COVID-19 treatment: real-time analysis of 6,538 studies

Summary of clinical evidence for COVID-19 treatment:
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 +56 more high-profit drugs PPIs -46% BMS mAbs -36% >$2,000 Darunavir -34% Acetaminophen -28% Cenicriviroc -28% >$2,000 Lufotrelvir >$2,000 Dexamethasone Losartan Sargramostim >$2,000 Cannabidiol 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 Azvudine Budesonide Probiotics HCQ Zinc Antiandro.. Sleep Metformin Ensitrelvir Vitamin A Melatonin Tixagevimab/c.. Bebtelovimab Quercetin Nitric Oxide 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 April 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 6,500 studies for 216 treatments.
$0 $1,000 $2,000+ -20+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments +56 more high-profit drugs PPIs -46% BMS mAbs -36% Acetaminophen -28% Cenicriviroc -28% Lufotrelvir -22% Dexame.. Losartan Sargramostim CBD 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 Azvudine Budesonide Probiotics HCQ Zinc Antiandro.. Sleep Metformin Vitamin A Melatonin Tixagev.. Bebtelovimab Quercetin Nitric Oxide 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 April 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 analyzes6,500+ studies for 216 treatments.
Mainstream media suppressed low-cost treatments and favored high-profit treatments:
c19early.org April 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 216 treatments 2020 2021 2022 2023 2024
c19early.org April 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 216 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 April 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 April 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:
April 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
7
11%
  $226
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..
10
40%
  $74,506
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
28
9%
  $2,400,867
Remdesivir
66
-1%
N/A
Conv. Plasma
56
-3%
N/A
Acetaminophen
14
-24%
N/A
PPIs
20
-40%
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 April 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 60% [52-67%] 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 Fluvoxamine 40% [24-53%] 22 $4 30K Sunlight 39% [26-50%] 6 $0 19K 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%] 137 $1 190K 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 Epigallocatech.. 38% [10-50%] 1 $5 114 very limited data H1RAs 37% [22-50%] 17 $5 70K Nitric Oxide 37% [11-56%] 13 $11 2K Sentinox 37% [-238-88%] 1 $25 39 very limited data Quercetin 35% [15-51%] 9 $5 841 Nitazoxanide 35% [-8-61%] 14 $4 3K Selenium 34% [-40-69%] 4 $1 21K Bebtelovimab 34% [-24-65%] 6 $1,200 13K intravenous Tixagev../c.. 34% [11-51%] 19 $855 30K variant dependent 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 Ensitrelvir 32% [7-50%] 8 $500 6K Bemnifosbuvir 32% [-74-73%] 4 $500 2K very limited data Metformin 32% [28-35%] 111 $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 Hydroxychlor.. 28% [25-31%] 423 $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 Andrograph.. 27% [-8-50%] 7 $5 1K Budesonide 27% [16-35%] 14 $4 27K Azvudine 27% [19-33%] 42 $25 50K 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 19% [-3-36%] 21 $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% [8-16%] 88 $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%] 52 $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 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%] 17 $50 15K Gabapentin -11% [-32-6%] 1 $10 129 very limited data Dornase alfa -12% [-87-34%] 3 $2,000 242 very limited data Cannabidiol -13% [-81-30%] 11 $25 18K 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 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 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 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 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 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 Sipavibart -241% [-1161-8%] 2 $2,000 2K intramuscular 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 April 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 60% 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 Fluvoxamine 40% 22 Sunlight 39% 6 Montelukast 39% 9 limited data Exercise 39% 68 Hydrogen Per.. 39% 8 very limited data Azelastine 39% 4 very limited data Vitamin D 38% 137 Cetylpyridin.. 