agents related to brain fog in COVID-19 patients. Authors analyzed frontal cortex transcriptome data and found upregulated genes involved in immune-related pathways and downr..
Jul 18
 Hammond et al., New England Journal of Medicine, doi:10.1056/NEJMoa2309002 Oral Nirmatrelvir–Ritonavir as Postexposure Prophylaxis for Covid-19
Delayed publication of the EPIC-PEP RCT showing no significant benefit with paxlovid for post-exposure prophylaxis. Results were available in 2023 on clinicaltrials.gov [Pfizer].
Jul 18
 Limaheluw et al., Frontiers in Public Health, doi:10.3389/fpubh.2024.1183706 Associations between meteorological factors and COVID-19: a global scoping review
Review of associations between meteorological factors and COVID-19. For sunlight/solar radiation authors found consistent evidence from experimental studies that higher solar radiation negatively affects SARS-CoV-2 viability. Several stud..
Jul 17
 Wimalawansa, S., Heliyon, doi:10.1016/j.heliyon.2024.e34691 Unlocking Insights: Navigating COVID-19 Challenges and Emulating Future Pandemic Resilience Strategies with Strengthening Natural Immunity
Review showing reduced efficacy of interventions with new variants and suggesting that regulators and health organizations should consider approval and strategic use of cost-effective adjunct therapies such as vitamin D and ivermectin tha..
Jul 16
 Imran et al., Clinical Nutrition Open Science, doi:10.1016/j.nutos.2024.07.004 Therapeutic Role of Vitamin D in COVID-19 Patients
Review of vitamin D for COVID-19. Low vitamin D levels have been associated with increased susceptibility to and severity of COVID-19. Vitamin D plays an essential role in modulating the immune response and reducing inflammation, with pro..
Jul 16
 Bell et al., PLOS ONE, doi:10.1371/journal.pone.0304822 Real-world effectiveness of sotrovimab in preventing hospitalization and mortality in high-risk patients with COVID-19 in the United States: A cohort study from the Mayo Clinic electronic health records
50% lower mortality (p=0.2), 12% lower combined mortality/hospitalization (p=0.7), 74% lower ICU admission (p=0.006), and 59% lower need for oxygen therapy (p<0.0001). Retrospective 35,485 high-risk COVID-19 outpatients showing lower ICU admission and respiratory support with sotrovimab. There was no significant difference for hospitalization.
Jul 16
 Zeng et al., eLife, doi:10.7554/elife.94973 Associations of proton pump inhibitors with susceptibility to influenza, pneumonia, and COVID-19: Evidence from a large population-based cohort study
46% higher mortality (p=0.02), 33% higher severe cases (p=0.004), and 8% more cases (p=0.1). UK Biobank retrospective with 160,923 patients showing increased risks of influenza, pneumonia, COVID-19 severity, and COVID-19 mortality with proton pump inhibitor (PPI) use.
Jul 16
 Giancola et al., Microorganisms, doi:10.3390/microorganisms12071443 Efficacy of a Multistrain Synbiotic Treatment in Acute and Post-Acute COVID-19 Patients: A Double-Blind, Placebo-Controlled Randomized Trial
33% improved recovery (p=0.32). RCT 52 acute COVID-19 inpatients in Italy showing a multistrain synbiotic formula prevented a decrease in gut microbiota diversity and prevented decreases in lymphocyte count and hemoglobin levels compared to placebo. The probiotic group ..
Jul 15
 Abdelhai et al., The Egyptian Journal of Hospital Medicine, doi:10.21608/EJHM.2024.368093 Impact of Rapid Correction of Vitamin D Deficiency on Patients with COVID-19 Disease: A Randomized-Controlled Trial
83% lower mortality (p<0.0001), 45% shorter hospitalization (p<0.0001), and 74% improved viral clearance (p<0.0001). RCT 250 hospitalized COVID-19 patients showing significant clinical improvement with high-dose intramuscular vitamin D3 treatment. Patients receiving 200,000 IU cholecalciferol daily for 4 days had increased vitamin D levels, reduced infl..
Jul 15
 Choi et al., The Lancet Infectious Diseases, doi:10.1016/S1473-3099(24)00353-0 Comparative effectiveness of combination therapy with nirmatrelvir–ritonavir and remdesivir versus monotherapy with remdesivir or nirmatrelvir–ritonavir in patients hospitalised with COVID-19: a target trial emulation study
267% higher mortality (p=0.07), 600% higher ICU admission (p<0.0001), 686% higher need for oxygen therapy (p<0.0001), and 182% worse results (p<0.0001). Target trial emulation study of 18,196 hospitalized COVID-19 patients in Hong Kong showing significantly higher ICU admission and AKI with remdesivir + paxlovid compared with paxlovid alone, and lower mortality and ventilatory support wit..
Jul 15
 Budelon Gonçalves et al., International Journal of Molecular Sciences, doi:10.3390/ijms25147749 Nutritional and Inflammatory Markers Associated with SARS-CoV-2 Infection in the Elderly
Retrospective 43 elderly hospitalized COVID-19 patients in Brazil showing no significant association between vitamin D levels and clinical outcomes. Patients with vitamin D deficiency showed increased inflammatory markers. Data in this st..
We aim to cover the most promising early treatments for COVID-19. We use pre-specified effect extraction criteria that prioritizes more serious outcomes, for details see methods. For specific outcomes and different treatment stages see the individual pages. Not all treatments are covered here, effectiveness has been reported for many other treatments in studies. Of the 4,583 studies, 2,350 present results comparing with a control group, 2,149 are treatment studies, and 201 analyze outcomes based on serum levels. There are 79 animal studies, 167 in silico studies, 278 in vitro studies, 309 reviews, and 215 meta analyses.
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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