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Hydroxychlor..
Iota-carragee..
Ivermectin
Lactoferrin
Lifestyle..
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Molnupiravir
Monoclonals..
Nigella Sativa
Nitazoxanide
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Vitamins..
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Home   COVID-19 treatment studies  COVID-19 treatment studies  COVID-19 studies   Select treatmentSelect treatmentTreatmentsTreatments
Alkalinization Meta Lactoferrin Meta
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

Other Treatments Global Adoption
COVID-19 early treatment: real-time analysis of 2,614 studies
Analysis of 49 COVID early treatments, approvals in 101 countries, database of 2,603 treatments  
Lahaye
Vitamin A sufficiency: 23% lower mortality [p=0.02] and 2% lower severe cases [p=0.4]
Kim
14 patient peginterferon lambda late treatment RCT: 200% higher ICU admission [p=1], 25% longer hospitalization [p=0.59], and 12% improved viral clearance [p=1]
Bucurica
11,182 patients vitamin D sufficiency: 28% fewer cases [p<0.0001]
Goodwin
416 patients molnupiravir early treatment: 110% higher mortality [p=0.47] and 58% lower hospitalization [p=0.7]
Schloss
Review of 22 nutritional factors that have been linked to COVID-19 outcomes, the role of nutrients in COVID-19 infection, and the prevalence of..
Cost per life saved from NNT in
studies to date
c19early.org Mar 2023
Melatonin
9
48%
  $8
Vitamin D
60
36%
  $10
Vitamin C
34
27%
  $12
Alkalinization
4
42%
  $18
Ivermectin
48
51%
  $22
Zinc
19
29%
  $23
HCQ
232
22%
  $29
Vitamin A
6
42%
  $30
Colchicine
36
35%
  $31
Aspirin
55
12%
  $33
Curcumin
7
63%
  $40
Fluvoxamine
6
47%
  $69
Probiotics
8
61%
  $99
Famotidine
18
17%
  $105
Metformin
46
32%
  $172
Antiandrogens
32
38%
  $179
Quercetin
4
59%
  $188
Nigella Sativa
4
73%
  $279
Nitazoxanide
6
42%
  $680
Budesonide
9
28%
  $887
Favipiravir
32
15%
  $1,015
Paxlovid
13
59%
  $46,111
Molnupiravir
15
23%
  $137,653
Casirivimab/i..
8
40%
  $181,694
Remdesivir
44
14%
  $208,615
Bamlaniv../e..
10
56%
  $301,549
Sotrovimab
9
57%
  $442,638
Tixagev../c..
5
38%
  $740,002
Conv. Plasma
39
-6%
N/A
Acetaminophen
13
-27%
N/A
Treatment cost times median NNT - details and limitations
Evusheld Paxlovid Alkalinization 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 Mar 2023 Time when COVID-19 studies showed efficacy
Evusheld Paxlovid Alkalinization 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 Mar 2023 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations. 1.4% 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% [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 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 Quercetin 50% [20-69%] 10 $5 1,387 Povidone-Iod.. 50% [37-61%] 20 $1 3,226 Tixagev../c.. 48% [27-64%] 9 $855 26,568 variant dependent Ensovibep 46% [-173-89%] 2 $2,100 885 limited data Diet 46% [36-54%] 22 $0 687,588 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 Alkalinization 43% [23-58%] 7 $1 1,092 Vitamin A 40% [-10-67%] 11 $2 18,305 Exercise 40% [33-46%] 53 $0 1,774,825 Bromhexine 39% [0-63%] 7 $5 834 very limited data Fluvoxamine 39% [19-54%] 14 $4 35,144 Curcumin 38% [26-47%] 23 $5 5,029 Vitamin D 37% [31-42%] 107 $1 182,747 Paxlovid 35% [26-43%] 25 $529 65,803 independent trials refused Spironolactone 34% [15-49%] 11 $5 28,145 Colchicine 34% [23-43%] 44 $1 30,452 Nitazoxanide 33% [-22-63%] 13 $4 3,606 Budesonide 31% [16-43%] 11 $4 26,206 Antiandrogens 30% [21-39%] 46 $5 119,230 Sleep 29% [20-37%] 13 $0 275,358 Zinc 28% [17-38%] 39 $1 45,473 Metformin 27% [22-32%] 61 $10 208,331 Ensitrelvir 27% [-19-55%] 2 $500 255 very limited data Nitric Oxide 27% [-11-52%] 9 $11 1,484 Sotrovimab 25% [-17-52%] 16 $2,100 33,142 variant dependent Hydroxychlor.. 