38% 4 limited data Phthalocyan.. 38% 4 Xiannuoxin 38% 2 very limited data Epigallocatec.. 38% 1 very limited data H1RAs 37% 17 Nitric Oxide 37% 13 Sentinox 37% 1 very limited data Quercetin 35% 9 Nitazoxanide 35% 14 Selenium 34% 4 Bebtelovimab 34% 6 intravenous Tixagev../c.. 34% 19 variant dependent Artemisinin 34% 3 very limited data Melatonin 34% 18 Vitamin A 33% 14 Ensitrelvir 32% 8 Bemnifosbuvir 32% 4 very limited data Metformin 32% 111 Sleep 31% 16 Spironolactone 31% 12 Antiandrogens 30% 49 Nafamostat 30% 7 very limited data Vitamin B12 30% 4 Zinc 30% 41 Hydroxychlor.. 28% 423 Niclosamide 28% 7 very limited data Probiotics 27% 29 Ibuzatrelvir 27% 1 very limited data Andrograph.. 27% 7 Budesonide 27% 14 Azvudine 27% 42 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 19% 21 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% 88 independent trials refused Deuremidevir 11% 2 very limited data Favipiravir 11% 74 worse w/longer followup Tocilizumab 8% 47 Aspirin 8% 79 Molnupiravir 5% 52 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 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% 17 Gabapentin -11% 1 very limited data Dornase alfa -12% 3 very limited data Cannabidiol -13% 11 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 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 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 Emvododstat -132% 1 very limited data Dalcetrapib -134% 1 very limited data Goflikicept -135% 1 subcutaneous 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 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 Sipavibart -241% 2 intramuscular 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 April 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.
Miscellaneous
Jiang
Review summarizing the structure, biological functions, and potential applications of the coronavirus membrane (M) protein, with emphasis on its..
Yang
Review of lipid metabolism as a host-pathogen interface in viral infections, with focus on SARS-CoV-2/COVID-19. Authors detail how SARS-CoV-2..
Xue
Genome-wide multi-omics study identifying shared and differential genetic architecture between COVID-19 and eight respiratory disorders (asthma,..
Kushwaha
Review of medicinal chemistry approaches for combating SARS-CoV-2 and COVID-19 therapeutics.
Montaldo
Observational study of 42 hospitalized COVID-19 patients (17 severe, 25 mild) and 23 healthy donors, characterizing plasma extracellular vesicles ..
Duan
In vitro study showing that TNF (Tumor Necrosis Factor) inhibits SARS-CoV-2 spike protein-induced cell-cell fusion and syncytia formation across..
Aktaruzzaman
Review of the link between COVID-19 and memory deficits, focusing on the role of brain microglial activation.
Pasquero
In vitro and mouse study showing benefit of PAD4 inhibition with GSK199 and BB-Cl-amidine against SARS-CoV-2 infection.
Zhang
Review synthesizing cross-virus evidence for convergent pathogenic mechanisms of IAV, SARS-CoV-2, and RSV in type II alveolar epithelial cells ..
Castro
In vitro study showing antiviral benefit with avasimibe, candesartan cilexetil, and ursolic acid against SARS-CoV-2 by targeting the viral nsp13..
Remdesivir
Zhu
Pharmacovigilance and EHR analysis of 8,143 FAERS remdesivir reports and over 255,000 TriNetX EHR records, showing significantly higher risk of..
Andrographolide
Songvut
Exploratory open-label PK/PD clinical trial of 12 outpatients with mild COVID-19 showing a -2.96 log10 reduction in viral load over 5 days with..
Curcumin
Ataya
In silico study showing that polyphenols, particularly 6"-O-acetyldaidzin and phloretin, bind to the neuropilin-1 (NRP-1) b1 domain CendR pocket..
Ursodeoxycholic acid
Song
Systematic review and meta-analysis of 15 studies with 716,310 participants showing lower COVID-19 infection risk, severe infection risk, and..
Dexamethasone
Gordon
Review of corticosteroid use in influenza and COVID-19 severe pneumonia. In influenza, the weight of evidence associates corticosteroid therapy with..
