COVID-19 treatment: real-time analysis of 6,649 studies

Physician treatment records
As with other viral infections, early treatment is more effective:
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Treatments show a wide range of efficacy and cost:
$0 $1,000 $2,000+ -25+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments +59 more high-profit drugs PPIs -46% BMS mAbs -36% >$2,000 Darunavir -34% Acetaminophen -28% Cenicriviroc -28% >$2,000 Cannabidiol Lufotrelvir >$2,000 Dexamethasone Losartan Sargramostim >$2,000 Lopinavir/ritonavir Ravulizumab >$2,000 Remdesivir $3,120 Conv. Plasma $5,000 Sarilumab >$2,000 Ibuprofen Masks Molnupiravir mutagenic/teratogenic Aspirin Tocilizumab Favipiravir Paxlovid Ratutrelvir Famotidine Vitamin C Sotrovimab $2,100 Colchicine TMPRSS2 i.. NAC Amubarvimab/r.. Vilobelimab $6,350 Ensitrelvir Azvudine Budesonide Probiotics HCQ Tixagevimab/c.. Zinc Antiandro.. Sleep Metformin Vitamin A Melatonin Bebtelovimab Nitric Oxide Quercetin H1RAs CPC Vitamin D H. Peroxide Exercise Fluvox. Sunlight Curcumin N. Sativa NaHCO₃ Casirivimab/i.. $2,100 Bamlanivimab/e.. Ensovibep >$2,000 PVP-I pH+ Diet Regdanvimab $2,100 Thermotherapy Ivermectin Lifestyle / free No prescription Prescription required High-cost Lowerrisk Higherrisk c19early.org June 2026 USA official early treatments COVID-19 involves the interplay of 500+ host/viral proteins/factors, modulated by many treatments. 0.5% of 11,000+proposed treatments show efficacy with ≥3 studies.Protocols combine treatments, none are 100% effective.c19early analyzes over 6,600 studies for 224 treatments.
$0 $1,000 $2,000+ -20+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments +59 more high-profit drugs PPIs -46% BMS mAbs -36% Acetaminophen -28% Cenicriviroc -28% CBD -23% Lufotrelvir -22% Dexame.. Losartan Sargramostim Lopinav.. Vit. B9 Ravulizumab Remdesivir C. Plasma Sarilumab Ibuprofen Masks Molnupiravir mutagenic/teratogenic Aspirin Tocilizumab Favipir.. Paxlovid Ratutrelvir Famotidine Vitamin C Sotrovimab Colchicine TMPRSS2 i.. NAC Amubarvimab/r.. Vilobelimab Ensitrelvir Azvudine Budesonide Probiotics HCQ Tixagev.. Zinc Antiandro.. Sleep Metformin Vitamin A Melatonin Bebtelovimab Nitric Oxide Quercetin H1RAs CPC Vitamin D H. Peroxide Exercise Fluvox. Sunlight Curcumin N. Sativa NaHCO₃ Casirivim.. Bamlan.. Ensovibep PVP-I pH+ Diet Regdanvimab Thermotherapy Ivermectin Lifestyle / free No prescription Prescription required High-cost Lowerrisk Higherrisk c19early.org June 2026 USA official early treatments COVID-19 involves the interplay of500+ host/viral proteins/factors. 0.5% of 11,000+ treatments showefficacy. Protocols combinetreatments. c19early analyzes6,600+ studies for 224 treatments.
Mainstream media suppressed low-cost treatments and favored high-profit treatments:
c19early.org June 2026 Media censorship for COVID-19 low-cost treatments Only 18 positive studies were covered: fluvoxamine (3), HCQ (2), antiandrogens (2), budesonide (2), vitamin D, melatonin, probiotics, ivermectin, cannabidiol, famotidinecurcumin, resveratrol, UDCA 53 negative studies were covered: HCQ (15), ivermectin (7), lopinavir/r.. (5), vitamin D (5), azithromycin (4), zinc (2), vitamin C (2), metformin (2), fluvoxamine (2)indomethacin, colchicine, selenium, probiotics, vitamin A, ibuprofen, antiandrogens, vitamin B9, cannabidiol 98% of studies showing significantly lower risk were censored: Media selectively covered negative studies for low-cost treatments Data from Altmetric: studies receiving significant mainstream media coverage from 6,000+ studies for 224 treatments 2020 2021 2022 2023 2024
c19early.org June 2026 C19 media censorship For low-cost treatments media covered only 18 positive studies: fluvoxamine (3), HCQ (2), antiandrogens (2), budesonide (2), vitamin D, ... 53 negative studies were covered: HCQ (15), ivermectin (7), lopinavir/r.. (5), vitamin D (5), azithromycin (4), ... 98% of positive studies were censored: Media censored positive studies Data from Altmetric: studies receiving significant media coverage from 6,000+ studies for 224 treatments 2020 2021 2022 2023 2024
Treatment protocols varied widely around the world:
Clinical evidence timeline:
Inhaled Heparin Cetylpyridinium Chloride Azelastine SA58 Azvudine Chlorpheniramine NaCl Tixagevimab/c.. Sodium Bicarbonate Paxlovid Regdanvimab Vitamin B12 Quercetin Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Molnupiravir Famotidine Budesonide Diet Melatonin Bamlanivimab/e.. Hydrogen Peroxide TMPRSS2 inhibitors Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Tocilizumab H1RAs Acetaminophen ↑risk Naso/oropharyngeal Exercise Vitamin D Antiandrogens Vitamin C PPIs ↑risk Colchicine Ivermectin Metformin Zinc HCQ 2020 2021 2022 2023 2024 2025 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org June 2026 Time when COVID-19 studies showed efficacy
Inhaled Heparin CPC Azelastine SA58 Azvudine Chlorpheniramine NaCl Tixagevimab/c.. Sodium Bicarb.. Paxlovid Regdanvimab Vitamin B12 Quercetin Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Molnupiravir Famotidine Budesonide Diet Melatonin Bamlanivimab/e.. Hydrogen Peroxide TMPRSS2 inhibitors Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Tocilizumab H1RAs Acetaminophen ↑risk Naso/oropharyngeal Exercise Vitamin D Antiandrogens Vitamin C PPIs ↑risk Colchicine Ivermectin Metformin Zinc HCQ 2020 2021 2022 2023 2024 2025 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org June 2026 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations. 0.5% of treatments show efficacy.
