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c19early.org COVID-19 treatment researchSelect treatment..Select..
Melatonin Meta
Metformin Meta
Azvudine Meta
Bromhexine Meta Molnupiravir Meta
Budesonide Meta
Colchicine Meta
Conv. Plasma Meta Nigella Sativa Meta
Curcumin Meta Nitazoxanide Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

COVID-19 early treatment: real-time analysis of 4,294 studies

Analysis of 75 COVID-19 early treatments, approvals in 117 countries, database of 7,703 treatments  
Sanz
22 patient vitamin D late treatment RCT: 83% lower ventilation (p=0.06) and 60% lower ICU admission (p=0.36)
Amani
Azvudine meta analysis: 52% lower mortality (p<0.0001), 10% lower ventilation (p=0.71), and 31% lower ICU admission (p=0.51)
Visser
40 patient vitamin K late treatment RCT: 200% higher mortality (p=1), 200% higher ICU admission (p=0.6), and 17% shorter hospitalization (p=0.52)
Hashmi
Early terminated REMAP-CAP results showing a trend towards benefit for non-critical patients despite very low dose, poor administration, and very..
Prasanth
Fluvoxamine meta analysis: 78% lower mortality (p=0.001) and 64% lower progression (p=0.02)
$0 $1,000 $2,000+ -25+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments BMS mAbs -36% $2,100 Acetaminophen -28% Lufotrelvir $2,000+ Cannabidiol Losartan Vitamin B9 Conv. Plasma $5,000 Ibuprofen Remdesivir $3,120 Ambavirumab/r.. Aspirin Molnupiravir mutagenic/teratogenic Favipiravir Famotidine Paxlovid Vitamin C NAC Nitric Oxide Zinc Colchicine HCQ Budesonide Probiotics Sotrovimab $2,100 Metformin Azvudine Sleep Antiandro.. Bebtelovimab Vitamin A Vitamin D Sunlight H. Peroxide Fluvox. Exercise Curcumin Tixagevimab/c.. N. Sativa NaHCO₃ Melatonin Ensovibep $2,000+ Casirivimab/i.. $2,100 Bamlanivimab/e.. pH+ Quercetin Diet PVP-I Thermotherapy Ivermectin Regdanvimab $2,100 Lifestyle / free No prescription Prescription required High-cost Lower risk Higher risk c19early.org June 2024 COVID-19 involves the interplay of 50+ host and viral proteinsand other factors, many treatments are known to modulate these.0.6% of 7,000+ proposed treatments show efficacy with ≥3 studies.Protocols combine treatments, none are 100% effective.c19early analyzes over 4,200 studies for 75 treatments.
$0 $1,000 $2,000+ -25+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments BMS mAbs -36% Acetaminophen -28% Lufotrelvir Cannabidiol Losartan Vitamin B9 Conv. Plasma Ibuprofen Remdesivir Ambavirumab/r.. Aspirin Molnupiravir mutagenic/teratogenic Favipiravir Famotidine Paxlovid Vitamin C NAC Nitric Oxide Zinc Colchicine HCQ Budesonide Probiotics Sotrovimab Metformin Azvudine Sleep Antiandro.. Bebtelovimab Vitamin A Vitamin D Sunlight H. Peroxide Fluvox. Exercise Curcumin Tixagevimab/c.. N. Sativa NaHCO₃ Melatonin Ensovibep Casirivim.. Bamlaniv.. pH+ Quercetin Diet PVP-I Thermotherapy Ivermectin Regdanvimab Lifestyle / free No prescription Prescription required High-cost Lower risk Higher risk c19early.org June 2024 COVID-19 involves the interplay of 50+ host and viralproteins and other factors, many treatments are knownto modulate these. 0.6% of 7,000+ proposed treatmentsshow efficacy with ≥3 studies. Protocols combinetreatments, none are 100% effective. c19early analyzesover 4,200 studies for 75 treatments.
Azvudine Evusheld Sodium Bicarbonate Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Famotidine Aspirin Molnupiravir Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide Budesonide Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Melatonin Acetaminophen ↑risk Exercise Vitamin D Antiandrogens Vitamin C Colchicine Ivermectin Metformin Zinc HCQ 2020 2021 2023 2024 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org June 2024 Time when COVID-19 studies showed efficacy
Azvudine Evusheld Sodium Bicarb.. Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Famotidine Aspirin Molnupiravir Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide Budesonide Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Melatonin Acetaminophen ↑risk Exercise Vitamin D Antiandrogens Vitamin C Colchicine Ivermectin Metformin Zinc HCQ 2020 2021 2023 2024 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org June 2024 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations. 0.6% of treatments show efficacy.
June 2024
c19early.org
Cost per life saved from NNT in
studies to date
Melatonin
9
48%
  $8
Vitamin D
68
36%
  $11
Alkalinization
8
46%
  $11
Zinc
20
29%
  $16
Sodium Bicarb..