Mostafavi
In vitro and mouse study showing benefit with dexamethasone, adalimumab (anti-TNF), anakinra (IL-1R antagonist), and anti-IL-1β antibodies in..
Bălan
Retrospective 52 mechanically ventilated ICU patients showing a "resistance paradox" in COVID-19-associated Ventilator-Associated Pneumonia (VAP),..
Colchicine
Ma
In silico study identifying MMP1 as a shared therapeutic target between gout and severe COVID-19, suggesting colchicine may exert anti-inflammatory..
N-acetylcysteine
Stranieri
Retrospective 80 hospitalized COVID-19 patients (40 survivors, 40 non-survivors) and 40 non-COVID-19 controls showing that lower plasma hydrogen..
Metformin
Felemban
114 patients prophylaxis: 44% lower ventilation (p=0.24), 9% lower ICU admission (p=0.79), 35% lower ARDS (p=0.38), and 46% higher hospital discharge (p=0.01)
Reis
RCT 399 adults with long COVID fatigue in Brazil showing significant benefit with fluvoxamine but not metformin for reducing fatigue severity...
Vitamin A
Ozpinar
Retrospective 44 hospitalized COVID-19 patients (23 moderate, 21 severe) and 39 healthy controls showing significant depletion of carotenoids,..
Favipiravir
Wawman
Post hoc pharmacokinetic analysis of 140 hospitalized COVID-19 patients from the PIONEER RCT, showing no statistically significant improvement in..
Fluvoxamine
Reis
RCT 399 adults with long COVID fatigue in Brazil showing significant benefit with fluvoxamine but not metformin for reducing fatigue severity...
Proton Pump Inhibitor
Bălan
Retrospective 52 mechanically ventilated ICU patients showing a "resistance paradox" in COVID-19-associated Ventilator-Associated Pneumonia (VAP),..
Recent studies (see the individual treatment pages for all studies):
Apr 2
 Henrich et al., NCT06161688 Placebo-Controlled, Randomized Trial of Ensitrelvir (S-217622) for Viral Persistence and Inflammation in People Experiencing Long COVID (PREVAIL-LC)
RCT 40 long COVID patients in the USA, showing no significant improvement with ensitrelvir.
Apr 2
 Zhu et al., Pharmaceuticals, doi:10.3390/ph19040574 Cardiovascular Risks of COVID-19 Therapeutics: Integrated Analysis of FAERS, Electronic Health Records, and Transcriptomics
Pharmacovigilance and EHR analysis of 8,143 FAERS remdesivir reports and over 255,000 TriNetX EHR records, showing significantly higher risk of cardiovascular adverse events (bradycardia, hypotension, and cardiac arrest) with remdesivir c..
Mar 31
 Song et al., Frontiers in Pharmacology, doi:10.3389/fphar.2026.1719144 Clinical effects of ursodeoxycholic acid in COVID-19 infection: a systematic review and dose–response meta-analysis
Systematic review and meta-analysis of 15 studies with 716,310 participants showing lower COVID-19 infection risk, severe infection risk, and ventilator use with ursodeoxycholic acid (UDCA) treatment. A dose-response relationship was obse..
Mar 31
 Reis et al., Annals of Internal Medicine, doi:10.7326/ANNALS-25-03959 The Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID
RCT 399 adults with long COVID fatigue in Brazil showing significant benefit with fluvoxamine but not metformin for reducing fatigue severity. Authors hypothesize that fluvoxamine's σ-1 receptor agonism and immunomodulatory properties may..
Mar 31
 Felemban et al., BMC Infectious Diseases, doi:10.1186/s12879-026-13170-4 The length of hospital stay in COVID-19 patients using pre-hospital metformin at a Saudi tertiary hospital: a retrospective cohort study
44% lower ventilation (p=0.24), 9% lower ICU admission (p=0.79), 35% lower ARDS (p=0.38), and 46% higher hospital discharge (p=0.01). Retrospective 114 hospitalized COVID-19 patients with T2DM in Saudi Arabia, showing significantly shorter hospital stay with pre-hospital metformin use.