Treatment cost per life saved:
June 2026
c19early.org
Cost per life saved from NNT in
studies to date
Melatonin
10
33%
  $8
Alkalinization
9
46%
  $9
Vitamin D
79
39%
  $11
Zinc
18
35%
  $14
Vitamin C
44
19%
  $18
Naso/orophar..
2
88%
  $20
HCQ
252
27%
  $26
Ivermectin
53
47%
  $26
Vitamin A
4
46%
  $30
Colchicine
41
22%
  $36
Aspirin
68
8%
  $45
Curcumin
8
63%
  $59
Famotidine
20
17%
  $94
Metformin
74
36%
  $109
Quercetin
4
79%
  $123
Probiotics
10
59%
  $172
Antiandrogens
32
37%
  $179
Nigella Sativa
5
57%
  $187
Nitric Oxide
8
12%
  $363
Fluvoxamine
10
44%
  $411
Budesonide
11
25%
  $887
Inhaled Heparin
3
50%
  $1,111
Azvudine
30
30%
  $1,248
Favipiravir
40
6%
  $1,935
Tixagev../c..
11
32%
  $85,743
Regdanvimab
7
63%
  $139,860
Bamlaniv../e..
14
51%
  $343,149
Sotrovimab
15
47%
  $352,800
Casirivimab/..
11
19%
  $452,469
Bebtelovimab
4
60%
  $737,601
Paxlovid
43
21%
  $881,260
Molnupiravir
29
9%
  $2,400,867
Remdesivir
66
-1%
N/A
Conv. Plasma
56
-3%
N/A
Dexamethas..
10
-16%
N/A
Acetaminophen
14
-24%
N/A
PPIs
20
-40%
N/A
Sipavibart
2
-132%
N/A
Treatment cost times median NNT - details and limitations. 0.5% of treatments show efficacy.
All clinical results for selected treatments. 0.5% of treatments show efficacy.
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No effective intervention was widely adopted; excess mortality declined only after Omicron.
0 1000 2000 3000 4000 Age-adjusted cumulativeexcess deaths per million Cumulative excess mortalityduring the COVID-19 pandemic c19early.org June 2026 2020 2021 2022 Omicron becamedominant worldwide Although available, noeffective interventionswere widely adopted Data from Our World in Data, see https://c19early.org/excess.html
Top journals with less bias against low-cost treatments:
Top journals that accept positive studies for low cost treatments: Nutrients, Scientific Reports, PLOS ONE, International Journal of Infectious Diseases, Frontiers in Medicine, Cureus, more...
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 Proxalutamide 78% [70-83%] 4 $500 1K limited data Indomethacin 74% [-20-94%] 4 $5 605 limited data Chlorhexidine 70% [58-79%] 5 $1 675 limited data SA58 67% [17-87%] 3 $700 4K limited data Olgotrelvir 67% [-718-99%] 1 $1,000 1K very limited data Mebendazole 62% [12-83%] 3 $1 411 very limited data Ivermectin 61% [53-67%] 106 $1 220K Chlorphenira.. 56% [46-64%] 3 $5 806 very limited data Thermotherapy 56% [9-78%] 4 $0 217 very limited data Regdanvimab 55% [30-72%] 12 $2,100 7K Diet 51% [42-58%] 30 $0 690K HOCl 50% [-32-81%] 3 $1 341 very limited data Inhaled Heparin 50% [17-70%] 3 $100 493 limited data Alkalinization 49% [36-59%] 14 $1 6K HH-120 49% [-60-84%] 2 $500 345 very limited data Povidone-Iod.. 48% [35-58%] 21 $1 2K Ensovibep 47% [-108-87%] 2 $2,100 885 limited data Bamlaniv../e.. 46% [24-61%] 22 $1,250 30K variant dependent Casirivimab/i.. 45% [26-59%] 34 $2,100 50K variant dependent Resveratrol 44% [-4-70%] 3 $1 360 limited data Adintrevimab 43% [-169-88%] 2 $2,100 2K intramuscular Bromhexine 43% [-5-69%] 7 $5 875 very limited data Sodium Bicar.. 43% [23-58%] 6 $1 1K Nigella Sativa 43% [24-57%] 14 $5 3K Propolis 41% [-13-69%] 3 $1 410 very limited data Curcumin 41% [30-50%] 28 $5 15K Sunlight 39% [26-50%] 6 $0 19K Fluvoxamine 39% [22-53%] 21 $4 30K Montelukast 39% [14-56%] 9 $2 2K limited data Exercise 39% [33-44%] 68 $0 1M Hydrogen Per.. 39% [6-60%] 8 $1 847 very limited data Azelastine 39% [0-62%] 4 $5 760 very limited data Vitamin D 38% [33-43%] 138 $1 200K Epigallocatech.. 38% [10-57%] 2 $5 1K very limited data Cetylpyridin.. 38% [15-55%] 4 $1 157 limited data Phthalocyan.. 38% [20-51%] 4 $5 5K Xiannuoxin 38% [-46-73%] 2 $106 1K very limited data H1RAs 37% [22-50%] 17 $5 70K Sentinox 37% [-238-88%] 1 $25 39 very limited data Nitazoxanide 36% [-4-61%] 14 $4 3K Quercetin 35% [15-51%] 9 $5 841 Nitric Oxide 35% [9-54%] 14 $11 2K Selenium 34% [-40-69%] 4 $1 21K Bebtelovimab 34% [-24-65%] 6 $1,200 13K intravenous Artemisinin 34% [11-51%] 3 $1 217 very limited data Melatonin 34% [24-42%] 18 $1 14K Vitamin A 33% [12-49%] 14 $2 22K Bemnifosbuvir 32% [-74-73%] 4 $500 2K very limited data Metformin 31% [28-35%] 112 $10 360K Sleep 31% [23-39%] 16 $0 420K Spironolactone 31% [15-44%] 12 $5 28K Antiandrogens 30% [21-38%] 49 $5 120K Nafamostat 30% [10-46%] 7 $1 16K very limited data Vitamin B12 30% [5-48%] 4 $1 11K Zinc 30% [20-38%] 41 $1 50K Tixagev../c.. 29% [4-48%] 20 $855 30K variant dependent Inosine Pran.. 29% [13-42%] 2 $50 414 limited data Hydroxychlor.. 28% [25-31%] 424 $1 590K Niclosamide 28% [9-43%] 7 $50 2K very limited data Probiotics 27% [18-36%] 29 $5 19K Ibuzatrelvir 27% [15-38%] 1 $1,390 126 very limited data Budesonide 27% [17-36%] 15 $4 28K Andrograph.. 27% [-8-50%] 7 $5 1K Azvudine 27% [19-33%] 42 $25 50K Ensitrelvir 26% [1-45%] 9 $500 6K Vilobelimab 26% [-4-48%] 1 $6,350 368 intravenous Amubarv../r.. 25% [-70-66%] 4 $1,380 1K intravenous Lactoferrin 24% [-24-53%] 8 $5 1K N-acetylcys.. 23% [14-32%] 25 $1 26K NaCl 23% [9-36%] 9 $0 1K TMPRSS2 inh. 23% [10-33%] 29 $5 19K Colchicine 23% [14-31%] 54 $1 30K Sotrovimab 22% [10-32%] 29 $2,100 50K variant dependent Vitamin C 21% [14-27%] 72 $1 80K Leritrelvir 21% [3-35%] 2 $88 1K very limited data UDCA 18% [-3-36%] 22 $15 40K Camostat 18% [-2-34%] 16 $1 2K SNS812 17% [4-29%] 1 $1,000 90 very limited data Famotidine 16% [7-24%] 29 $5 110K Ratutrelvir 14% [3-24%] 1 $1,500 50 very limited data Vitamin K 14% [0-25%] 2 $1 7K very limited data Atilotrelvir 13% [1-23%] 1 $65 1K very limited data Paxlovid 12% [8-15%] 89 $1,390 170K independent trials refused Deuremidevir 11% [-1-21%] 2 $112 1K very limited data Favipiravir 11% [3-18%] 74 $20 30K worse w/longer followup Tocilizumab 8% [-6-21%] 47 $2,000 21K Aspirin 8% [2-13%] 79 $1 180K Molnupiravir 5% [-3-12%] 54 $707 180K mutagenic/teratogenic Empagliflozin 4% [-11-16%] 1 $300 4K very limited data Masks 2% [-25-24%] 4 $5 350K Ibuprofen 0% [-9-9%] 13 $1 50K Acebilustat 0% [-1462-94%] 1 $2,000 120 very limited data Levilimab 0% [-289-74%] 1 $2,000 206 subcutaneous Vidofludimus 0% [-597-86%] 1 $2,000 220 very limited data Verapamil 0% [-379-79%] 1 $5 144 very limited data iC1e/K 0% [-1287-93%] 1 $10,000 20 intravenous Adalimumab 0% [-268-73%] 1 $1,000 68 very limited data Zunsemetinib 0% [-1287-93%] 1 $1,000 20 very limited data Brilacidin 0% [-281-74%] 1 $2,000 120 intravenous Sarilumab -0% [-21-17%] 11 $2,000 2K intravenous/subcutaneous Pomotrelvir -1% [-104-50%] 1 $1,390 230 very limited data Elderberry -1% [-4-2%] 1 $25 171 very limited data Conv. Plasma -2% [-6-2%] 58 $5,000 30K intravenous Vadadustat -3% [-89-44%] 1 $596 448 very limited data Apremilast -3% [-42-25%] 2 $2,000 594 limited data DFV890 -3% [-159-59%] 1 $2,000 142 very limited data Dimethyl fum.. -3% [-48-29%] 1 $20 713 very limited data rhu-pGSN -3% [-587-84%] 1 $5,000 61 intravenous Ropeginterfero.. -3% [-1010-90%] 1 $10,000 132 subcutaneous Remdesivir -4% [-13-4%] 81 $3,120 200K worse w/longer followup Aviptadil -5% [-74-37%] 3 $1,000 775 limited data Interleukin-2 -5% [-36-19%] 2 $2,100 94 intravenous Nicotine -5% [-50-26%] 1 $20 213 very limited data Ravulizumab -5% [-45-24%] 2 $2,000 481 intravenous HuMax-IL8 -6% [-147-54%] 1 $10,000 43 intravenous AER002 -6% [-18-4%] 1 $2,000 36 intravenous Lanadelumab -7% [-135-52%] 1 $10,000 55 very limited data Vitamin B9 -8% [-41-18%] 12 $1 50K CK0802 -8% [-257-67%] 1 $5,000 30 intravenous Plasma-activ.. -9% [-234-64%] 1 $100 23 very limited data Ibrutinib -9% [-1541-93%] 1 $9,000 46 very limited data FX06 -10% [-156-53%] 1 $10,000 49 intravenous Diacerein -10% [-111-43%] 1 $10 14 very limited data Razuprotafib -10% [-116-44%] 2 $2,000 134 subcutaneous Gimsilumab -10% [-80-30%] 1 $2,000 225 intravenous Iodine -10% [-121-45%] 1 $1 141 very limited data Lopinavir/r.. -11% [-28-4%] 18 $50 16K Gabapentin -11% [-32-6%] 1 $10 129 very limited data Dornase alfa -12% [-87-34%] 3 $2,000 242 very limited data Sargramostim -13% [-85-31%] 4 $2,000 870 very limited data Conestat alfa -14% [-1439-92%] 2 $79,000 121 intravenous Brexanolone -14% [-129-43%] 1 $34,000 28 very limited data Losartan -15% [-84-29%] 6 $5 1K limited data Peg.. Lambda -15% [-107-36%] 5 $500 2K subcutaneous Efmarodocokin.. -15% [-111-41%] 1 $2,000 266 intravenous Pentoxifylline -15% [-363-71%] 3 $50 178 very limited data Dolutegravir -15% [-71-22%] 2 $130 1K intravenous Plitidepsin -16% [-356-71%] 2 $2,000 163 intravenous MAS825 -16% [-83-26%] 1 $5,000 138 intravenous Trimodulin -17% [-116-37%] 1 $2,000 166 intravenous Dexamethas.. -17% [-40-2%] 12 $1 27K Losmapimod -18% [-76-21%] 1 $2,000 48 very limited data Amantadine -19% [-167-47%] 3 $10 527 very limited data Silymarin -20% [-302-64%] 1 $5 50 very limited data Metronidazole -20% [-677-81%] 1 $5 44 very limited data Lufotrelvir -22% [-198-50%] 1 $2,000 58 intravenous Defibrotide -23% [-127-34%] 1 $100,000 150 intravenous Cannabidiol -23% [-95-22%] 12 $25 19K Tenecteplase -25% [-946-85%] 1 $8,000 13 intravenous Pacritinib -28% [-210-47%] 1 $2,000 200 very limited data Cenicriviroc -28% [-66-1%] 3 $2,000 1K limited data Acetaminoph.. -28% [-41--17%] 27 $1 540K Crizanlizumab -29% [-103-18%] 2 $2,500 463 intravenous Voxvoganan -29% [-728-80%] 1 $200 23 very limited data Cyproheptadine -30% [-133-27%] 2 $10 136 very limited data Astegolimab -31% [-133-31%] 1 $2,000 264 intravenous Alunacedase alfa -31% [-238-49%] 1 $2,000 178 intravenous Belnacasan -34% [-129-22%] 1 $1,000 31 very limited data Darunavir -34% [-120-18%] 5 $40 2K very limited data Tradipitant -36% [-161-30%] 1 $1,200 145 very limited data BMS mAbs -36% [-492-69%] 1 $2,100 210 subcutaneous Domperidone -36% [-123-17%] 1 $10 173 very limited data Zansecimab -36% [-263-49%] 1 $2,000 95 intravenous GPAT -38% [-81--5%] 1 $50 243 very limited data Atovaquone -39% [-526-69%] 1 $50 60 very limited data GB0139 -40% [-449-64%] 1 $2,000 41 very limited data Brensocatib -41% [-88--6%] 1 $2,000 404 very limited data Danicopan -43% [-168-24%] 1 $2,000 201 very limited data Fenretinide -44% [-193-29%] 1 $700 351 very limited data XAV-19 -45% [-221-35%] 2 $2,000 667 intravenous PPIs -46% [-67--28%] 40 $5 220K Beta-glucans -49% [-823-76%] 2 $25 64 very limited data Olokizumab -50% [-309-45%] 1 $2,000 248 subcutaneous Ixekizumab -50% [-681-71%] 1 $5,000 32 subcutaneous Edaravone -50% [-699-72%] 1 $5,000 38 intravenous TRV027 -54% [-202-22%] 2 $2,000 318 intravenous Glenzocimab -60% [-236-24%] 1 $2,000 62 intravenous Asapiprant -63% [-242-22%] 1 $1,000 194 very limited data Siltuximab -64% [-252-23%] 1 $2,000 149 intravenous rNAPc2 -65% [-304-32%] 1 $3,000 156 subcutaneous Avdoralimab -68% [-226-13%] 1 $2,000 207 intravenous Cytokine Adsor.. -72% [-545-54%] 2 $5,000 83 very limited data SIR1-365 -88% [-790-61%] 1 $1,000 42 very limited data Zafirlukast -100% [-1933-80%] 1 $5 40 very limited data Obefazimod -101% [-1675-77%] 1 $2,000 305 very limited data Estetrol -102% [-683-48%] 1 $50 171 very limited data Amiodarone -103% [-680-47%] 1 $10 143 very limited data P2Et -114% [-2174-80%] 1 $20 91 very limited data BI 764198 -117% [-488-20%] 1 $1,000 129 very limited data Varespladib -120% [-4351-89%] 1 $1,000 18 very limited data Posaconazole -131% [-200--78%] 1 $2,000 249 very limited data Sipavibart -132% [-427--2%] 2 $2,000 2K intramuscular Emvododstat -132% [-628-26%] 1 $2,000 187 very limited data Dalcetrapib -134% [-5564-90%] 1 $700 208 very limited data Goflikicept -135% [-492-7%] 1 $2,000 247 subcutaneous AZD5156 -139% [-5482-90%] 1 $2,000 57 intramuscular Ramipril -144% [-5754-90%] 1 $5 114 very limited data Ensifentrine -150% [-5695-89%] 1 $1,000 45 very limited data YKYY017 -150% [-5977-90%] 1 $500 239 very limited data Pemivibart -150% [-6014-90%] 1 $5,775 477 intravenous Donidalorsen -151% [-602-11%] 1 $2,000 103 intravenous/subcutaneous MIB-626 -156% [-5797-89%] 1 $1,000 39 very limited data Zavegepant -168% [-1988-66%] 1 $1,100 43 very limited data Tiprelestat -189% [-6132-87%] 1 $2,000 17 intravenous Mefenamic Acid -189% [-6566-87%] 1 $50 36 very limited data Apilimod -199% [-7108-88%] 1 $700 141 very limited data Baloxavir -200% [-6491-86%] 1 $200 20 very limited data Antroquinonol -200% [-7125-88%] 1 $1,000 124 very limited data Zenuzolac -200% [-2732-68%] 1 $500 90 very limited data Ammonium Ch.. -202% [-1506-43%] 1 $10 120 very limited data Astodrimer So.. -205% [-7302-87%] 1 $10 197 very limited data Brequinar -205% [-7243-87%] 1 $700 115 very limited data Hesperidin -209% [-2820-67%] 1 $5 211 very limited data Selinexor -286% [-1586-11%] 1 $3,300 117 very limited data Pegipanermin -290% [-3230-54%] 1 $5,000 77 subcutaneous Efzofitimod -291% [-7370-80%] 1 $2,000 32 very limited data LSALT peptide -407% [-10036-75%] 1 $2,000 61 intravenous Clevudine -744% [-14450-51%] 1 $10 61 very limited data All studies (pooled effects, all stages) c19early.org June 2026 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 Chlorhexidine 70% 5 limited data SA58 67% 3 limited data Olgotrelvir 67% 1 very limited data Mebendazole 62% 3 very limited data Ivermectin 61% 106 Chlorphenira.. 56% 3 very limited data Thermotherapy 56% 4 very limited data Regdanvimab 55% 12 Diet 51% 30 HOCl 50% 3 very limited data Inhaled Heparin 50% 3 limited data Alkalinization 49% 14 HH-120 49% 2 very limited data Povidone-Iod.. 48% 21 Ensovibep 47% 2 limited data Bamlaniv../e.. 46% 22 variant dependent Casirivimab/.. 45% 34 variant dependent Resveratrol 44% 3 limited data Adintrevimab 43% 2 intramuscular Bromhexine 43% 7 very limited data Sodium Bicar.. 43% 6 Nigella Sativa 43% 14 Propolis 41% 3 very limited data Curcumin 41% 28 Sunlight 39% 6 Fluvoxamine 39% 21 Montelukast 39% 9 limited data Exercise 39% 68 Hydrogen Per.. 39% 8 very limited data Azelastine 39% 4 very limited data Vitamin D 38% 138 Epigallocatec.. 38% 2 very limited data Cetylpyridin.. 38% 4 limited data Phthalocyan.. 38% 4 Xiannuoxin 38% 2 very limited data H1RAs 37% 17 Sentinox 37% 1 very limited data Nitazoxanide 36% 14 Quercetin 35% 9 Nitric Oxide 35% 14 Selenium 34% 4 Bebtelovimab 34% 6 intravenous Artemisinin 34% 3 very limited data Melatonin 34% 18 Vitamin A 33% 14 Bemnifosbuvir 32% 4 very limited data Metformin 31% 112 Sleep 31% 16 Spironolactone 31% 12 Antiandrogens 30% 49 Nafamostat 30% 7 very limited data Vitamin B12 30% 4 Zinc 30% 41 Tixagev../c.. 29% 20 variant dependent Inosine Pran.. 29% 2 limited data Hydroxychlor.. 28% 424 Niclosamide 28% 7 very limited data Probiotics 27% 29 Ibuzatrelvir 27% 1 very limited data Budesonide 27% 15 Andrograph.. 27% 7 Azvudine 27% 42 Ensitrelvir 26% 9 Vilobelimab 26% 1 intravenous Amubarv../r.. 25% 4 intravenous Lactoferrin 24% 8 N-acetylcys.. 23% 25 NaCl 23% 9 TMPRSS2 inh. 23% 29 Colchicine 23% 54 Sotrovimab 22% 29 variant dependent Vitamin C 21% 72 Leritrelvir 21% 2 very limited data UDCA 18% 22 Camostat 18% 16 SNS812 17% 1 very limited data Famotidine 16% 29 Ratutrelvir 14% 1 very limited data Vitamin K 14% 2 very limited data Atilotrelvir 13% 1 very limited data Paxlovid 12% 89 independent trials refused Deuremidevir 11% 2 very limited data Favipiravir 11% 74 worse w/longer followup Tocilizumab 8% 47 Aspirin 8% 79 Molnupiravir 5% 54 mutagenic/teratogenic Empagliflozin 4% 1 very limited data Masks 2% 4 Ibuprofen 0% 13 Acebilustat 0% 1 very limited data Levilimab 0% 1 subcutaneous Vidofludimus 0% 1 very limited data Verapamil 0% 1 very limited data iC1e/K 0% 1 intravenous Adalimumab 0% 1 very limited data Zunsemetinib 0% 1 very limited data Brilacidin 0% 1 intravenous Sarilumab -0% 11 intravenous/subcutaneous Pomotrelvir -1% 1 very limited data Elderberry -1% 1 very limited data Conv. Plasma -2% 58 intravenous Vadadustat -3% 1 very limited data Apremilast -3% 2 limited data DFV890 -3% 1 very limited data Dimethyl fu.. -3% 1 very limited data rhu-pGSN -3% 1 intravenous Ropeginterfer.. -3% 1 subcutaneous Remdesivir -4% 81 worse w/longer followup Aviptadil -5% 3 limited data Interleukin-2 -5% 2 intravenous Nicotine -5% 1 very limited data Ravulizumab -5% 2 intravenous HuMax-IL8 -6% 1 intravenous AER002 -6% 1 intravenous Lanadelumab -7% 1 very limited data Vitamin B9 -8% 12 CK0802 -8% 1 intravenous Plasma-activ.. -9% 1 very limited data Ibrutinib -9% 1 very limited data FX06 -10% 1 intravenous Diacerein -10% 1 very limited data Razuprotafib -10% 2 subcutaneous Gimsilumab -10% 1 intravenous Iodine -10% 1 very limited data Lopinavir/r.. -11% 18 Gabapentin -11% 1 very limited data Dornase alfa -12% 3 very limited data Sargramostim -13% 4 very limited data Conestat alfa -14% 2 intravenous Brexanolone -14% 1 very limited data Losartan -15% 6 limited data Peg.. Lambda -15% 5 subcutaneous Efmarodocoki.. -15% 1 intravenous Pentoxifylline -15% 3 very limited data Dolutegravir -15% 2 intravenous Plitidepsin -16% 2 intravenous MAS825 -16% 1 intravenous Trimodulin -17% 1 intravenous Dexamethas.. -17% 12 Losmapimod -18% 1 very limited data Amantadine -19% 3 very limited data Silymarin -20% 1 very limited data Metronidazole -20% 1 very limited data Lufotrelvir -22% 1 intravenous Defibrotide -23% 1 intravenous Cannabidiol -23% 12 Tenecteplase -25% 1 intravenous Pacritinib -28% 1 very limited data Cenicriviroc -28% 3 limited data Acetaminoph.. -28% 27 Crizanlizumab -29% 2 intravenous Voxvoganan -29% 1 very limited data Cyproheptadine -30% 2 very limited data Astegolimab -31% 1 intravenous Alunacedase a.. -31% 1 intravenous Belnacasan -34% 1 very limited data Darunavir -34% 5 very limited data Tradipitant -36% 1 very limited data BMS mAbs -36% 1 subcutaneous Domperidone -36% 1 very limited data Zansecimab -36% 1 intravenous GPAT -38% 1 very limited data Atovaquone -39% 1 very limited data GB0139 -40% 1 very limited data Brensocatib -41% 1 very limited data Danicopan -43% 1 very limited data Fenretinide -44% 1 very limited data XAV-19 -45% 2 intravenous PPIs -46% 40 Beta-glucans -49% 2 very limited data Olokizumab -50% 1 subcutaneous Ixekizumab -50% 1 subcutaneous Edaravone -50% 1 intravenous TRV027 -54% 2 intravenous Glenzocimab -60% 1 intravenous Asapiprant -63% 1 very limited data Siltuximab -64% 1 intravenous rNAPc2 -65% 1 subcutaneous Avdoralimab -68% 1 intravenous Cytokine Adso.. -72% 2 very limited data SIR1-365 -88% 1 very limited data Zafirlukast -100% 1 very limited data Obefazimod -101% 1 very limited data Estetrol -102% 1 very limited data Amiodarone -103% 1 very limited data P2Et -114% 1 very limited data BI 764198 -117% 1 very limited data Varespladib -120% 1 very limited data Posaconazole -131% 1 very limited data Sipavibart -132% 2 intramuscular Emvododstat -132% 1 very limited data Dalcetrapib -134% 1 very limited data Goflikicept -135% 1 subcutaneous AZD5156 -139% 1 intramuscular Ramipril -144% 1 very limited data Ensifentrine -150% 1 very limited data YKYY017 -150% 1 very limited data Pemivibart -150% 1 intravenous Donidalorsen -151% 1 intravenous/subcutaneous MIB-626 -156% 1 very limited data Zavegepant -168% 1 very limited data Tiprelestat -189% 1 intravenous Mefenamic Acid -189% 1 very limited data Apilimod -199% 1 very limited data Baloxavir -200% 1 very limited data Antroquinonol -200% 1 very limited data Zenuzolac -200% 1 very limited data Ammonium C.. -202% 1 very limited data Astodrimer S.. -205% 1 very limited data Brequinar -205% 1 very limited data Hesperidin -209% 1 very limited data Selinexor -286% 1 very limited data Pegipanermin -290% 1 subcutaneous Efzofitimod -291% 1 very limited data LSALT peptide -407% 1 intravenous Clevudine -744% 1 very limited data All studies (pooled effects, all stages) c19early.org June 2026 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. 0.5% 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. 0.5% 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. 0.5% 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. 0.5% 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. 0.5% 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. 0.5% of proposed treatments show efficacy in clinical studies.
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Random-effects meta-analysis of long covid results. 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. 0.5% of proposed treatments show efficacy in clinical studies.
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Random-effects meta-analysis of transmission results. 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. 0.5% of proposed treatments show efficacy in clinical studies.
LATE TREATMENT
Physician / TeamLocationPatients HospitalizationHosp. MortalityDeath
Dr. David Uip (*) Brazil 2,200 38.6% (850) 2.5% (54)
Dr. Jake Scott (**) USA 1,000 10.0% (100)
Average 38.6% 6.2%
EARLY TREATMENT PROTOCOLS - 40 physicians/teams
Physician / TeamLocationPatients HospitalizationHosp. MortalityDeath
Dr. Roberto Alfonso Accinelli
0/360 deaths for treatment within 3 days		 Peru 1,265 0.6% (7)
Dr. Mohammed Tarek Alam
patients up to 84 years old		 Bangladesh 100 0.0% (0)
Dr. Oluwagbenga Alonge Nigeria 310 0.0% (0)
Dr. Raja Bhattacharya
up to 88yo, 81% comorbidities		 India 148 1.4% (2)
Dr. Flavio Cadegiani Brazil 3,450 0.1% (4) 0.0% (0)
Dr. Alessandro Capucci Italy 350 4.6% (16)
Dr. Shankara Chetty South Africa 8,000 0.0% (0)
Dr. Deborah Chisholm USA 100 0.0% (0)
Dr. Ryan Cole USA 400 0.0% (0) 0.0% (0)
Dr. Marco Cosentino
earlier treatment results were better		 Italy 392 6.4% (25) 0.3% (1)
Dr. Jeff Davis USA 6,000 0.0% (0)
Dr. Dhanajay India 500 0.0% (0)
Dr. Bryan Tyson & Dr. George Fareed USA 20,000 0.0% (6) 0.0% (4)
Dr. Raphael Furtado Brazil 170 0.6% (1) 0.0% (0)
Rabbi Yehoshua Gerzi Israel 860 0.1% (1) 0.0% (0)
Dr. Heather Gessling USA 1,500 0.1% (1)
Dr. Ellen Guimarães Brazil 500 1.6% (8) 0.4% (2)
Dr. Syed Haider USA 4,000 0.1% (5) 0.0% (0)
Dr. Mark Hancock USA 24 0.0% (0)
Dr. Sabine Hazan USA 1,000 0.0% (0)
Dr. Mollie James USA 3,500 1.1% (40) 0.0% (1)
Dr. Roberta Lacerda Brazil 550 1.5% (8) 0.4% (2)
Dr. Katarina Lindley USA 100 5.0% (5) 0.0% (0)
Dr. Ben Marble USA 150,000 0.0% (4)
Dr. Edimilson Migowski Brazil 2,000 0.3% (7) 0.1% (2)
Dr. Abdulrahman Mohana Saudi Arabia 2,733 0.0% (0)
Dr. Carlos Nigro Brazil 5,000 0.9% (45) 0.5% (23)
Dr. Benoit Ochs Luxembourg 800 0.0% (0)
Dr. Ortore Italy 240 1.2% (3) 0.0% (0)
Dr. Valerio Pascua
one patient already on oxygen died		 Honduras 415 6.3% (26) 0.2% (1)
Dr. Sebastian Pop Romania 300 0.0% (0)
Dr. Brian Proctor USA 869 2.3% (20) 0.2% (2)
Dr. Anastacio Queiroz Brazil 700 0.0% (0)
Dr. Didier Raoult France 8,315 2.6% (214) 0.1% (5)
Dr. Karin Ried
up to 99yo, 73% comorbidities		 Turkey 237 0.4% (1)
Dr. Roman Rozencwaig
patients up to 86 years old		 Canada 80 0.0% (0)
Dr. Vipul Shah India 8,000 0.1% (5)
Dr. Silvestre Sobrinho Brazil 116 8.6% (10) 0.0% (0)
Dr. Unknown Brazil 957 1.7% (16) 0.2% (2)
Dr. Vladimir Zelenko USA 2,200 0.5% (12) 0.1% (2)
Average 2.2% 0.1%
Physicians using early combined treatment protocols had much lower hospitalization and mortality rates compared with those following guidelines focusing on late treatment. Results are subject to selection and ascertainment bias and accurate analysis requires details of the patient populations and followup, however the results are consistent across many teams, and consistent with the extensive controlled clinical evidence showing a significant reduction in risk with many early treatments, and complementary/synergistic benefits with combined treatments. (*) Dr. Uip reportedly prescribed early treatment for himself, but not for patients1. (**) Dr. Scott reports treating hundreds of patients and losing over a hundred, but has not provided specific numbers2. Dr. Scott reports following (and helping create) US guidelines.
Vitamin D
di Filippo
114 patients prophylaxis: 50% fewer symptomatic cases (p=0.12)
Convalescent Plasma
Rahardjo
RCT 30 hospitalized COVID-19 patients in Indonesia showing significantly shorter length of hospital stay with convalescent plasma, however there are..
Probiotics
Morikawa
Retrospective 283 hospitalized COVID-19 patients in Japan showing potential benefit with butyrate-producing Clostridium butyricum (CB)-containing..
Bačić
Analysis of 74 participants (34 receiving a 12-week multi-strain probiotic containing Saccharomyces boulardii, Lacticaseibacillus rhamnosus GG, and..
Soleimani
In vitro study showing benefit with postbiotics derived from Lacticaseibacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12..
Miscellaneous
Porta
Review of SARS-CoV-2 non-structural proteins as targets for direct-acting small-molecule antivirals.
Soto Albrecht
In vitro study showing that inhibition of mitochondrial oxidative phosphorylation (OXPHOS) enhances SARS-CoV-2 replication, while restoration of..
Jia
Review of strategies for developing and engineering broadly neutralizing antibodies against SARS-CoV-2 to counteract rapid viral mutation and immune..
Akinbolade
Review of existing medicines for viruses with epidemic or pandemic potential (Ebola, Marburg, influenza, mpox, MERS-CoV, SARS-CoV, and SARS-CoV-2),..
Amahong
Integrative meta-analysis identifying conserved host protein targets shared across SARS-CoV-2, influenza A, Zika, and Dengue for potential host..
Metformin
Ngiam
59,762 patients prophylaxis: 20% lower long COVID (p=0.01)
Paxlovid
Liu
Retrospective 300 elderly hospitalized COVID-19 patients in China, showing no mortality benefit with antivirals (paxlovid and molnupiravir) in..
Kueper
669 patients early treatment: 87% worse recovery (p=0.02) and 148% worse viral clearance (p=0.01)
Molnupiravir
Liu
Retrospective 300 elderly hospitalized COVID-19 patients in China, showing no mortality benefit with antivirals (paxlovid and molnupiravir) in..