4
41%
  $17
Vitamin C
42
19%
  $17
Ivermectin
52
48%
  $25
Colchicine
43
28%
  $26
HCQ
246
26%
  $27
Aspirin
63
11%
  $33
Vitamin A
5
30%
  $45
Curcumin
8
63%
  $59
Famotidine
21
18%
  $94
Probiotics
8
61%
  $99
Quercetin
5
61%
  $127
Metformin
64
34%
  $144
Antiandrogens
32
37%
  $179
Nigella Sativa
5
57%
  $187
Fluvoxamine
10
44%
  $411
Budesonide
12
26%
  $574
Nitazoxanide
6
42%
  $680
Azvudine
14
33%
  $1,237
Favipiravir
38
12%
  $1,717
Tixagev../c..
10
42%
  $74,506
Regdanvimab
7
63%
  $139,860
Paxlovid
30
30%
  $181,887
Casirivimab/i..
9
31%
  $203,958
Molnupiravir
19
20%
  $262,368
Bamlaniv../e..
12
56%
  $269,237
Sotrovimab
10
49%
  $352,800
Bebtelovimab
4
60%
  $737,601
Remdesivir
59
4%
  $1,558,440
Conv. Plasma
45
-1%
N/A
Acetaminophen
14
-24%
N/A
Treatment cost times median NNT - details and limitations. 0.6% of treatments show efficacy.
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All clinical results for selected treatments. 0.6% of treatments show efficacy.
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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% [22-95%] 1 $1 394 very limited data Cost Studies Patients Improvement Relative Risk Chlorhexidine 79% [66-87%] 3 $1 509 limited data Proxalutamide 78% [70-83%] 4 $500 1,953 limited data Indomethacin 74% [-20-94%] 4 $5 605 limited data Cetylpyridin.. 68% [-620-99%] 1 $1 23 very limited data Regdanvimab 63% [51-71%] 11 $2,100 7,430 Ivermectin 60% [53-67%] 104 $1 220,174 Thermotherapy 56% [9-78%] 4 $0 217 very limited data Povidone-Iod.. 51% [38-61%] 21 $1 3,249 Diet 50% [41-58%] 28 $0 693,236 Quercetin 49% [21-68%] 11 $5 1,436 Alkalinization 49% [36-59%] 14 $1 6,383 HH-120 49% [-60-84%] 2 $500 345 very limited data Bamlaniv../e.. 48% [26-63%] 20 $1,250 34,837 variant dependent Bemnifosbuvir 47% [-57-82%] 3 $500 359 very limited data Casirivimab/i.. 47% [28-61%] 29 $2,100 59,056 variant dependent Ensovibep 46% [-173-89%] 2 $2,100 885 limited data Adintrevimab 43% [-169-88%] 2 $2,100 2,483 intramuscular Melatonin 43% [30-54%] 18 $1 14,301 Bromhexine 43% [-5-69%] 7 $5 875 very limited data Sodium Bicarb.. 43% [24-57%] 7 $1 1,092 Nigella Sativa 43% [24-57%] 14 $5 3,333 Tixagev../c.. 43% [26-56%] 17 $855 29,530 variant dependent Curcumin 41% [30-51%] 26 $5 14,748 Montelukast 40% [15-58%] 8 $2 2,868 limited data Exercise 39% [34-44%] 66 $0 1,936,481 Fluvoxamine 39% [21-52%] 21 $4 38,283 Hydrogen Per.. 38% [5-59%] 7 $1 835 very limited data Phthalocyanine 38% [20-51%] 4 $5 5,245 Xiannuoxin 38% [-46-73%] 2 $106 1,027 very limited data Sunlight 37% [22-50%] 5 $0 19,665 Propolis 37% [-23-68%] 2 $1 270 very limited data Vitamin D 37% [31-42%] 121 $1 195,530 Vitamin A 36% [6-56%] 14 $2 22,297 Selenium 34% [-40-69%] 4 $1 21,452 Bebtelovimab 34% [-24-65%] 6 $1,200 13,329 intravenous Nitazoxanide 33% [-22-63%] 13 $4 3,606 Spironolactone 31% [15-44%] 12 $5 28,019 Antiandrogens 30% [21-38%] 49 $5 120,172 Sleep 30% [22-38%] 15 $0 429,001 Vitamin B12 30% [5-48%] 4 $1 11,407 Azvudine 30% [16-41%] 19 $25 12,000 Metformin 29% [25-33%] 91 $10 281,811 Sotrovimab 29% [12-42%] 22 $2,100 43,988 variant dependent Probiotics 28% [18-37%] 26 $5 19,398 Budesonide 28% [18-36%] 15 $4 28,194 Hydroxychlor.. 28% [24-31%] 417 $1 538,337 Colchicine 27% [18-36%] 56 $1 33,066 Zinc 27% [17-36%] 44 $1 55,200 Andrographol.. 27% [-8-50%] 7 $5 1,245 Nitric Oxide 27% [-8-50%] 11 $11 2,201 Ensitrelvir 26% [-14-52%] 3 $500 1,450 very limited data N-acetylcys.. 25% [14-34%] 24 $1 26,243 Lactoferrin 24% [-24-53%] 8 $5 1,419 Vitamin C 21% [14-27%] 71 $1 88,767 UDCA 17% [5-29%] 13 $15 37,170 Paxlovid 17% [13-20%] 62 $1,390 120,524 independent trials refused Famotidine 17% [8-24%] 30 $5 114,119 Favipiravir 15% [5-24%] 68 $20 30,674 worse w/longer followup Vitamin K 14% [0-25%] 2 $1 7,806 very limited data Molnupiravir 13% [4-22%] 41 $707 137,199 mutagenic/teratogenic Aspirin 12% [6-17%] 73 $1 186,324 Deuremidevir 11% [-1-21%] 2 $112 1,432 very limited data Ambavir../r.. 11% [-154-69%] 3 $1,380 1,531 intravenous Peg.. Lambda 7% [-138-63%] 4 $500 2,143 subcutaneous Remdesivir 2% [-6-9%] 70 $3,120 187,297 worse w/longer followup Ibuprofen 0% [-9-9%] 13 $1 54,707 Conv. Plasma -1% [-5-3%] 46 $5,000 29,830 intravenous Vitamin B9 -11% [-47-15%] 11 $1 54,354 Losartan -15% [-127-42%] 5 $5 665 very limited data Cannabidiol -19% [-128-38%] 7 $25 16,883 Lufotrelvir -22% [-198-50%] 1 $2,000 58 intravenous Acetaminoph.. -28% [-41--17%] 27 $1 543,459 BMS mAbs -36% [-492-69%] 1 $2,100 210 subcutaneous All studies (pooled effects, all stages) c19early.org June 2024 Favors treatment Favors control
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% 1 very limited data Studies, Improvement Relative Risk Chlorhexidine 79% 3 limited data Proxalutamide 78% 4 limited data Indomethacin 74% 4 limited data Cetylpyridin.. 68% 1 very limited data Regdanvimab 63% 11 Ivermectin 60% 104 Thermotherapy 56% 4 very limited data Povidone-Iod.. 51% 21 Diet 50% 28 Quercetin 49% 11 Alkalinization 49% 14 HH-120 49% 2 very limited data Bamlaniv../e.. 48% 20 variant dependent Bemnifosbuvir 47% 3 very limited data Casirivimab/.. 47% 29 variant dependent Ensovibep 46% 2 limited data Adintrevimab 43% 2 intramuscular Melatonin 43% 18 Bromhexine 43% 7 very limited data Sodium Bicar.. 43% 7 Nigella Sativa 43% 14 Tixagev../c.. 43% 17 variant dependent Curcumin 41% 26 Montelukast 40% 8 limited data Exercise 39% 66 Fluvoxamine 39% 21 Hydrogen Per.. 38% 7 very limited data Phthalocyanine 38% 4 Xiannuoxin 38% 2 very limited data Sunlight 37% 5 Propolis 37% 2 very limited data Vitamin D 37% 121 Vitamin A 36% 14 Selenium 34% 4 Bebtelovimab 34% 6 intravenous Nitazoxanide 33% 13 Spironolactone 31% 12 Antiandrogens 30% 49 Sleep 30% 15 Vitamin B12 30% 4 Azvudine 30% 19 Metformin 29% 91 Sotrovimab 29% 22 variant dependent Probiotics 28% 26 Budesonide 28% 15 Hydroxychlor.. 28% 417 Colchicine 27% 56 Zinc 27% 44 Andrographol.. 27% 7 Nitric Oxide 27% 11 Ensitrelvir 26% 3 very limited data N-acetylcys.. 25% 24 Lactoferrin 24% 8 Vitamin C 21% 71 UDCA 17% 13 Paxlovid 17% 62 independent trials refused Famotidine 17% 30 Favipiravir 15% 68 worse w/longer followup Vitamin K 14% 2 very limited data Molnupiravir 13% 41 mutagenic/teratogenic Aspirin 12% 73 Deuremidevir 11% 2 very limited data Ambavir../r.. 11% 3 intravenous Peg.. Lambda 7% 4 subcutaneous Remdesivir 2% 70 worse w/longer followup Ibuprofen 0% 13 Conv. Plasma -1% 46 intravenous Vitamin B9 -11% 11 Losartan -15% 5 very limited data Cannabidiol -19% 7 Lufotrelvir -22% 1 intravenous Acetaminoph.. -28% 27 BMS mAbs -36% 1 subcutaneous All studies (pooled effects, all stages) c19early.org June 2024 Rotate device for details Favors treatment Favors control
Random effects meta-analysis of all studies (pooled effects, all stages). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all stages and outcomes depend on the distribution of stages and outcomes tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage and outcome analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of early treatment studies (pooled effects). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all outcomes are affected by the distribution of outcomes tested, please see detail pages for specific outcome analysis. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of all mortality results (all stages). Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Pooled results across all stages depend on the distribution of stages tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of early treatment mortality results. Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of prophylaxis studies (pooled effects). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all outcomes are affected by the distribution of outcomes tested, please see detail pages for specific outcome analysis. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of prophylaxis mortality results. Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
LATE TREATMENT
Physician / TeamLocationPatients HospitalizationHosp. MortalityDeath
Dr. David Uip (*) Brazil 2,200 38.6% (850) Ref. 2.5% (54) Ref.
EARLY TREATMENT - 40 physicians/teams
Physician / TeamLocationPatients HospitalizationHosp. ImprovementImp. MortalityDeath ImprovementImp.
Dr. Roberto Alfonso Accinelli
0/360 deaths for treatment within 3 days
Peru 1,265 0.6% (7) 77.5%
Dr. Mohammed Tarek Alam
patients up to 84 years old
Bangladesh 100 0.0% (0) 100.0%
Dr. Oluwagbenga Alonge Nigeria 310 0.0% (0) 100.0%
Dr. Raja Bhattacharya
up to 88yo, 81% comorbidities
India 148 1.4% (2) 44.9%
Dr. Flavio Cadegiani Brazil 3,450 0.1% (4) 99.7% 0.0% (0) 100.0%
Dr. Alessandro Capucci Italy 350 4.6% (16) 88.2%
Dr. Shankara Chetty South Africa 8,000 0.0% (0) 100.0%
Dr. Deborah Chisholm USA 100 0.0% (0) 100.0%
Dr. Ryan Cole USA 400 0.0% (0) 100.0% 0.0% (0) 100.0%
Dr. Marco Cosentino
vs. 3-3.8% mortality during period; earlier treatment better
Italy 392 6.4% (25) 83.5% 0.3% (1) 89.6%
Dr. Jeff Davis USA 6,000 0.0% (0) 100.0%
Dr. Dhanajay India 500 0.0% (0) 100.0%
Dr. Bryan Tyson & Dr. George Fareed USA 20,000 0.0% (6) 99.9% 0.0% (4) 99.2%
Dr. Raphael Furtado Brazil 170 0.6% (1) 98.5% 0.0% (0) 100.0%
Rabbi Yehoshua Gerzi Israel 860 0.1% (1) 99.7% 0.0% (0) 100.0%
Dr. Heather Gessling USA 1,500 0.1% (1) 97.3%
Dr. Ellen Guimarães Brazil 500 1.6% (8) 95.9% 0.4% (2) 83.7%
Dr. Syed Haider USA 4,000 0.1% (5) 99.7% 0.0% (0) 100.0%
Dr. Mark Hancock USA 24 0.0% (0) 100.0%
Dr. Sabine Hazan USA 1,000 0.0% (0) 100.0%
Dr. Mollie James USA 3,500 1.1% (40) 97.0% 0.0% (1) 98.8%
Dr. Roberta Lacerda Brazil 550 1.5% (8) 96.2% 0.4% (2) 85.2%
Dr. Katarina Lindley USA 100 5.0% (5) 87.1% 0.0% (0) 100.0%
Dr. Ben Marble USA 150,000 0.0% (4) 99.9%
Dr. Edimilson Migowski Brazil 2,000 0.3% (7) 99.1% 0.1% (2) 95.9%
Dr. Abdulrahman Mohana Saudi Arabia 2,733 0.0% (0) 100.0%
Dr. Carlos Nigro Brazil 5,000 0.9% (45) 97.7% 0.5% (23) 81.3%
Dr. Benoit Ochs Luxembourg 800 0.0% (0) 100.0%
Dr. Ortore Italy 240 1.2% (3) 96.8% 0.0% (0) 100.0%
Dr. Valerio Pascua
one death for a patient presenting on the 5th day in need of supplemental oxygen
Honduras 415 6.3% (26) 83.8% 0.2% (1) 90.2%
Dr. Sebastian Pop Romania 300 0.0% (0) 100.0%
Dr. Brian Proctor USA 869 2.3% (20) 94.0% 0.2% (2) 90.6%
Dr. Anastacio Queiroz Brazil 700 0.0% (0) 100.0%
Dr. Didier Raoult France 8,315 2.6% (214) 93.3% 0.1% (5) 97.6%
Dr. Karin Ried
up to 99yo, 73% comorbidities, av. age 63
Turkey 237 0.4% (1) 82.8%
Dr. Roman Rozencwaig
patients up to 86 years old
Canada 80 0.0% (0) 100.0%
Dr. Vipul Shah India 8,000 0.1% (5) 97.5%
Dr. Silvestre Sobrinho Brazil 116 8.6% (10) 77.7% 0.0% (0) 100.0%
Dr. Unknown Brazil 957 1.7% (16) 95.7% 0.2% (2) 91.5%
Dr. Vladimir Zelenko USA 2,200 0.5% (12) 98.6% 0.1% (2) 96.3%
Mean improvement with early treatment protocols 238,381 HospitalizationHosp. 94.4% MortalityDeath 94.9%
Physician results with early treatment protocols compared to no early treatment. These results are subject to selection and ascertainment bias and more accurate analysis requires details of the patient populations and followup, however results are consistently better across many teams, and consistent with the extensive controlled trial evidence that shows a significant reduction in risk with many early treatments, and improved results with the use of multiple treatments in combination.
Sanz
22 patient late treatment RCT: 83% lower ventilation (p=0.06) and 60% lower ICU admission (p=0.36)
Cardoso
614 patients sufficiency: 67% lower progression (p<0.0001)
Singhsakul
97 patients sufficiency: 51% lower severe cases (p=0.02) and 67% fewer moderate/severe cases (p=0.34)
Amani
Meta analysis: 52% lower mortality (p<0.0001), 10% lower ventilation (p=0.71), and 31% lower ICU admission (p=0.51)
Visser
40 patient late treatment RCT: 200% higher mortality (p=1), 200% higher ICU admission (p=0.6), and 17% shorter hospitalization (p=0.52)
Hashmi
Early terminated REMAP-CAP results showing a trend towards benefit for non-critical patients despite very low dose, poor administration, and very..
Prasanth
Meta analysis: 78% lower mortality (p=0.001) and 64% lower progression (p=0.02)
Chen
413 patients prophylaxis: 81% lower ICU admission (p=0.008), 39% lower progression (p=0.009), and 17% shorter hospitalization (p=0.001)
Panagea
Systematic review of 36 studies for post-COVID neurocognitive impairment. All studies showed persistent cognitive changes after COVID-19, with..
Lu
1,217 patient early treatment RCT: 13% faster recovery (p=0.03) and 25% faster viral clearance (p<0.0001)
Verma
Mouse study showing persistent neurological deficits after SARS-CoV-2 infection, and failure of nirmatrelvir and molnupiravir to prevent..
Geng
RCT 155 adults with long COVID (PASC) showing no significant benefit with nirmatrelvir+ritonavir (paxlovid) compared to ritonavir.
Verma
Mouse study showing persistent neurological deficits after SARS-CoV-2 infection, and failure of nirmatrelvir and molnupiravir to prevent..
Ciszewski
In Vitro study showing that SARS-CoV-2 spike and nucleocapsid proteins induce endothelial-mesenchymal transition (EndMT) in endothelial cells, with..
Shafiee
Meta analysis: 27% lower mortality (p=0.02), 39% lower hospitalization (p=0.3), and 53% improved recovery (p=0.0005)
Shafiee
Meta analysis: 27% lower mortality (p=0.02), 39% lower hospitalization (p=0.3), and 53% improved recovery (p=0.0005)
Kamble
In Vitro study showing that a water-dispersible nano-spray formulation of curcumin inhibits SARS-CoV-2 infection in Vero E6 cells. Authors found..
Taheri
RCT 90 outpatients with post-COVID-19 anosmia showing significant improvements in smell alterations with olfactory training after 3 and 12 months...
Corada
211 patient early treatment RCT: 17% lower progression (p=0.03), 20% faster recovery (p=0.19), and 4% improved viral clearance (p=0.45)
Bes-Berlandier
91 patients prophylaxis: 10% higher progression (p=1)
Bes-Berlandier
91 patients prophylaxis: 67% higher progression (p=0.31)
Recent studies (see the individual treatment pages for all studies):

Jun 13
Hashmi et al., Critical Care Reviews, CCR24 Ivermectin for patients admitted to an ICU with COVID-19: REMAP-CAP randomized controlled trial
Early terminated REMAP-CAP results showing a trend towards benefit for non-critical patients despite very low dose, poor administration, and very... Early terminated REMAP-CAP results delayed >600 days, showing no significant differences with very low dose, poor administration, very late treatment of ICU patients. Results trend towards benefit for non-critical patients, with 32% lower..
Jun 12
Prasanth et al., Scientific Reports, doi:10.1038/s41598-024-64260-9 A systematic review and meta-analysis, investigating dose and time of fluvoxamine treatment efficacy for COVID-19 clinical deterioration, death, and Long-COVID complications
78% lower mortality (p=0.001) and 64% lower progression (p=0.02). Systematic review and meta analysis of 14 studies showing significantly lower COVID-19 clinical deterioration and mortality with fluvoxamine treatment. Subgroup analysis indicated that higher doses (≥200mg/day) and earlier treatment (with..
Jun 11
Cardoso et al., medRxiv, doi:10.1101/2024.06.10.24308690 Vitamin D levels and COVID-19 severe pneumonia: a prospective case-control study
67% lower progression (p<0.0001). Prospective case-control study of 614 patients in Brazil showing lower vitamin D levels associated with increased risk of severe COVID-19 pneumonia.
Jun 9
Singhsakul et al., Journal of Southeast Asian Medical Research, doi:10.55374/jseamed.v8.202 Association of vitamin D level and severity of COVID-19 disease
51% lower severe cases (p=0.02) and 67% fewer moderate/severe cases (p=0.34). Retrospective 97 hospitalized COVID-19 patients in Thailand showing vitamin D deficiency associated with higher risk of severe illness.
Jun 8
Chen et al., Translational Medicine of Aging, doi:10.1016/j.tma.2024.04.001 Metformin alleviates inflammatory response and severity rate of COVID-19 infection in elderly individuals
81% lower ICU admission (p=0.008), 39% lower progression (p=0.009), and 17% shorter hospitalization (p=0.001). Retrospective 413 hospitalized COVID-19 patients with type 2 diabetes in China showing lower ICU admission, lower pneumonia incidence, and shorter hospital stay with metformin use.
Jun 7
Geng et al., JAMA Internal Medicine, doi:10.1001/jamainternmed.2024.2007 Nirmatrelvir-Ritonavir and Symptoms in Adults With Postacute Sequelae of SARS-CoV-2 Infection
RCT 155 adults with long COVID (PASC) showing no significant benefit with nirmatrelvir+ritonavir (paxlovid) compared to ritonavir.
Jun 3
Taheri et al., Brazilian Journal of Otorhinolaryngology, doi:10.1016/j.bjorl.2024.101451 Therapeutic effects of olfactory training and systemic vitamin A in patients with COVID-19-related olfactory dysfunction: a double-blinded randomized controlled clinical trial
RCT 90 outpatients with post-COVID-19 anosmia showing significant improvements in smell alterations with olfactory training after 3 and 12 months. Adding oral vitamin A to olfactory training resulted in higher rates of improvement, but th..
Jun 3
Shafiee et al., Journal of Evidence-Based Integrative Medicine, doi:10.1177/2515690x241258403 Alkalinization Using Sodium Bicarbonate for COVID-19 Treatment: A Systematic Review and Meta-Analysis
27% lower mortality (p=0.02), 39% lower hospitalization (p=0.3), and 53% improved recovery (p=0.0005). Meta analysis of 7 studies showing significantly lower mortality, shorter hospitalization, and higher recovery with alkalinization using sodium bicarbonate for COVID-19.
Jun 3
Kamble et al., Emergent Materials, doi:10.1007/s42247-024-00754-6 Nanoparticulate curcumin spray imparts prophylactic and therapeutic properties against SARS-CoV-2
In Vitro study showing that a water-dispersible nano-spray formulation of curcumin inhibits SARS-CoV-2 infection in Vero E6 cells. Authors found that pre-treatment effectively inhibited SARS-CoV-2 infection, and subsequent exposure to the..
Jun 3
Verma et al., bioRxiv, doi:10.1101/2024.06.02.596989 Persistent Neurological Deficits in Mouse PASC Reveal Antiviral Drug Limitations
Mouse study showing persistent neurological deficits after SARS-CoV-2 infection, and failure of nirmatrelvir and molnupiravir to prevent neurological damage. Authors found decreased tyrosine hydroxylase expression in the olfactory bulb an..
May 31
Zhang et al., Heliyon, doi:10.1016/j.heliyon.2024.e31160 Non-linear effects of meteorological factors on COVID-19: An analysis of 440 counties in the americas
Retrospective 440 counties/districts across 7 countries in the Americas, showing solar radiation exhibited an overall negative association with daily new COVID-19 cases. The study used generalized additive models (GAM) and distributed lag..
May 31
Zhang et al., Phytomedicine, doi:10.1016/j.phymed.2024.155784 Computational Discovery of Mitochondrial Dysfunction Biomarkers in Severe SARS-CoV-2 Infection: Facilitating Pytomedicine Screening
In Silico and In Vitro study showing potential benefits of curcumin for severe COVID-19 by protecting mitochondrial function and reducing dysregulated metabolism and immune response. Authors identified five mitochondrial dysfunction bioma..
May 31
Rajak et al., Biotechnology of Medicinal Plants with Antiallergy Properties, doi:10.1007/978-981-97-1467-4_4 Antiallergic Implications of Curcumin During COVID-19: Current Status and Perspectives
Review of the potential of curcumin for allergic and inflammatory reactions in COVID-19. Authors highlight that curcumin has numerous health benefits, including antioxidative, anti-inflammatory, antidiabetic, and antimicrobial activities...
May 31
Chang et al., Biomedicines, doi:10.3390/biomedicines12061223 SARS-CoV-2 Spike Protein 1 Causes Aggregation of α-Synuclein via Microglia-Induced Inflammation and Production of Mitochondrial ROS: Potential Therapeutic Applications of Metformin
In Vitro and rat study showing that the SARS-CoV-2 spike protein S1 subunit causes aggregation of α-synuclein and microglial activation, which may contribute to the neurological symptoms seen in long COVID. In rats, intranasal administrat..
May 31
Han et al., Journal of Thoracic Disease, doi:10.21037/jtd-23-1043 The efficacy and safety of hydroxychloroquine for COVID-19 prophylaxis and clinical assessment: an updated meta-analysis of randomized trials
Meta analysis of 9 RCTs with 7,825 participants showing significantly lower COVID-19 cases with HCQ prophylaxis. Authors only cover the period until January 2022. The very long publication delay may be due to the reported difficulty publi..
May 31
Olawore et al., Clinical Epidemiology, doi:10.2147/CLEP.S458901 Risk of Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) Among Patients with Type 2 Diabetes Mellitus on Anti-Hyperglycemic Medications
19% lower PASC (p=0.29). Retrospective 7,047 outpatients with type 2 diabetes showing a lower risk of PASC (long COVID) with metformin compared to sulfonylurea or DPP-4 inhibitor use, without statistical significance.
May 30
Hou et al., Scientific Reports, doi:10.1038/s41598-024-63081-0 Metformin is a potential therapeutic for COVID-19/LUAD by regulating glucose metabolism
In Silico and In Vitro study showing metformin as a potential therapeutic for COVID-19/LUAD by regulating glucose metabolism. Authors identified PTEN and mTOR as potential core target genes of metformin for treating COVID-19/LUAD. Bioinfo..
May 30
Bai et al., The Clinical Respiratory Journal, doi:10.1111/crj.13790 COPD patients with high blood eosinophil counts exhibit a lower rate of omicron infection and milder post‐infection symptoms
31% lower hospitalization (p=0.18) and 24% fewer cases (p=0.0001). Retrospective 315 COPD patients in China showing significantly lower COVID-19 cases with budesonide/formoterol or budesonide/glycopyrronium/formoterol use. Note that Table 4 includes only infected patients, we show the COVID-19 hospitaliz..
May 29
Yunze et al., Research Square, doi:10.21203/rs.3.rs-4329762/v1 Therapeutic effect and potential mechanism of curcumin, an active ingredient in Tongnao Decoction, on COVID-19 combined with stroke: a network pharmacology study and GEO database mining
In Silico study showing that curcumin, the active ingredient in Tongnao Decoction, may be beneficial for COVID-19 combined with stroke through the CCNA2, JAK2, MMP9, PPARG, PTGS2, and STAT3 target pathways, with MMP9 being the most import..
May 28
Bes-Berlandier et al., BMC Infectious Diseases, doi:10.1186/s12879-024-09269-1 Management of immunosuppression in lung transplant recipients and COVID-19 outcomes: an observational retrospective cohort-study
67% higher progression (p=0.31). Retrospective 91 lung transplant recipients with COVID-19 showing no significant difference in poor outcomes with casirivimab/imdevimab or tixagevimab/cilgavimab prophylaxis in univariate analysis.
May 28
Ciszewski et al., Cell Communication and Signaling, doi:10.1186/s12964-024-01665-z Diverse roles of SARS-CoV-2 Spike and Nucleocapsid proteins in EndMT stimulation through the TGF-β-MRTF axis inhibited by aspirin
In Vitro study showing that SARS-CoV-2 spike and nucleocapsid proteins induce endothelial-mesenchymal transition (EndMT) in endothelial cells, with the nucleocapsid protein having a more potent effect. The spike protein stimulates TGF-β1 ..
May 28
Landi et al., Journal of Cardiovascular Medicine, doi:10.2459/JCM.0000000000001639 Edoxaban and/or colchicine for patients with coronavirus disease 2019 managed in the out-of-hospital setting (CONVINCE): a randomized clinical trial
4% higher hospitalization (p=0.98), 5% higher need for oxygen therapy (p=0.97), 40% improvement (p=0.97), and 11% improved viral clearance (p=0.77). Early terminated RCT with 14 colchicine, 13 edoxaban, 16 colchicine+edoxaban, and 16 control patients, showing no significant difference in outcomes with treatment up to 7 days after PCR diagnosis.
May 27
Yang et al., Frontiers in Pharmacology, doi:10.3389/fphar.2024.1367686 Therapeutic effects of vitamin D supplementation on COVID-19 aggravation: a systematic review and meta-analysis of randomized controlled trials
Meta analysis of 19 RCTs with 2,435 total participants showing significantly lower ICU admission and mechanical ventilation with vitamin D treatment. Results were better for moderate to severe COVID-19 patients, and with multiple dose ver..
May 25
Beşler et al., Clinical Science of Nutrition, doi:10.62210/ClinSciNutr.2024.86 Investigation of potential effects of quercetin on COVID-19 treatment: a systematic review of randomized controlled trials
Systematic review of RCTs investigating quercetin for COVID-19. Five studies with a total of 803 participants were included. Authors found that quercetin treatment led to reductions in cases, viral persistence, hospitalization, oxygen req..
May 24
Horby et al., medRxiv, doi:10.1101/2024.05.23.24307731 Molnupiravir or nirmatrelvir-ritonavir versus usual care in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
11% higher mortality (p=0.55), 43% higher ventilation (p=0.59), 9% lower hospital discharge (p=0.46), and 12% improved viral clearance (p<0.0001). RECOVERY RCT showing no significant differences in mortality, ventilation, or discharge with either molnupiravir (923 patients) or paxlovid (137 patients). Viral load was improved with treatment but did not translate into clinical benefit..
May 23
Lee et al., Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfae069.1573 Effectiveness of regdanvimab on clinical outcomes in COVID-19 infected patients on hemodialysis
59% lower mortality (p=0.002). Retrospective 230 hemodialysis patients with COVID-19, showing lower mortality with regdanvimab. Details of the adjusted results are not provided.
May 22
Guan et al., The American Journal of the Medical Sciences, doi:10.1016/j.amjms.2024.05.005 High-dose Vitamin C Intake and COVID-19 Related Symptoms During the SARS-CoV-2 Pandemic
31% fewer symptomatic cases (p=0.007). Retrospective 2,746 individuals in China showing significantly lower incidence of COVID-19 symptoms and fever with higher vitamin C intake, with a dose response relationship.
May 21
Hemilä et al., Frontiers in Medicine, doi:10.3389/fmed.2024.1391346 Rebound effect explains the divergence in survival after 5 days in a controlled trial on vitamin C for COVID-19 patients
Reanalysis of the REMAP-CAP and LOVIT-COVID vitamin C RCTs [Adhikari] showing that the poor results may be explained by a rebound effect due to the abrupt termination of vitamin C treatment after 4 days. Authors describe a rebound effect ..