Mar 31
 Pasquero et al., iScience, doi:10.1016/j.isci.2026.115038 Targeting peptidyl-arginine deiminase 4 suppresses SARS-CoV-2 replication and modulates the inflammatory response
In vitro and mouse study showing benefit of PAD4 inhibition with GSK199 and BB-Cl-amidine against SARS-CoV-2 infection.
Mar 31
 Kushwaha et al., Fabad Journal of Pharmaceutical Sciences, doi:10.55262/fabadeczacilik.1757782 Medicinal Chemistry Approaches for Combatting SARS-CoV-2 and COVID-19 Therapeutics
Review of medicinal chemistry approaches for combating SARS-CoV-2 and COVID-19 therapeutics.
Mar 27
 Zimmerman et al., NCT05965726 RECOVER-VITAL: A Platform Protocol for Evaluation of Interventions for Viral Persistence, Viral Reactivation, and Immune Dysregulation in Post-Acute Sequelae of SARS-CoV-2 Infection (PASC)
9% worse improvement (p=0.22). RCT 964 patients showing no difference in improvement of long COVID with 15-day or 25-day paxlovid compared with placebo. Results appeared in the registry 15 months after primary completion, with no publication or announcement [clinicaltr..
Mar 26
 Wang et al., Journal of Biological Chemistry, doi:10.1016/j.jbc.2026.111408 Direct interaction between human DDX1 and SARS-CoV-2 Nucleocapsid protein is regulated by phosphorylation
In vitro study showing that the SARS-CoV-2 nucleocapsid (N) protein interacts with human RNA helicases DDX1 and DDX21 through mechanistically distinct pathways, with DDX1 binding being phosphorylation-dependent and DDX21 binding being..
Mar 26
 Razi et al., COVID, doi:10.3390/covid6040056 A Study on the Impact of Sunlight, Ultraviolet Radiation, and Temperature Variability on COVID-19 Mortality: Spatiotemporal Evidence from Small Countries and U.S. States and Territories
45% lower mortality (p<0.0001). Ecological study of 129 geographical regions worldwide showing lower COVID-19 mortality with higher ambient Ultraviolet (UV) Index, sunlight duration, and temperature. Authors analyzed daily data from January 2020 to January 2023 utilizin..
Mar 26
 Wawman et al., ERJ Open Research, doi:10.1183/23120541.01560-2025 The Relationship Between Plasma Favipiravir Concentrations and Clinical Outcomes in COVID-19
Post hoc pharmacokinetic analysis of 140 hospitalized COVID-19 patients from the PIONEER RCT, showing no statistically significant improvement in clinical outcomes among favipiravir-treated patients who achieved target plasma concentratio..
Mar 26
 Xue et al., medRxiv, doi:10.64898/2026.03.21.26348591 Disentangling the Shared and Differential Genetic Architecture Between COVID-19 and Other Respiratory Disorders: A Multi-Omics Genome-Wide Analysis
Genome-wide multi-omics study identifying shared and differential genetic architecture between COVID-19 and eight respiratory disorders (asthma, COPD, IPF, ILD, pneumonia, bacterial pneumonia, viral pneumonia, and influenza).
Mar 25
 Mostafavi et al., bioRxiv, doi:10.64898/2026.03.21.713333 IL-1β and TNF drive endothelial dysfunction and coagulopathy in acute COVID-19
In vitro and mouse study showing benefit with dexamethasone, adalimumab (anti-TNF), anakinra (IL-1R antagonist), and anti-IL-1β antibodies in preventing SARS-CoV-2-induced endothelial dysfunction and coagulopathy.
Mar 24
 Azhir et al., Communications Medicine, doi:10.1038/s43856-026-01535-4 Paxlovid shows organ-specific and age-specific impacts on risk of developing post-acute sequelae of COVID-19
7% higher long COVID (p=0.29). