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Colchicine
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Hydroxychlor..
Iota-carragee..
Ivermectin
Lactoferrin
Lifestyle..
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Molnupiravir
Monoclonals..
Nigella Sativa
Nitazoxanide
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Povidone-Iod..
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Vitamins..
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Home   COVID-19 treatment studies  COVID-19 treatment studies  COVID-19 studies   Select treatmentSelect treatmentTreatmentsTreatments
Melatonin Meta
Bromhexine Meta Metformin Meta
Budesonide Meta Molnupiravir Meta
Cannabidiol Meta
Colchicine Meta Nigella Sativa Meta
Conv. Plasma Meta Nitazoxanide Meta
Curcumin Meta Nitric Oxide Meta
Ensovibep Meta Paxlovid Meta
Famotidine Meta Peg.. Lambda Meta
Favipiravir Meta Povidone-Iod.. Meta
Fluvoxamine Meta Quercetin Meta
Hydroxychlor.. Meta Remdesivir Meta
Iota-carragee.. Meta
Ivermectin Meta Zinc Meta
Lactoferrin Meta

Other Treatments Global Adoption
COVID-19 early treatment: real-time analysis of 2,324 studies
Analysis of 47 COVID early treatments, approvals in 80 countries, database of 1,974 treatments  
No treatment, vaccine, or intervention is 100% available and effective. All practical, effective, and safe means should be used based on risk/benefit analysis.
Tallon
116,370 patients vitamin D sufficiency: 42% lower hospitalization [p<0.0001]
Milosavljevic
733 patients metformin prophylaxis: 33% lower severe cases [p=0.03]
Gershengorn
6,284 patients casirivimab/imdevimab early treatment: 95% higher hospitalization [p=0.09]
Aidouni
1,124 patients aspirin ICU: 31% lower mortality [p=0.003] and 10% lower ventilation [p=0.33]
Boschi
In Vitro study showing that ivermectin blocked hemagglutination (clumping of red blood cells) when added to red blood cells prior to SARS-CoV-2..
Cost per life saved from NNT in
studies to date
c19early.org Dec 2022
Melatonin
9
48%
  $8
Vitamin D
59
37%
  $11
Vitamin C
33
27%
  $12
Ivermectin
48
51%
  $22
Colchicine
33
37%
  $26
HCQ
228
22%
  $29
Zinc
18
28%
  $30
Vitamin A
6
42%
  $30
Curcumin
7
63%
  $40
Aspirin
53
12%
  $41
Famotidine
18
17%
  $105
Quercetin
4
59%
  $116
Probiotics
7
61%
  $145
Metformin
42
32%
  $161
Antiandrogens
31
40%
  $175
Fluvoxamine
5
37%
  $240
Nigella Sativa
4
73%
  $279
Nitazoxanide
6
42%
  $680
Budesonide
7
30%
  $887
Favipiravir
29
13%
  $1,015
Paxlovid
9
64%
  $69,222
Molnupiravir
11
28%
  $88,734
Casirivimab/i..
8
40%
  $181,694
Remdesivir
40
16%
  $208,615
Bamlaniv../e..
10
56%
  $301,549
Tixagev../c..
4
41%
  $412,873
Sotrovimab
7
68%
  $442,638
Conv. Plasma
19
-10%
N/A
Acetaminophen
11
-32%
N/A
Treatment cost times median NNT - details and limitations
Sotrovimab Evusheld Paxlovid Fluvoxamine Lactoferrin Molnupiravir Quercetin Famotidine Acetaminophen ↑risk Budesonide Bamlanivimab/e.. Curcumin REGEN-COV Povidone-Iodine Probiotics Nigella Sativa Melatonin Aspirin 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 Dec 2022 Time when COVID-19 studies showed efficacy
Sotrovimab Evusheld Paxlovid Fluvoxamine Lactoferrin Molnupiravir Quercetin Famotidine Acetaminophen ↑risk Budesonide Bamlanivimab/e.. Curcumin REGEN-COV Povidone-Iodine Probiotics Nigella Sativa Melatonin Aspirin 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 Dec 2022 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 1,279 Ivermectin 62% [54-69%] 93 $1 134,223 Bamlaniv../e.. 55% [30-71%] 14 $1,250 24,423 variant dependent Nigella Sativa 53% [27-70%] 11 $5 2,959 Diet 52% [41-61%] 19 $0 607,729 Casirivimab/i.. 51% [31-66%] 25 $2,100 54,453 variant dependent 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 Lactoferrin 48% [30-62%] 4 $5 786 Ensovibep 46% [-173-89%] 2 $2,100 885 limited data Ensitrelvir 45% [19-63%] 1 $500 28 very limited data Spironolactone 45% [18-63%] 10 $5 3,137 Bebtelovimab 44% [-827-97%] 2 $1,200 1,134 intravenous Melatonin 43% [30-54%] 18 $1 14,301 Vitamin A 40% [-10-67%] 11 $2 18,305 Curcumin 39% [31-46%] 21 $5 4,804 Paxlovid 38% [27-47%] 19 $529 53,931 independent trial refused Exercise 38% [30-44%] 48 $0 1,732,155 Colchicine 37% [26-46%] 40 $1 29,991 Vitamin D 36% [30-42%] 101 $1 181,970 Peg.. Lambda 35% [-132-82%] 3 $500 2,116 subcutaneous Budesonide 33% [18-45%] 9 $4 25,919 Sotrovimab 33% [-26-65%] 12 $2,100 18,482 variant dependent 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 Nitric Oxide 28% [-10-53%] 8 $11 1,450 Zinc 28% [16-38%] 38 $1 45,372 Metformin 27% [22-31%] 55 $10 206,012 Hydroxychlor.. 25% [21-29%] 372 $1 495,620 Vitamin C 22% [14-30%] 56 $1 58,331 Probiotics 22% [12-31%] 20 $5 17,944 Molnupiravir 21% [-4-41%] 24 $707 67,587 mutagenic/teratogenic Favipiravir 21% [9-31%] 55 $20 25,682 N-acetylcys.. 20% [9-30%] 17 $1 24,853 Famotidine 15% [5-25%] 25 $5 92,443 Remdesivir 15% [6-23%] 44 $3,120 133,239 intravenous Aspirin 12% [6-17%] 61 $1 172,519 Ibuprofen -1% [-10-8%] 12 $1 54,527 Conv. Plasma -10% [-42-14%] 19 $5,000 21,323 Acetaminoph.. -30% [-52--11%] 17 $1 91,239 Cannabidiol -45% [-167-21%] 6 $25 3,784 All studies (pooled effects, all stages) c19early.org Dec 2022 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% 93 Bamlaniv../e.. 55% 14 variant dependent Nigella Sativa 53% 11 Diet 52% 19 Casirivimab/.. 51% 25 variant dependent Povidone-Iod.. 51% 20 Tixagev../c.. 50% 8 variant dependent Bromhexine 50% 6 very limited data Lactoferrin 48% 4 Ensovibep 46% 2 limited data Ensitrelvir 45% 1 very limited data Spironolactone 45% 10 Bebtelovimab 44% 2 intravenous Melatonin 43% 18 Vitamin A 40% 11 Curcumin 39% 21 Paxlovid 38% 19 independent trial refused Exercise 38% 48 Colchicine 37% 40 Vitamin D 36% 101 Peg.. Lambda 35% 3 subcutaneous Budesonide 33% 9 Sotrovimab 33% 12 variant dependent Nitazoxanide 33% 13 Antiandrogens 31% 45 Fluvoxamine 31% 13 Sleep 31% 12 Nitric Oxide 28% 8 Zinc 28% 38 Metformin 27% 55 Hydroxychlor.. 25% 372 Vitamin C 22% 56 Probiotics 22% 20 Molnupiravir 21% 24 mutagenic/teratogenic Favipiravir 21% 55 N-acetylcys.. 20% 17 Famotidine 15% 25 Remdesivir 15% 44 intravenous Aspirin 12% 61 Ibuprofen -1% 12 Conv. Plasma -10% 19 Acetaminoph.. -30% 17 Cannabidiol -45% 6 All studies (pooled effects, all stages) c19early.org Dec 22 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 - 35 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 4,375 0.2% (9) 99.5% 0.1% (3) 97.2%
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. Vladimir Zelenko USA 2,200 0.5% (12) 98.6% 0.1% (2) 96.3%
Mean improvement with early treatment protocols 219,653 HospitalizationHosp. 94.7% MortalityDeath 94.3%
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.. 45% 19
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PLPaxlovid 44% 18
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ZnZinc 41% 6
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SSotrovimab 37% 11
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FPVFavipiravir 30% 16
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MPMolnupiravir 26% 21
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
V.CVitamin C 24% 5
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ACEAcetaminophen -17% 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IBIbuprofen -52% 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Early treatments approved by >2 countries. 80 countries have officially approved treatments. Details.
Tallon
116,370 patients sufficiency: 42% lower hospitalization [p<0.0001]
Green
Sufficiency: 19% fewer cases [p<0.0001]
Sharif
Prophylaxis: 28% lower severe cases [p=0.001]
Milosavljevic
733 patients prophylaxis: 33% lower severe cases [p=0.03]
Gershengorn
6,284 patients early treatment: 95% higher hospitalization [p=0.09]
Aidouni
1,124 patients ICU: 31% lower mortality [p=0.003] and 10% lower ventilation [p=0.33]
Ali
1,645 patients prophylaxis: 28% lower mortality [p=0.07]
Zekri-Nechar
201 patients late treatment: 16% higher mortality [p=0.57] and 16% higher ICU admission [p=0.57]
Boschi
In Vitro study showing that ivermectin blocked hemagglutination (clumping of red blood cells) when added to red blood cells prior to SARS-CoV-2..
Green
113,075 patients: 42% fewer cases [p<0.0001]
Pitanga
4,476 patients: 33% fewer cases [p=0.05]
Matsuyama
279 patient early treatment RCT: 69% improved viral clearance [p=0.03]
Quek
Safety analysis of 42 day treatment with a povidone-iodine throat spray in 117 patients compared with 60 controls, showing no significant..
Guldemir
477 patients prophylaxis: 31% lower hospitalization [p=0.05]
Sharif
Prophylaxis: 46% lower severe cases [p=0.001]
Sharif
Prophylaxis: 40% lower severe cases [p=0.0001]
Levin
1,121 patient prophylaxis RCT: 75% lower severe cases [p=0.33] and 42% fewer symptomatic cases [p=0.06]
Landsteiner de Sampaio Amêndola
Meta analysis: 24% lower mortality [p=0.01] and 20% lower hospitalization [p=0.04]
Bovard
In Vitro study showing iota-carrageenan inhibits SARS-CoV-2 in reconstituted human airway epithelia. Authors note that the absence of toxicity or..
Marcec
Meta analysis: 43% lower hospitalization [p=0.03]
Ameri
226 patient ICU RCT: 29% lower mortality [p<0.0001], 28% lower ventilation [p=0.003], 25% improved recovery [p=0.001], and 29% shorter hospitalization [p=0.03]
Zheng
6,020 patients early treatment: 100% higher combined mortality/hospitalization [p=0.005]
Sinha
1,218 patient early treatment RCT: 65% lower hospitalization [p=0.005], 53% better improvement [p=0.01], and 48% improved viral clearance [p<0.0001]
Zheng
6,020 patients early treatment: 50% lower combined mortality/hospitalization [p=0.005]
Sitasuwan
Retrospective 1,940 outpatients in Thailand, showing lower risk of clinical deterioration with early vs. late favipiravir treatment.
Recent studies (see the individual treatment pages for all studies):

Dec 2
Gershengorn et al., PLOS ONE, doi:10.1371/journal.pone.0278770 The clinical effectiveness of REGEN-COV in SARS-CoV-2 infection with Omicron versus Delta variants
95% higher hospitalization [p=0.09]. Retrospective 2,083 outpatients in the USA, showing higher risk of hospitalization with casirivimab/imdevimab, without statistical significance. There may be significant unadjusted confounding by indication.
Nov 30
Aidouni et al., Research Square, doi:10.21203/rs.3.rs-2313880/v1 (Preprint) The impact of asprin use on the outcome of patients admitted to the intensive care unit with COVID-19 infection
31% lower mortality [p=0.003] and 10% lower ventilation [p=0.33]. Prospective study of 1,124 COVID-19 ICU patients, showing lower mortality with aspirin treatment.
Nov 28
Boschi et al., bioRxiv, doi:10.1101/2022.11.24.517882 (Preprint) (In Vitro) SARS-CoV-2 Spike Protein Induces Hemagglutination: Implications for COVID-19 Morbidities and Therapeutics and for Vaccine Adverse Effects
In Vitro study showing that ivermectin blocked hemagglutination (clumping of red blood cells) when added to red blood cells prior to SARS-CoV-2 spike protein, and reversed hemagglutination when added afterwards. Spike protein from four li..
Nov 28
Matsuyama et al., Scientific Reports, doi:10.1038/s41598-022-24683-8 A prospective, randomized, open-label trial of early versus late povidone-iodine gargling in patients with COVID-19
69% improved viral clearance [p=0.03]. RCT 430 COVID+ patients in Japan, showing significantly lower viral infectivity from culture, and significantly faster PCR viral clearance with PVP-I. For days 2-4 the study compares treatment with PVP-I vs. water (on day 5 both groups re..
Nov 26
Sharif et al., Nutrients, doi:10.3390/nu14235029 Impact of Zinc, Vitamins C and D on Disease Prognosis among Patients with COVID-19 in Bangladesh: A Cross-Sectional Study
77% higher mortality [p=0.74]. Retrospective COVID-19 patients in Bangladesh, showing higher mortality with acetaminophen use in unadjusted results.
Nov 22
Levin et al., Clinical Infectious Diseases, doi:10.1093/cid/ciac899 AZD7442 (Tixagevimab/Cilgavimab) for Post-exposure Prophylaxis of Symptomatic COVID-19
75% lower severe cases [p=0.33] and 42% fewer symptomatic cases [p=0.06]. 1,121 patient PEP RCT showing lower symptomatic cases with tixagevimab/cilgavimab, without statistical significance.
Nov 21
Landsteiner de Sampaio Amêndola et al., Journal of Clinical Medicine, doi:10.3390/jcm11226865 (meta analysis) COVID-19 Infection in Rheumatic Patients on Chronic Antimalarial Drugs: A Systematic Review and Meta-Analysis
24% lower mortality [p=0.01] and 20% lower hospitalization [p=0.04]. Systematic review and meta analysis of 20 studies on HCQ use in rheumatic disease patients, showing significantly lower mortality and hospitalization with HCQ prophylaxis.
Nov 19
Ameri et al., Inflammopharmacology, doi:10.1007/s10787-022-01096-7 Efficacy and safety of oral melatonin in patients with severe COVID-19: a randomized controlled trial
29% lower mortality [p<0.0001], 28% lower ventilation [p=0.003], 25% improved recovery [p=0.001], and 29% shorter hospitalization [p=0.03]. RCT 226 ICU patients in Iran, showing lower mortality with melatonin treatment.
Nov 19
Ali et al., Chest, doi:10.1016/j.chest.2022.11.013 Cardiovascular complications are the primary drivers of mortality in hospitalized patients with SARS-CoV-2 community-acquired pneumonia
28% lower mortality [p=0.07]. Retrospective 1,645 hospitalized patients in the USA, showing lower mortality with aspirin use, without statistical significance.
Nov 18
Quek et al., Annals of Medicine, doi:10.1080/07853890.2022.2108132 Stable thyroid function despite regular use of povidone-iodine throat spray for SARS-CoV-2 prophylaxis
Safety analysis of 42 day treatment with a povidone-iodine throat spray in 117 patients compared with 60 controls, showing no significant differences in thyroid function. Authors note the study included relatively young and healthy patien..
Nov 18
Nicoll et al., Journal of Clinical Medicine, doi:10.3390/jcm11226818 (Review) COVID-19 Prevention: Vitamin D Is Still a Valid Remedy
Discussion of limitations and concerns for [Jolliffe].
Nov 17
Planas et al., bioRxiv, doi:10.1101/2022.11.17.516888 (Preprint) (In Vitro) Resistance of Omicron subvariants BA.2.75.2, BA.4.6 and BQ.1.1 to neutralizing antibodies
In Vitro study suggesting a lack of efficacy for bebtelovimab with BQ.1.1.
Nov 17
Marcec et al., Journal of Infection, doi:10.1016/j.jinf.2022.11.011 A meta-analysis regarding fluvoxamine and hospitalization risk of COVID-19 patients: TOGETHER making a difference
43% lower hospitalization [p=0.03]. Meta analysis of 7 fluvoxamine outpatient studies showing significantly lower hospitalization with treatment.
Nov 17
Bubenek-Turconi et al., European Journal of Anaesthesiology, doi:10.1097/EJA.0000000000001776 Clinical characteristics and factors associated with ICU mortality during the first year of the SARS-Cov-2 pandemic in Romania
22% lower mortality [p=0.01]. Prospective study of 9,058 COVID-19 ICU patients in Romania, showing lower mortality with HCQ treatment.
Nov 16
Zheng et al., BMJ, doi:10.1136/bmj-2022-071932 Comparative effectiveness of sotrovimab and molnupiravir for prevention of severe covid-19 outcomes in patients in the community: observational cohort study with the OpenSAFELY platform
50% lower combined mortality/hospitalization [p=0.005]. Retrospective 3,331 sotrovimab and 2,689 molnupiravir patients in the UK, showing lower risk of combined hospitalization/death with sotrovimab.
Nov 16
Rahman et al., PLOS ONE, doi:10.1371/journal.pone.0277790 Efficacy of colchicine in patients with moderate COVID-19: A double-blinded, randomized, placebo-controlled trial
71% lower mortality [p=0.04] and 71% lower progression [p=0.04]. RCT 300 patients in Bangladesh, published 2 years after completion, showing significantly lower mortality with treatment at 28 days (not significant at 14 days). 1.2mg colchicine on day 1 followed by 0.6mg for 13 days.
Nov 16
Guldemir et al., Work, doi:10.3233/wor-220292 Clinical characteristics of bus drivers and field officers infected with COVID-19: A cross-sectional study from Istanbul
5% lower hospitalization [p=0.89]. Retrospective 477 COVID+ public transportation workers in Turkey, showing no significant difference in hospitalization with vitamin D use in unadjusted results.
Nov 15
Tallon et al., Diabetes Research and Clinical Practice, doi:10.1016/j.diabres.2022.110156 Impact of diabetes status and related factors on COVID-19-associated hospitalization: A nationwide retrospective cohort study of 116,370 adults with SARS-CoV-2 infection
42% lower hospitalization [p<0.0001]. Retrospective 116,370 COVID+ patients in the USA, showing higher risk of hospitalization with vitamin D deficiency/insufficiency.
Nov 15
Pandit et al., medRxiv, doi:10.1101/2022.11.14.22282195 (Preprint) The Paxlovid Rebound Study: A Prospective Cohort Study to Evaluate Viral and Symptom Rebound Differences Between Paxlovid and Untreated COVID-19 Participants
1% improved recovery [p=0.9], 3% improved viral clearance [p=0.73], and 171% worse results [p=0.06]. Prospective study of 170 COVID-19 patients in the USA, showing no significant difference in symptomatic and viral recovery times, and higher risk of symptomatic rebound, without statistical significance. There were more elderly patients i..
Nov 15
Zekri-Nechar et al., Medicina, doi:10.3390/medicina58111649 Analysis of Prior Aspirin Treatment on in-Hospital Outcome of Geriatric COVID-19 Infected Patients
16% higher mortality [p=0.57] and 16% higher ICU admission [p=0.57]. Retrospective 201 consecutive elderly hospitalized patients in Spain, showing higher mortality with aspirin use in unadjusted results. The aspirin group was older and had higher prevalence of hypertension and dyslipidemia. Table 1 shows t..
Nov 14
Sinha et al., Cureus, doi:10.7759/cureus.31508 Efficacy and Safety of Molnupiravir in Mild COVID-19 Patients in India
65% lower hospitalization [p=0.005], 53% better improvement [p=0.01], and 48% improved viral clearance [p<0.0001]. RCT 1,218 outpatients in India, showing lower hospitalization, better clinical improvement, and improved viral clearance with molnupiravir.
Nov 14
Sukumar et al., F1000Research, doi:10.12688/f1000research.109023.1 The Frontline War: A Case-control study of risk factors for COVID-19 among health care workers
38% fewer cases [p=0.3]. Case control study of healthcare workers in India, showing lower risk of cases with HCQ prophylaxis, without statistical significance. While authors comment negatively, as may be required for publication, and this study alone is not stati..
Nov 12
Gibbons et al., Scientific Reports, doi:10.1038/s41598-022-24053-4 Association between vitamin D supplementation and COVID-19 infection and mortality
33% lower mortality [p<0.0001] and 20% fewer cases [p<0.0001]. PSM retrospective in the USA, showing lower COVID-19 mortality and cases with vitamin D prophylaxis.
Nov 11
Rahmati et al., Journal of Medical Virology, doi:10.1002/jmv.28298 The effect of adherence to high‐quality dietary pattern on COVID‐19 outcomes: A systematic review and meta‐analysis
62% lower hospitalization [p=0.004] and 28% fewer cases [p<0.0001]. Meta analysis of 5 diet and COVID-19 studies, showing lower risk of COVID-19 cases and hospitalization with higher quality diets.
Nov 11
Chirumbolo, S., Journal of Medical Virology, doi:10.1002/jmv.28301 The widest use of paracetamol in home therapy might have actually increased the occurrence of severe forms of COVID‐19 in Italy, affecting hospitalization and death rates.
Analysis of COVID-19 cases in Italy reporting a higher risk of hospitalization in intensive therapy units after the recommendation to use paracetamol.
Nov 11
Sitasuwan et al., Medicine, doi:10.1097/MD.0000000000031681 Early antiviral and supervisory dexamethasone treatment improve clinical outcomes of nonsevere COVID-19 patients
Retrospective 1,940 outpatients in Thailand, showing lower risk of clinical deterioration with early vs. late favipiravir treatment.
Nov 10
Sidky et al., medRxiv, doi:10.1101/2022.11.09.22282142 (Preprint) Assessing the Effect of Selective Serotonin Reuptake Inhibitors in the Prevention of Post-Acute Sequelae of COVID-19
N3C retrospective 17,933 COVID-19 patients in the USA, showing lower risk of PASC for SSRIs with or without S1R agonist activity.
Nov 10
De Forni et al., PLoS ONE, doi:10.1371/journal.pone.0276751 (In Vitro) Synergistic drug combinations designed to fully suppress SARS-CoV-2 in the lung of COVID-19 patients
Vero E6 In Vitro study showing remdesivir and ivermectin or azithromycin to be highly synergistic with 4-13 times lower concentration required for 100% inhibition.
Nov 9
Milosavljevic et al., Journal of Community Hospital Internal Medicine Perspectives, doi:10.55729/2000-9666.1127 Evaluation of Glycemic Control and Predictors of Severe Illness and Death in Patients With Diabetes Hospitalized With COVID-19
33% lower severe cases [p=0.03]. Retrospective 733 hospitalized COVID-19 patients with diabetes in the USA, showing lower risk of severity with metformin use.
Nov 8
Said et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.1011522 The effect of Nigella sativa and vitamin D3 supplementation on the clinical outcome in COVID-19 patients: A randomized controlled clinical trial
77% improved recovery [p=0.09] and 61% improved viral clearance [p=0.08]. 120 patient RCT comparing vitamin D, nigella sativa, and combined vitamin D+nigella sativa, showing improved symptom recovery and viral clearance with both vitamin D and nigella sativa, and further improvements with the combination of bot..
Nov 8
Sittichai et al., Frontiers in Physiology, doi:10.3389/fphys.2022.1030568 (meta analysis) Effects of physical activity on the severity of illness and mortality in COVID-19 patients: A systematic review and meta-analysis
Systematic review and meta analysis of 18 studies, showing significantly lower COVID-19 severity and mortality with physical activity.
Nov 7
Green et al., European Journal of General Practice, doi:10.1080/13814788.2022.2138855 A higher frequency of physical activity is associated with reduced rates of SARS-CoV-2 infection
19% fewer cases [p<0.0001]. Retrospective 113,075 people in Israel, showing lower risk of COVID-19 cases with higher vitamin D levels.
Nov 7
Trkulja et al., Research Square, doi:10.21203/rs.3.rs-2239187/v1 (Preprint) Outpatients prescribed with fluvoxamine around the time of COVID-19 diagnosis are not at a reduced risk of subsequent hospitalization and death compared to their non-prescribed peers: population-based matched cohort study
27% lower mortality [p=0.41] and 37% higher hospitalization [p=0.5]. Retrospective COVID+ patients in Croatia, showing no significant difference in outcomes with fluvoxamine prophylaxis.
Nov 5
Schwartz et al., medRxiv, doi:10.1101/2022.11.03.22281881 (Preprint) Real-world effectiveness of nirmatrelvir/ritonavir use for COVID-19: A population-based cohort study in Ontario, Canada
50% lower mortality [p<0.0001] and 43% lower combined mortality/hospitalization [p<0.0001]. Retrospective 177,545 patients in Canada, 8,876 treated with paxlovid, showing lower mortality and hospitalization with treatment, and declining efficacy over the two time periods analyzed.
Nov 4
Abdallah et al., Clinical Infectious Diseases, doi:10.1093/cid/ciac807 Twice daily oral zinc in the treatment of patients with Coronavirus Disease-19: A randomized double-blind controlled trial
30% lower mortality [p=0.27], 38% lower combined mortality/ICU admission [p=0.04], 54% lower ICU admission [p=0.01], and 42% lower need for oxygen therapy [p=0.009]. RCT 470 patients with symptoms ≤7 days, showing significantly lower ICU admission and combined mortality/ICU admission with zinc treatment. Greater benefit was seen for patients treated within 3 days. 25mg elemental zinc bid for 15 days.
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 2,324 studies, 1,568 present results comparing with a control group, 1,427 are treatment studies, and 141 analyze outcomes based on serum levels. There are 29 animal studies, 58 in silico studies, 120 in vitro studies, and 123 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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