May 18
Rothman et al., medRxiv, doi:10.1101/2024.05.16.24307115 Effect of Montelukast vs Placebo on Time to Sustained Recovery in Outpatients with COVID-19: The ACTIV-6 Randomized Clinical Trial
1% fewer combined hospitalization/ER visits (p=1), 32% lower progression (p=0.29), and 2% improved recovery (p=0.71). RCT 1,250 outpatients with mild to moderate COVID-19 showing no significant difference in time to sustained recovery with montelukast treatment. There were no deaths and only 2 hospitalizations in each group. Notably, results were better ..
May 17
Xu et al., Molecular Biomedicine, doi:10.1186/s43556-024-00183-1 Effects of different treatments for type 2 diabetes mellitus on mortality of coronavirus disease from 2019 to 2021 in China: a multi-institutional retrospective study
52% lower mortality (p=0.01), 54% lower ventilation (p=0.007), and 72% lower ARDS (p=0.04). Retrospective 4,922 COVID-19 patients with type 2 diabetes in China, showing lower mortality with metformin and alpha-glucosidase inhibitor treatment and higher mortality with insulin treatment.
May 17
Gaweł et al., Biomedicines, doi:10.3390/biomedicines12051120 Colostrum Lactoferrin Following Active and Recovered SARS-CoV-2 Infections during Pregnancy
Analysis of 69 lactating mothers showing higher colostrum lactoferrin concentrations in mothers with a history of COVID-19 infection during pregnancy or delivery compared to pre-pandemic controls. The highest lactoferrin concentrations we..
May 16
Huang et al., Journal of Dentistry, doi:10.1016/j.jdent.2024.105082 Satisfaction with Government Recommended Pre-Procedural Mouth Rinses in the Mitigation of Covid-19 in Hong Kong SAR: A Triple Blind Randomized Controlled Clinical Trial
RCT 228 dental patients showing high satisfaction and acceptability of three pre-procedural mouthrinses (povidone-iodine, hydrogen peroxide, and chlorhexidine digluconate) recommended by the Hong Kong government for mitigating COVID-19 tr..
May 16
Zhou et al., PLOS ONE, doi:10.1371/journal.pone.0300512 The efficacy and safety of fluvoxamine in patients with COVID-19: A systematic review and meta-analysis from randomized controlled trials
Meta analysis of 6 RCTs with 4,711 total participants showing significantly lower clinical deterioration and hospitalization with fluvoxamine treatment for COVID-19. Fluvoxamine doses ≥200mg daily were more effective than lower doses. The..
May 16
Naggie, S., JAMA, doi:10.1001/jama.2024.8723 Error in the Exclusion of Participants From Analysis in the ACTIV-6 Platform Randomized Clinical Trial
Partial correction to ACTIV-6 600 confirming that 16% of patients were missing in the analysis. It's not clear how the trial could have such a large error for the number of patients randomized, why the correction took over a year, or why ..
May 15
Irfan et al., BMC Infectious Diseases, doi:10.1186/s12879-024-09387-w Phytoconstituents of Artemisia Annua as potential inhibitors of SARS CoV2 main protease: an in silico study
In Silico study showing that quercetin binds strongly to the SARS-CoV-2 main protease (Mpro) and may be a potential inhibitor of viral replication. Authors screened 25 compounds from Artemisia annua and found that quercetin had one of the..
May 15
Wang et al., Cell Biochemistry and Function, doi:10.1002/cbf.4039 1,25‐Dihydroxyvitamin D3 attenuates platelet aggregation potentiated by SARS‐CoV‐2 spike protein via inhibiting integrin αIIbβ3 outside‐in signaling
In Vitro study showing that calcitriol minimizes platelet aggregation mediated by SARS-CoV-2 spike protein via inhibiting integrin αIIbβ3 outside-in signaling. Authors find that calcitriol reduces platelet aggregation and Src-mediated sig..
May 15
Gertner et al., Cureus, doi:10.7759/cureus.60364 Colchicine and/or Naltrexone for Hospitalized COVID-19 Patients Not Requiring High Levels of Ventilatory Support (COLTREXONE): A Prospective, Randomized, Open-Label Trial
65% lower ICU admission (p=0.11), 43% improved recovery (p=0.14), 34% lower need for oxygen therapy (p=0.34), and 20% shorter hospitalization (p=0.13). Open-label RCT 137 hospitalized COVID-19 patients, showing lower progression to ICU/step-down ICU and improved recovery with colchicine, both without statistical significance. The primary outcome was changed mid-trial due to the low numbe..
We aim to cover the most promising early treatments for COVID-19. We use pre-specified effect extraction criteria that prioritizes more serious outcomes, for details see methods. For specific outcomes and different treatment stages see the individual pages. Not all treatments are covered here, effectiveness has been reported for many other treatments in studies. Of the 4,294 studies, 2,218 present results comparing with a control group, 2,020 are treatment studies, and 198 analyze outcomes based on serum levels. There are 70 animal studies, 152 in silico studies, 250 in vitro studies, 268 reviews, and 195 meta analyses.
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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