25% [21-28%] 385 $1 513,020 Probiotics 24% [15-33%] 22 $5 18,114 Lactoferrin 24% [-30-56%] 6 $5 1,213 Vitamin C 22% [14-30%] 57 $1 58,405 Favipiravir 20% [9-30%] 59 $20 28,372 N-acetylcys.. 19% [8-29%] 19 $1 25,043 Molnupiravir 16% [-5-33%] 30 $707 104,953 mutagenic/teratogenic Famotidine 15% [5-25%] 25 $5 92,443 Remdesivir 12% [4-20%] 48 $3,120 134,963 intravenous Aspirin 12% [6-17%] 63 $1 172,617 Peg.. Lambda 7% [-138-63%] 4 $500 2,143 subcutaneous Ibuprofen -1% [-10-8%] 12 $1 54,527 Conv. Plasma -5% [-16-5%] 40 $5,000 27,132 intravenous Cannabidiol -19% [-128-38%] 7 $25 3,784 Acetaminoph.. -27% [-43--13%] 20 $1 94,209 All studies (pooled effects, all stages) c19early.org Mar 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 Ivermectin 62% 95 Bamlaniv../e.. 55% 14 variant dependent Nigella Sativa 53% 11 Casirivimab/.. 53% 26 variant dependent Quercetin 50% 10 Povidone-Iod.. 50% 20 Tixagev../c.. 48% 9 variant dependent Ensovibep 46% 2 limited data Diet 46% 22 Sunlight 45% 4 Bebtelovimab 44% 2 intravenous Melatonin 43% 18 Alkalinization 43% 7 Vitamin A 40% 11 Exercise 40% 53 Bromhexine 39% 7 very limited data Fluvoxamine 39% 14 Curcumin 38% 23 Vitamin D 37% 107 Paxlovid 35% 25 independent trials refused Spironolactone 34% 11 Colchicine 34% 44 Nitazoxanide 33% 13 Budesonide 31% 11 Antiandrogens 30% 46 Sleep 29% 13 Zinc 28% 39 Metformin 27% 61 Ensitrelvir 27% 2 very limited data Nitric Oxide 27% 9 Sotrovimab 25% 16 variant dependent Hydroxychlor.. 25% 385 Probiotics 24% 22 Lactoferrin 24% 6 Vitamin C 22% 57 Favipiravir 20% 59 N-acetylcys.. 19% 19 Molnupiravir 16% 30 mutagenic/teratogenic Famotidine 15% 25 Remdesivir 12% 48 intravenous Aspirin 12% 63 Peg.. Lambda 7% 4 subcutaneous Ibuprofen -1% 12 Conv. Plasma -5% 40 intravenous Cannabidiol -19% 7 Acetaminoph.. -27% 20 All studies (pooled effects, all stages) c19early.org Mar 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 - 37 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%
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 235,564 HospitalizationHosp. 94.0% MortalityDeath 94.7%
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
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(H)CQHydroxychlor.. 62% 36
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IVMIvermectin 62% 37
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
RDRemdesivir 61% 4
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
V.DVitamin D 60% 11
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FVFluvoxamine 56% 6
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CICasirivimab/i.. 47% 20
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PLPaxlovid 41% 23
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ZnZinc 41% 6
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SSotrovimab 34% 14
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FPVFavipiravir 26% 17
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
V.CVitamin C 24% 5
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MPMolnupiravir 18% 26
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ACEAcetaminophen -17% 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TCTixagev../c.. -29% 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IBIbuprofen -52% 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Early treatments approved by >2 countries. 101 countries have officially approved treatments. Details.
Lahaye
Sufficiency: 23% lower mortality [p=0.02] and 2% lower severe cases [p=0.4]
Lahaye
Sufficiency: 28% lower mortality [p=0.26] and 53% lower severe cases [p=0.02]
Schloss
Review of 22 nutritional factors that have been linked to COVID-19 outcomes, the role of nutrients in COVID-19 infection, and the prevalence of..
Kim
14 patient late treatment RCT: 200% higher ICU admission [p=1], 25% longer hospitalization [p=0.59], and 12% improved viral clearance [p=1]
Bucurica
11,182 patients sufficiency: 28% fewer cases [p<0.0001]
Montini
Case control analysis with 149 multiple sclerosis patients and 292 matched controls in Italy, showing lower risk of COVID-19 cases with higher..
Bhat
580 patients prophylaxis: 34% fewer symptomatic cases [p=0.01]
Schloss
Review of 22 nutritional factors that have been linked to COVID-19 outcomes, the role of nutrients in COVID-19 infection, and the prevalence of..
Topan
2,342 patients sufficiency: 31% lower mortality [p=0.02] and 11% lower severe cases [p=0.02]
Domazet Bugarin
152 patient ICU RCT: 21% lower mortality [p=0.2], no change in recovery [p=0.71], and 6% longer hospitalization [p=0.76]
Liu
Prospective study of 250 healthcare workers in the USA. The results are unclear - Figure 3 shows ~40% lower incidence with vitamin D supplementation..
Şengül
318 patients prophylaxis: 69% fewer cases [p=0.004]
Kim
In Silico analysis of drug–drug interactions for paxlovid. From 2,248 prescription drugs, 1,628 were predicted to have 2,445 interactions with..
Durstenfeld
4,684 patients long COVID: 14% higher PASC [p=0.4]
Goodwin
416 patients early treatment: 110% higher mortality [p=0.47] and 58% lower hospitalization [p=0.7]
Goodwin
505 patients early treatment: 75% lower mortality [p=0.55] and 60% lower hospitalization [p=0.35]
Schloss
Review of 22 nutritional factors that have been linked to COVID-19 outcomes, the role of nutrients in COVID-19 infection, and the prevalence of..
Schloss
Review of 22 nutritional factors that have been linked to COVID-19 outcomes, the role of nutrients in COVID-19 infection, and the prevalence of..
Wang
55 patient late treatment RCT: 39% shorter hospitalization [p=0.0009]
Samajdar
102 patients late treatment: 69% lower hospitalization [p=0.07] and 29% improved recovery [p=0.008]
Langen
Extensive review of melatonin and the evidence of beneficial effects for many health issues including COVID-19.
Matino
218 patient late treatment RCT: 12% higher mortality [p=0.85], 45% higher ventilation [p=0.39], 6% higher combined mortality/ICU admission [p=0.87], and 34% worse recovery [p=0.12]
Recent studies (see the individual treatment pages for all studies):

Mar 21
Lahaye et al., Nutrients, doi:10.3390/nu15061516 Minerals and Antioxidant Micronutrients Levels and Clinical Outcome in Older Patients Hospitalized for COVID-19 during the First Wave of the Pandemic
28% lower mortality [p=0.26] and 53% lower severe cases [p=0.02]. Retrospective 235 hospitalized COVID-19 patients in France, showing lower zinc levels associated with severe cases. Results are provided for zinc levels as a continuous value.
Mar 15
Wang et al., Frontiers in Public Health, doi:10.3389/fpubh.2023.1145669 Efficacy of nasal irrigation and oral rinse with sodium bicarbonate solution on virus clearance for COVID-19 patients
39% shorter hospitalization [p=0.0009]. RCT 55 mild/moderate patients in China, showing shorter hospitalization with sodium bicarbonate nasal irrigation and oral rinsing. Oral rinse with 5% sodium bicarbonate solution three times daily. Nasal irrigation two times with the solut..
Mar 15
Goodwin et al., PLOS ONE, doi:10.1371/journal.pone.0281915 Evaluation of outpatient treatment for non-hospitalised patients with COVID-19: The experience of a regional centre in the UK
110% higher mortality [p=0.47] and 58% lower hospitalization [p=0.7]. Retrospective 604 outpatients in the UK, showing lower risk of hospitalization with molnupiravir treatment, without statistical significance due to the small number of hospitalizations.
Mar 15
Schloss et al., Inflammopharmacology, doi:10.1007/s10787-023-01183-3 (Review) Nutritional deficiencies that may predispose to long COVID
Review of 22 nutritional factors that have been linked to COVID-19 outcomes, the role of nutrients in COVID-19 infection, and the prevalence of multiple nutritional deficiencies in the population.
