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Other Treatments Global Adoption
COVID-19 early treatment: real-time analysis of 2,424 studies
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All studies   Early treatment   Mortality   Early mortality   Prophylaxis   Prophylaxis mortality   Recent     Select treatment...
Analysis of 48 COVID early treatments, approvals in 80 countries, database of 2,110 treatments  
Recently added (more..)  Curcumin  Quercetin  Zinc  Casirivimab/imdevimab  Paxlovid
Shafiee
Curcumin meta analysis: 62% lower mortality [p=0.003]
Di Pierro
100 patient quercetin early treatment RCT: 37% improved recovery [p=0.007] and 58% improved viral clearance [p<0.0001]
Almasaud
Prospective study of 123 COVID+ patients and 48 controls, showing significantly lower zinc levels in COVID-19 patients, and a negative correlation..
Shimizu
In Vitro study showing that casirivimab/imdevimab may induce antibody-dependent enhancement (ADE) within a specific concentration range. No ADE was..
Heilmann
In Vitro and In Silico study showing selection of resistant mutations with nirmatrelvir use. Several mutations were identified that confer..
Cost per life saved from NNT in
studies to date c19early.org Jan 2023
Melatonin
9
48%
  $8
Vitamin D
59
37%
  $11
Vitamin C
33
27%
  $12
Ivermectin
48
51%
  $22
Colchicine
33
37%
  $26
HCQ
229
22%
  $30
Zinc
18
28%
  $30
Vitamin A
6
42%
  $30
Curcumin
7
63%
  $40
Aspirin
54
12%
  $41
Famotidine
18
17%
  $105
Probiotics
7
61%
  $145
Metformin
44
31%
  $172
Antiandrogens
31
40%
  $175
Quercetin
4
59%
  $188
Fluvoxamine
5
37%
  $240
Nigella Sativa
4
73%
  $279
Nitazoxanide
6
42%
  $680
Favipiravir
30
13%
  $928
Paxlovid
11
63%
  $59,777
Molnupiravir
12
24%
  $126,836
Casirivimab/i..
8
40%
  $181,694
Remdesivir
40
16%
  $208,615
Bamlaniv../e..
10
56%
  $301,549
Tixagev../c..
4
41%
  $412,873
Sotrovimab
8
56%
  $499,044
Conv. Plasma
31
-8%
N/A
Acetaminophen
12
-25%
N/A
Treatment cost times median NNT - details and limitations
Evusheld Paxlovid Fluvoxamine Famotidine Molnupiravir Quercetin Bamlanivimab/e.. Acetaminophen ↑risk Budesonide Probiotics Curcumin REGEN-COV Aspirin Povidone-Iodine Nigella Sativa Melatonin Favipiravir Vitamin D Vitamin C Colchicine Remdesivir Antiandrogens Ivermectin Metformin Zinc HCQ 2020 2021 2022 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org Jan 2023 Time when COVID-19 studies showed efficacy
Evusheld Paxlovid Fluvoxamine Famotidine Molnupiravir Quercetin Bamlanivimab/e.. Acetaminophen ↑risk Budesonide Probiotics Curcumin REGEN-COV Aspirin Povidone-Iodine Nigella Sativa Melatonin Favipiravir Vitamin D Vitamin C Colchicine Remdesivir Antiandrogens Ivermectin Metformin Zinc HCQ 2020 2021 2022 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org Jan 2023 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations
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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% [11-96%] 1 $1 394 very limited data Cost Studies Patients Improvement Relative Risk Proxalutamide 78% [70-83%] 4 $500 1,953 limited data Indomethacin 74% [-20-94%] 4 $5 605 limited data Quercetin 63% [27-81%] 9 $5 1,337 Ivermectin 62% [54-69%] 95 $1 134,554 Bamlaniv../e.. 55% [30-71%] 14 $1,250 24,423 variant dependent Nigella Sativa 53% [27-70%] 11 $5 2,959 Casirivimab/i.. 53% [33-66%] 26 $2,100 54,453 variant dependent Diet 51% [40-59%] 20 $0 686,190 Povidone-Iod.. 51% [37-61%] 20 $1 3,226 Tixagev../c.. 50% [30-64%] 8 $855 26,460 variant dependent Bromhexine 50% [-8-77%] 6 $5 684 very limited data Ensovibep 46% [-173-89%] 2 $2,100 885 limited data Spironolactone 45% [18-63%] 10 $5 3,137 Sunlight 45% [19-62%] 4 $0 19,635 Bebtelovimab 44% [-827-97%] 2 $1,200 1,134 intravenous Melatonin 43% [30-54%] 18 $1 14,301 Exercise 41% [34-47%] 50 $0 1,773,101 Vitamin A 40% [-10-67%] 11 $2 18,305 Paxlovid 40% [29-49%] 20 $529 26,783 independent trial refused Curcumin 39% [27-49%] 22 $5 4,979 Colchicine 37% [26-46%] 40 $1 29,991 Vitamin D 37% [31-42%] 102 $1 182,076 Peg.. Lambda 35% [-132-82%] 3 $500 2,116 subcutaneous Lactoferrin 34% [-25-66%] 5 $5 995 Nitazoxanide 33% [-22-63%] 13 $4 3,606 Antiandrogens 31% [21-40%] 45 $5 94,222 Fluvoxamine 31% [17-43%] 13 $4 34,828 Sleep 31% [21-40%] 12 $0 273,377 Budesonide 31% [15-43%] 10 $4 26,104 Zinc 28% [16-38%] 38 $1 45,372 Ensitrelvir 27% [-19-55%] 2 $500 255 very limited data Nitric Oxide 27% [-11-52%] 9 $11 1,484 Metformin 27% [22-31%] 58 $10 207,604 Sotrovimab 25% [-38-60%] 13 $2,100 18,902 variant dependent Hydroxychlor.. 25% [21-29%] 376 $1 497,827 Vitamin C 22% [14-30%] 56 $1 58,331 Probiotics 22% [12-31%] 20 $5 17,944 Favipiravir 21% [9-31%] 56 $20 25,756 N-acetylcys.. 20% [9-30%] 17 $1 24,853 Molnupiravir 20% [-5-39%] 25 $707 69,837 mutagenic/teratogenic Famotidine 15% [5-25%] 25 $5 92,443 Remdesivir 15% [6-23%] 44 $3,120 133,239 intravenous Aspirin 12% [6-17%] 62 $1 172,519 Ibuprofen -1% [-10-8%] 12 $1 54,527 Conv. Plasma -8% [-25-7%] 31 $5,000 25,016 Acetaminoph.. -27% [-47--9%] 18 $1 93,885 Cannabidiol -45% [-167-21%] 6 $25 3,784 All studies (pooled effects, all stages) c19early.org Jan 2023 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 Proxalutamide 78% 4 limited data Indomethacin 74% 4 limited data Quercetin 63% 9 Ivermectin 62% 95 Bamlaniv../e.. 55% 14 variant dependent Nigella Sativa 53% 11 Casirivimab/.. 53% 26 variant dependent Diet 51% 20 Povidone-Iod.. 51% 20 Tixagev../c.. 50% 8 variant dependent Bromhexine 50% 6 very limited data Ensovibep 46% 2 limited data Spironolactone 45% 10 Sunlight 45% 4 Bebtelovimab 44% 2 intravenous Melatonin 43% 18 Exercise 41% 50 Vitamin A 40% 11 Paxlovid 40% 20 independent trial refused Curcumin 39% 22 Colchicine 37% 40 Vitamin D 37% 102 Peg.. Lambda 35% 3 subcutaneous Lactoferrin 34% 5 Nitazoxanide 33% 13 Antiandrogens 31% 45 Fluvoxamine 31% 13 Sleep 31% 12 Budesonide 31% 10 Zinc 28% 38 Ensitrelvir 27% 2 very limited data Nitric Oxide 27% 9 Metformin 27% 58 Sotrovimab 25% 13 variant dependent Hydroxychlor.. 25% 376 Vitamin C 22% 56 Probiotics 22% 20 Favipiravir 21% 56 N-acetylcys.. 20% 17 Molnupiravir 20% 25 mutagenic/teratogenic Famotidine 15% 25 Remdesivir 15% 44 intravenous Aspirin 12% 62 Ibuprofen -1% 12 Conv. Plasma -8% 31 Acetaminoph.. -27% 18 Cannabidiol -45% 6 All studies (pooled effects, all stages) c19early.org Jan 23 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.
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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.
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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.
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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.
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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.
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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.
LATE TREATMENT
Physician / TeamLocationPatients HospitalizationHosp. MortalityDeath
Dr. David Uip (*) Brazil 2,200 38.6% (850) Ref. 2.5% (54) Ref.
EARLY TREATMENT - 36 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. 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. 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. Vladimir Zelenko USA 2,200 0.5% (12) 98.6% 0.1% (2) 96.3%
Mean improvement with early treatment protocols 235,394 HospitalizationHosp. 93.8% MortalityDeath 94.5%
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.
Treatment
Improvement
  (early)
Studies
  (early)
BUBudesonide 82% 1
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PXProxalutamide 71% 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
BLBamlaniv../e.. 69% 8
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
V.DVitamin D 65% 9
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(H)CQHydroxychlor.. 62% 36
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IVMIvermectin 62% 37
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
RDRemdesivir 61% 4
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FVFluvoxamine 56% 6
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CICasirivimab/i.. 47% 20
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PLPaxlovid 46% 19
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ZnZinc 41% 6
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SSotrovimab 37% 11
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FPVFavipiravir 30% 16
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
V.CVitamin C 24% 5
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MPMolnupiravir 24% 22
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ACEAcetaminophen -17% 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IBIbuprofen -52% 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Early treatments approved by >2 countries. 80 countries have officially approved treatments. Details.
Curcumin
Shafiee
Meta analysis: 62% lower mortality [p=0.003]
Chitre
175 patient early treatment RCT: 11% faster recovery [p=0.04]
Quercetin
Di Pierro
100 patient early treatment RCT: 37% improved recovery [p=0.007] and 58% improved viral clearance [p<0.0001]
Zinc
Almasaud
Prospective study of 123 COVID+ patients and 48 controls, showing significantly lower zinc levels in COVID-19 patients, and a negative correlation..
Kladnik
Ex Vivo study showing zinc pyrithione to be a potent inhibitor of SARS-CoV-2 entry and replication.
Casirivimab/imdevimab
Shimizu
In Vitro study showing that casirivimab/imdevimab may induce antibody-dependent enhancement (ADE) within a specific concentration range. No ADE was..
Paxlovid
Heilmann
In Vitro and In Silico study showing selection of resistant mutations with nirmatrelvir use. Several mutations were identified that confer..
Jochmans
In Vitro study showing selection of nirmatrelvir-resistant mutations with a protease inhibitor.
Metformin
Mannucci
Prophylaxis: 38% lower mortality [p=0.02] and 15% lower hospitalization [p=0.25]
Yeh
Prophylaxis: 44% lower progression [p<0.0001] and 37% lower hospitalization [p<0.0001]
HCQ
Dhibar
1,168 patient prophylaxis RCT: 27% fewer symptomatic cases [p=0.32] and 21% fewer cases [p=0.21]
Mitjà
2,037 patients meta analysis: 33% improved viral clearance [p=0.02]
Favipiravir
Shah
499 patient late treatment RCT: 26% lower mortality [p=0.24], 24% lower ventilation [p=0.21], and 6% improved recovery [p=0.53]
Ivermectin
MedInCell
399 patient prophylaxis RCT: 72% fewer cases [p<0.0001]
Sarojvisut
317 patient late treatment RCT: 104% higher ICU admission [p=0.62], 104% worse improvement [p=0.62], and 4% faster recovery [p=0.63]
Recent studies (see the individual treatment pages for all studies):
Jan 14
 Shafiee et al., Phytotherapy Research, doi:10.1002/ptr.7724 Curcumin for the treatment of COVID-19 patients: A meta-analysis of randomized controlled trials
62% lower mortality [p=0.003]. Meta analysis of 13 curcumin RCTs showing lower mortality with treatment. Authors note that subgroup analysis suggested improved efficacy with early treatment and with combined treatment.
Jan 13
 Di Pierro et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.1096853 Quercetin as a possible complementary agent for early-stage COVID-19: Concluding results of a randomized clinical trial
37% improved recovery [p=0.007] and 58% improved viral clearance [p<0.0001]. RCT 100 outpatients in Pakistan, 50 treated with quercetin phytosome, showing faster viral clearance and improved recovery with treatment. Patients in the treatment group were significantly younger (41 vs. 54).
Jan 11
 Heilmann et al., Science Translational Medicine, doi:10.1126/scitranslmed.abq7360 (In Vitro) SARS-CoV-2 3CLpro mutations selected in a VSV-based system confer resistance to nirmatrelvir, ensitrelvir, and GC376
In Vitro and In Silico study showing selection of resistant mutations with nirmatrelvir use. Several mutations were identified that confer resistance to 3CLpro inhibitors nirmatrelvir, ensitrelvir, and GC376. Authors note that most of the..
Jan 10
 Almasaud et al., Nutrients, doi:10.3390/nu15020340 Association of Serum Zinc and Inflammatory Markers with the Severity of COVID-19 Infection in Adult Patients
Prospective study of 123 COVID+ patients and 48 controls, showing significantly lower zinc levels in COVID-19 patients, and a negative correlation between zinc levels and COVID-19 severity. Moderate and severe cases were significantly old..
Jan 10
 Jochmans et al., mBio, doi:10.1128/mbio.02815-22 (In Vitro) The Substitutions L50F, E166A, and L167F in SARS-CoV-2 3CLpro Are Selected by a Protease Inhibitor In Vitro and Confer Resistance To Nirmatrelvir
In Vitro study showing selection of nirmatrelvir-resistant mutations with a protease inhibitor.
Jan 7
 Dhibar et al., Scientific Reports, doi:10.1038/s41598-022-26053-w The ‘myth of Hydroxychloroquine (HCQ) as post-exposure prophylaxis (PEP) for the prevention of COVID-19’ is far from reality
27% fewer symptomatic cases [p=0.32] and 21% fewer cases [p=0.21]. Low dose low-risk patient HCQ PEP RCT, showing lower symptomatic cases with treatment, without statistical significance. There were no moderate or severe cases. HCQ 800mg on day one followed by 400mg once weekly for 3 weeks.
Jan 5
 MedInCell Press Release (Preprint) MedinCell announces positive results for the SAIVE clinical study in prevention of Covid-19 infection in a contact-based population
72% fewer cases [p<0.0001]. PEP RCT 399 patients in Bulgaria showing significantly lower COVID-19 cases with ivermectin prophylaxis. Limited information is currently available.
Jan 4
 Mitjà et al., Clinical and Translational Science, doi:10.1111/cts.13468 Hydroxychloroquine for treatment of non‐hospitalized adults with COVID-19: A meta-analysis of individual participant data of randomized trials
33% improved viral clearance [p=0.02]. Extremely high COI (includes authors of trials playing a key role in the suppression of treatment, and funded by the Gates Foundation) IPD meta analysis of 11 HCQ outpatient treatment and prophylaxis trials, showing significantly improved..
Jan 3
 Ram et al., Research Square, doi:10.21203/rs.3.rs-2418159/v1 (Preprint) Analysis of trace elements (Zn and Cu) levels in COVID-19 patients with ICU and Non-ICU hospitalization
Prospective analysis of 122 hospitalized COVID-19 patients, showing significantly lower zinc levels in ICU patients compared with non-ICU patients. Zinc levels were lower in non-survivors compared with survivors, without statistical signi..
Dec 29
 De Nicolò et al., Nutrients, doi:10.3390/nu15010169 Possible Impact of Vitamin D Status and Supplementation on SARS-CoV-2 Infection Risk and COVID-19 Symptoms in a Cohort of Patients with Inflammatory Bowel Disease
88% lower IgG positivity [p=0.002]. Prospective study of 106 IBD patients in Italy, showing lower risk of IgG positivity with vitamin D supplementation. Vitamin D levels below 30 ng/mL were associated with a higher probability of symptomatic cases.
Dec 27
 Baldia et al., BMC Geriatrics, doi:10.1186/s12877-022-03709-w The association of prior paracetamol intake with outcome of very old intensive care patients with COVID-19: results from an international prospective multicentre trial
12% lower mortality [p=0.2]. Prospective study of 2,646 ICU patients ≥70 years old, showing no significant difference in mortality with acetaminophen use in the 10 days prior to ICU admission.
Dec 26
 Lorman et al., medRxiv, doi:10.1101/2022.12.22.22283791 (Preprint) A machine learning-based phenotype for long COVID in children: an EHR-based study from the RECOVER programhttps://www.medrxiv.org/content/10.1101/2022.12.22.22283791
Retrospective 87,398 pediatric patients in the USA, reporting acetaminophen and aspirin associated with PASC, without specific details. Authors note that this could be related to use for MIS-C treatment.
Dec 24
 Bramante et al., medRxiv, doi:10.1101/2022.12.21.22283753 (Preprint) Outpatient treatment of Covid-19 with metformin, ivermectin, and fluvoxamine and the development of Long Covid over 10-month follow-up
41% lower PASC [p=0.01]. Long-term 10 month followup for NCT04510194, showing significantly lower incidence of PASC with metformin treatment. Adjusted results are provided for metformin but not for ivermectin or fluvoxamine. For many issues with this trial, see [..
Dec 22
 Fountain-Jones et al., medRxiv, doi:10.1101/2022.12.21.22283811 (Preprint) Antiviral treatments lead to the rapid accrual of hundreds of SARS-CoV-2 mutations in immunocompromised patients
Analysis of immunocompromised patients showing rapid creation of new variants with molnupiravir. All patients treated with molnupiravir accrued new mutations in the spike protein of the virus, including non-synonymous mutations that alter..
Dec 20
 Zadeh et al., Innovation in Aging, doi:10.1093/geroni/igac059.3047 Effect of aspirin in COVID-19 outcomes of older adults with a history of coronary artery disease
37% lower mortality [p=0.28] and 1% higher ICU admission [p=0.79]. Retrospective 4,017 coronary artery disease patients hospitalized for COVID-19 in the USA, showing no significant difference in outcomes with low dose aspirin use.
Dec 19
 Hussein et al., BMJ Open, doi:10.1136/bmjopen-2022-064953 Real-world effectiveness of casirivimab and imdevimab among patients diagnosed with COVID-19 in the ambulatory setting: a retrospective cohort study using a large claims database
60% lower combined mortality/hospitalization [p<0.0001]. Retrospective 73,759 outpatients treated with casirivimab/imdevimab, showing lower mortality with treatment. This result is subject to potentially substantial confounding by indication - patients with more severe cases may be more likely ..
Dec 16
 Higgins et al., JAMA, doi:10.1001/jama.2022.23257 Long-term (180-Day) Outcomes in Critically Ill Patients With COVID-19 in the REMAP-CAP Randomized Clinical Trial
1% lower mortality [p=0.9]. Long-term followup for the REMAP-CAP very late stage ICU trial, showing no significant difference with convalescent plasma treatment.
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 2,424 studies, 1,611 present results comparing with a control group, 1,468 are treatment studies, and 143 analyze outcomes based on serum levels. There are 29 animal studies, 60 in silico studies, 124 in vitro studies, and 124 meta analyses.
Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, 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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