Epigallocatechin Gallate
Kawai
1,003 patient prophylaxis RCT: 67% lower hospitalization (p=0.5), 67% lower progression (p=0.5), and 1% fewer cases (p=1)
Cannabidiol
Torrejón-Guirado
1,051 patients prophylaxis: 154% more cases (p=0.001)
Defibrotide
Jara Rubio
150 patient late treatment RCT: 23% higher mortality (p=0.56), 200% higher progression (p=0.14), no change in ICU admission (p=1), and 18% longer hospitalization (p=0.41)
Elderberry
Setz
In vitro study showing synergistic antiviral activity of black elderberry fruit extract and iota-carrageenan against SARS-CoV-2 Omicron, influenza A..
Iota-carrageenan
Setz
In vitro study showing synergistic antiviral activity of black elderberry fruit extract and iota-carrageenan against SARS-CoV-2 Omicron, influenza A..
Povidone-Iodine
Widyarman
RCT 40 COVID-19 outpatients showing lower salivary SARS-CoV-2 viral load with cetylpyridinium chloride (CPC), povidone-iodine (PVP-I), and sodium..
Cetylpyridinium Chloride
Widyarman
RCT 40 COVID-19 outpatients showing lower salivary SARS-CoV-2 viral load with cetylpyridinium chloride (CPC), povidone-iodine (PVP-I), and sodium..
Ivermectin
Lakatos
10 patient early treatment RCT: 62% lower progression (p=1)
HCQ
Amal
Meta analysis of 17 studies with 229,142 autoimmune patients treated with HCQ, showing significantly lower mortality with HCQ use.
Lopinavir/ritonavir
Strub-Wourgaft
894 patient early treatment RCT: 20% higher progression (p=0.87) and 12% lower hospitalization (p=1)
Budesonide
Strub-Wourgaft
960 patient early treatment RCT: 91% lower progression (p=0.37) and 5% lower hospitalization (p=1)
Recent studies (see the individual treatment pages for all studies):
Jun 18
 Haidar et al., NCT05648110 Study Understanding Pre-Exposure pRophylaxis of NOvel Anitbodies (SUPERNOVA)
139% higher mortality (p=1). RCT 57 patients showing no significant differences with AZD5156 (sipavibart + cilgavimab).
Jun 10
 di Filippo et al., Endocrine, doi:10.1007/s12020-026-04677-6 Impact of chronic cholecalciferol supplementation and vitamin D status on risk of post-vaccination SARS-CoV-2 breakthrough infection
50% fewer symptomatic cases (p=0.12). Retrospective 114 vaccinated outpatients showing lower risk of symptomatic COVID-19 cases with adequate vitamin D status and cholecalciferol supplementation (similar point estimate for the full and matched population, but without statisti..
Jun 5
 Soto Albrecht et al., Science Advances, doi:10.1126/sciadv.adz3081 Mitochondrial OXPHOS restricts SARS-CoV-2 replication
In vitro study showing that inhibition of mitochondrial oxidative phosphorylation (OXPHOS) enhances SARS-CoV-2 replication, while restoration of OXPHOS restricts it, suggesting that compounds boosting OXPHOS (such as metformin) may have a..
Jun 3
 Jia et al., Viruses, doi:10.3390/v18060642 Broad Neutralizing Antibodies Against SARS-CoV-2: Current Progress and Engineering Strategies
Review of strategies for developing and engineering broadly neutralizing antibodies against SARS-CoV-2 to counteract rapid viral mutation and immune escape.
Jun 3
 Ngiam et al., Infectious Diseases and Therapy, doi:10.1007/s40121-026-01362-z Prior SGLT2 Inhibitor and Metformin Use and Risk of Long COVID in Type 2 Diabetes: A Nationwide Population-Based Cohort Study
20% lower long COVID (p=0.01). Retrospective 71,698 patients with type 2 diabetes in Singapore showing reduced risk of long COVID with prior metformin use and SGLT2 inhibitor use.
Jun 2
 Kueper et al., Interactive Journal of Medical Research, doi:10.2196/80263 COVID-19 Rebound in Nirmatrelvir Plus Ritonavir Treatment and Control Groups: Prospective Cohort Study
87% worse recovery (p=0.02) and 148% worse viral clearance (p=0.01). Prospective observational study of 669 COVID-19 outpatients in the USA showing higher rates of viral and symptom rebound with paxlovid.
Jun 2
 Porta et al., Pharmaceutics, doi:10.3390/pharmaceutics18060693 Targeting SARS-CoV-2 Non-Structural Proteins: A Blueprint for Next-Generation Small-Molecule Coronavirus Antivirals
Review of SARS-CoV-2 non-structural proteins as targets for direct-acting small-molecule antivirals.
May 31
 Kawai et al., AJPM Focus, doi:10.1016/j.focus.2026.100517 Effects of green tea gargling on Coronavirus Disease-2019: A multi-center randomized controlled trial
67% lower hospitalization (p=0.5), 67% lower progression (p=0.5), and 1% fewer cases (p=1). RCT 1,012 adults in Japan showing no statistically significant reduction in COVID-19 incidence with green tea gargling compared to water gargling. In the full analysis set, incidence was 5.4% in both groups. In the per-protocol set (PPS, ..
May 29
 Liu et al., Medicine, doi:10.1097/MD.0000000000049099 Independent mortality predictors in older COVID-19 patients with delayed hospitalization: A retrospective study from Eastern China, 2023
Retrospective 300 elderly hospitalized COVID-19 patients in China, showing no mortality benefit with antivirals (paxlovid and molnupiravir) in multivariable analysis, OR 1.15 [0.28-4.74], without statistical significance.
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.
References