Mar 13
Kim et al., Proceedings of the National Academy of Sciences, doi:10.1073/pnas.2221857120 Computational prediction of interactions between Paxlovid and prescription drugs
In Silico analysis of drug–drug interactions for paxlovid. From 2,248 prescription drugs, 1,628 were predicted to have 2,445 interactions with nirmatrelvir and/or ritonavir (673 for nirmatrelvir and 1,403 ritonavir). For 873 drugs, author..
Mar 9
Siuka et al., F1000Research, doi:10.12688/f1000research.131730.1 The effect of Vitamin D levels on the course of COVID-19 in hospitalized patients – a 1-year prospective cohort study
56% lower mortality [p=0.24], 59% higher ICU admission [p=0.59], and 61% higher severe cases [p=0.009]. Prospective study of 301 hospitalized patients in Slovenia, showing higher mortality with vitamin D deficiency, without statistical significance. Fewer patients with severe cases were deficient, which authors hypothesize was due to their..
Mar 6
Bucurica et al., Diagnostics, doi:10.3390/diagnostics13050998 Association of Vitamin D Deficiency and Insufficiency with Pathology in Hospitalized Patients
28% fewer cases [p<0.0001]. Retrospective 11,182 hospitalized patients in Romania, showing vitamin D deficiency associated with COVID-19 cases.
Mar 6
Bhat et al., Journal of Infection, doi:10.1016/j.jinf.2023.03.004 Effect of calcifediol supplementation as add-on therapy on the immune repertoire in recipients of the ChAdOx1 nCoV-19 vaccine: A prospective open-label, placebo-controlled, clinical trial
34% fewer symptomatic cases [p=0.01]. Prospective study of 580 ChAdOx1 recipients, 262 treated with calcifediol (patient choice), showing lower cases with treatment. Supplementation did not significantly affect antibody levels following ChAdOx1 receipt. Calcifediol patients w..
Mar 5
Langen, M., Rounding The Earth (Review) (Preprint) Melatonin - the Hormone of Both Sun and Darkness - Protects Your Health and Can Save Your Life
Extensive review of melatonin and the evidence of beneficial effects for many health issues including COVID-19.
Mar 5
Durstenfeld et al., medRxiv, doi:10.1101/2023.03.02.23286730 Association of Nirmatrelvir/Ritonavir Treatment with Long COVID Symptoms in an Online Cohort of Non-Hospitalized Individuals Experiencing Breakthrough SARS-CoV-2 Infection in the Omicron Era
14% higher PASC [p=0.4]. Retrospective 4,684 COVID+ patients mostly in the USA, 988 treated with paxlovid, showing higher odds of long COVID with treatment, without statistical significance.
Mar 5
Liu et al., The Journal of Nutrition, doi:10.1016/j.tjnut.2023.03.001 Vitamin D and SARS-CoV-2 Infection: SERVE Study (SARS-CoV-2 Exposure and the Role of Vitamin D among Hospital Employees)
Prospective study of 250 healthcare workers in the USA. The results are unclear - Figure 3 shows ~40% lower incidence with vitamin D supplementation, while the text indicates OR 1.18. Authors collected symptom information, stating that &q..
Mar 4
Matino et al., Nutrients, doi:10.3390/nu15051285 Effect of Lactoferrin on Clinical Outcomes of Hospitalized Patients with COVID-19: The LAC Randomized Clinical Trial
12% higher mortality [p=0.85], 45% higher ventilation [p=0.39], 6% higher combined mortality/ICU admission [p=0.87], and 34% worse recovery [p=0.12]. RCT 218 hospitalized patients in Italy, showing no significant differences with lactoferrin treatment. Authors note that in several previous studies showing clinical improvement, lactoferrin was given at an earlier stage of disease. Autho..
Mar 4
Ibrahim Alhajjaji et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2023.02.011 Effect of zinc supplementation on symptom reduction and length of hospital stay among pediatric patients with Coronavirus Disease 2019 (COVID-19)
88% lower mortality [p=0.13], 26% lower ventilation [p=0.75], 3% lower ICU admission [p=1], and 73% lower progression [p=0.004]. Retrospective 101 hospitalized pediatric patients in Saudi Arabia, showing zinc treatment associated with lower respiratory failure and shorter hospitalization in unadjusted results. Patients receiving zinc were older. Authors note elevat..
Mar 3
Al-Gharrawi et al., Scientific Reports, doi:10.1038/s41598-023-30859-7 Association of ApaI rs7975232 and BsmI rs1544410 in clinical outcomes of COVID-19 patients according to different SARS-CoV-2 variants
Retrospective 3,184 patients in Iran, showing COVID-19 outcomes for specific variants were associated with genotypes of the ApaI rs7975232 and BsmI rs1544410 vitamin D receptor polymorphisms.
Mar 3
Samajdar et al., Lung India, doi:10.4103/lungindia.lungindia_268_22 Effectiveness of budesonide formoterol fixed-dose combination MDI in reducing cough symptoms in COVID-19 patients: A real-world evidence study
69% lower hospitalization [p=0.07] and 29% improved recovery [p=0.008]. Prospective study of 102 patients in India, showing improved recovery of cough with budesonide+formoterol. Authors note better results with earlier treatment. Budesonide 800mcg + formoterol 12mcg bid for 7 days.
Mar 3
Kirenga et al., Molecular Psychiatry, doi:10.1038/s41380-023-02004-3 Association of fluvoxamine with mortality and symptom resolution among inpatients with COVID-19 in Uganda: a prospective interventional open-label cohort study
68% lower mortality [p<0.0001] and 53% improved recovery [p=0.04]. Prospective study of 316 hospitalized patients in Uganda, 94 receiving fluvoxamine, showing significantly lower mortality and improved recovery with treatment.
Mar 2
Cousins et al., medRxiv, doi:10.1101/2023.02.28.23286515 Association between spironolactone use and COVID-19 outcomes in population-scale claims data: a retrospective cohort study
18% lower mortality [p=0.004] and 17% lower ventilation [p<0.0001]. PSM retrospective 898,303 hospitalized COVID-19 patients in the USA, 16,324 on spironolactone, showing lower mortality and ventilation with spironolactone use.
Mar 2
Spivak et al., Microbiology Spectrum, doi:10.1128/spectrum.04674-22 A Randomized Clinical Trial Testing Hydroxychloroquine for Reduction of SARS-CoV-2 Viral Shedding and Hospitalization in Early Outpatient COVID-19 Infection
73% higher hospitalization [p=0.54], 20% improved recovery [p=0.19], and 17% improved viral clearance [p=0.19]. Delayed publication of an early terminated late treatment RCT with low-risk (no mortality) outpatients in the USA, showing no significant differences with HCQ. Authors do not provide symptom onset data, but the subgroup analysis suggests ..
Mar 1
Irie, K., Yakugaku Zasshi, doi:10.1248/yakushi.22-00169-1 (Dosing) Pharmacokinetic Study of Antiviral Drugs in Patients with COVID-19
Pharmacokinetics study measuring the blood concentration of favipiravir in 7 critical patients in Japan, showing concentrations below the EC50 in 33 of 36 samples when using the standard dosing regimen. Authors note that patient character..
Feb 28
Punzalan et al., Frontiers in Immunology, doi:10.3389/fimmu.2023.1123497 Utility of laboratory and immune biomarkers in predicting disease progression and mortality among patients with moderate to severe COVID-19 disease at a Philippine tertiary hospital
42% higher mortality [p=0.12] and 59% higher progression [p=0.001]. Prospective study of 400 hospitalized patients in the Philippines, showing higher progression with remdesivir in unadjusted results, without statistical significance.
Feb 28
Topan et al., Nutrients, doi:10.3390/nu15051227 25 Hydroxyvitamin D Serum Concentration and COVID-19 Severity and Outcome—A Retrospective Survey in a Romanian Hospital
31% lower mortality [p=0.02] and 11% lower severe cases [p=0.02]. Retrospective 2,342 hospitalized COVID-19 patients in Romania with vitamin D levels measured on admission day, showing lower risk of mortality and severe/critical cases with vitamin D levels ≥ 20ng/mL.
Feb 28
Domazet Bugarin et al., Nutrients, doi:10.3390/nu15051234 Vitamin D Supplementation and Clinical Outcomes in Severe COVID-19 Patients—Randomized Controlled Trial
21% lower mortality [p=0.2], no change in recovery [p=0.71], and 6% longer hospitalization [p=0.76]. Very late stage RCT 155 ICU patients in Croatia with low vitamin D levels, showing no significant differences with 10,000IU cholecalciferol daily. Calcifediol or calcitriol, which avoids several days delay in conversion, may be more succe..
Feb 28
Mathew et al., Rheumatology Advances in Practice, doi:10.1093/rap/rkad025 Predictors of COVID-19 severity and outcomes in Indian patients with rheumatic diseases: a prospective cohort study
20% lower mortality [p=0.8], no change in hospitalization [p=0.94], and 40% lower severe cases [p=0.37]. Prospective study of 64 rheumatic disease patients with COVID-19, showing no significant difference in outcomes with HCQ use.
Feb 28
Llanos-Cuentas et al., BMC Research Notes, doi:10.1186/s13104-023-06281-7 Hydroxychloroquine to prevent SARS-CoV-2 infection among healthcare workers: early termination of a phase 3, randomised, open-label, controlled clinical trial
69% more cases [p=0.46]. Early terminated healthcare worker PrEP RCT with only 68 patients and 8 cases, showing no significant difference with HCQ. No information on symptoms per group, case severity, or the timing of cases is provided.
Feb 28
Chen et al., Infection and Drug Resistance, doi:10.2147/idr.s400561 Plasma 25(OH)D Level is Associated with the Nucleic Acid Negative Conversion Time of COVID-19 Patients: An Exploratory Study
40% improved viral clearance [p=0.01]. Retrospective 158 COVID+ patients in China, showing low vitamin D levels associated with slower viral clearance.
Feb 27
Bader et al., Nutrients, doi:10.3390/nu15051188 The Effect of Weekly 50,000 IU Vitamin D3 Supplements on the Serum Levels of Selected Cytokines Involved in Cytokine Storm: A Randomized Clinical Trial in Adults with Vitamin D Deficiency
RCT 100 patients in Jordan, showing that high-dose cholecalciferol (50,000 IU/week) significantly increased IL-6, indicating that high weekly doses could have a negative effect for cytokine storm with COVID-19. Other studies have found no..
Feb 27
Chavda et al., Pharmacological Reports, doi:10.1007/s43440-023-00463-7 (Review) Nasal sprays for treating COVID-19: a scientific note
Review of nasal sprays for treatment of COVID-19. Authors note that the nasal epithelium is typically the primary site of SARS-CoV-2 infection, and there may be significant advantages for treatments via the nasal route.
Feb 27
Tan et al., Journal of the ASEAN Federation of Endocrine Societies, doi:10.15605/jafes.038.01.07 Association of Vitamin D levels on the Clinical Outcomes of Patients Hospitalized for COVID-19 in a Tertiary Hospital
71% lower progression [p=0.04], 91% lower mortality [p=0.002], and 82% lower ICU admission [p=0.01]. Retrospective 135 hospitalized COVID-19 patients in the Philippines, showing higher risk of a poor outcome with vitamin D deficiency.
Feb 27
Wang et al., The Lancet Regional Health - Western Pacific, doi:10.1016/j.lanwpc.2023.100716 (meta analysis) Relationship between antidepressants and severity of SARS-CoV-2 Omicron infection: a retrospective cohort study using real-world data
PSM retrospective 60,903 hospitalized COVID-19 patients in Hong Kong, showing antidepressants associated with lower mortality, including for SSRIs, and for FIASMA antidepressants.
Feb 24
Kim et al., Frontiers in Medicine, doi:10.3389/fmed.2023.1095828 Peginterferon lambda for the treatment of hospitalized patients with mild COVID-19: A pilot phase 2 randomized placebo-controlled trial
200% higher ICU admission [p=1], 25% longer hospitalization [p=0.59], and 12% improved viral clearance [p=1]. Very small RCT with 14 hospitalized patients in the USA showing no significant differences with peginterferon lambda. Viral load was improved, however 86% of treatment versus 14% of control patients received remdesivir, and the median bas..
Feb 24
European Medicines Agency (News) Refusal of the marketing authorisation for Lagevrio (molnupiravir)
The European Medicines Agency has recommended the refusal of the marketing authorisation of molnupiravir.
Feb 24
Shah et al., BMJ Open, doi:10.1136/bmjopen-2022-067910 Colchicine and high-intensity rosuvastatin in the treatment of non-critically ill patients hospitalised with COVID-19: a randomised clinical trial
75% higher mortality [p=0.54], 200% higher ventilation [p=0.28], and 46% higher severe cases [p=0.34]. RCT 250 late stage (80% on oxygen) hospitalized patients in the USA, showing no significant differences with combined colchicine/rosuvastatin treatment. There was a trend towards increased risk, which authors note may be due to chance bec..
Feb 23
Ma et al., PLOS ONE, doi:10.1371/journal.pone.0282210 Is metformin use associated with low mortality in patients with type 2 diabetes mellitus hospitalized for COVID-19? a multivariable and propensity score-adjusted meta-analysis
Meta analysis of 22 metformin studies, showing significantly lower mortality with metformin use prior to hospitalization.
Feb 22
Wan et al., Journal of Infection, doi:10.1016/j.jinf.2023.02.029 Molnupiravir and nirmatrelvir-ritonavir reduce mortality risk during post-acute COVID-19 phase
11% lower mortality [p=0.02], 1% lower hospitalization [p=0.76], and 4% higher progression [p=0.18]. Retrospective 30,040 hospitalized patients in Hong Kong, showing lower mortality with molnupiravir treatment.
Feb 21
Mitsushima et al., International Journal of General Medicine, doi:10.2147/IJGM.S394413 Risk of Underlying Diseases and Effectiveness of Drugs on COVID-19 Inpatients Assessed Using Medical Claims in Japan: Retrospective Observational Study
44% higher mortality [p=0.01]. Retrospective 18,566 hospitalized patients in Japan, showing higher mortality with remdesivir treatment.
Feb 21
Kim et al., International Journal of Environmental Research and Public Health, doi:10.3390/ijerph20053832 Serious Clinical Outcomes of COVID-19 Related to Acetaminophen or NSAIDs from a Nationwide Population-Based Cohort Study
71% higher mortality [p=0.34], 14% higher ventilation [p=1], 40% lower ICU admission [p=0.72], and 9% higher need for oxygen therapy [p=0.87]. PSM retrospective in South Korea, showing no significant differences in outcomes with acetaminophen use vs. NSAID use. Adherence and dosage are unknown.
Feb 21
Merck, Press Release (Preprint) Merck Provides Update on Phase 3 MOVe-AHEAD Trial Evaluating LAGEVRIO™ (molnupiravir) for Post-exposure Prophylaxis for Prevention of COVID-19
MOVe-AHEAD PEP RCT reporting no significant difference in cases. Limited information is available. There were 23.6% fewer cases with treatment, but the number of cases and confidence interval are not provided.
Feb 20
Miraz et al., International Journal of Clinical Practice, doi:10.1155/2023/9917306 Nigelladine A among Selected Compounds from Nigella sativa Exhibits Propitious Interaction with Omicron Variant of SARS-CoV-2: An In Silico Study
In Silico study of 96 phytochemical compounds of nigella sativa, identifying Nigelladine A as the most promising compound for SARS-CoV-2 inhibition with the highest docking scores for the spike protein and Mpro. Dithymoquinone, kaempferol..
Feb 20
Naggie et al., JAMA, doi:10.1001/jama.2023.1650 Effect of Higher-Dose Ivermectin for 6 Days vs Placebo on Time to Sustained Recovery in Outpatients With COVID-19: A Randomized Clinical Trial
600µg/kg arm of ACTIV-6. Results of this trial are unreliable, with multiple critical anomalies, and no response from the authors. For details see [c19early].
Feb 20
Delgado et al., Research Square, doi:10.21203/rs.3.rs-2596201/v1 (Preprint) Investigational medications in 9,638 hospitalized patients with severe COVID-19: lessons from the “fail-and-learn” strategy during the first two waves of the pandemic in 2020
26% lower mortality [p=0.002]. PSM retrospective 9,638 patients in the USA, showing significantly lower mortality with HCQ in early 2020 (1,157 HCQ patients), and no significant difference in late 2020 (82 HCQ patients). The few patients treated in the later period may..
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 2,614 studies, 1,700 present results comparing with a control group, 1,547 are treatment studies, and 153 analyze outcomes based on serum levels. There are 31 animal studies, 63 in silico studies, 133 in vitro studies, and 131 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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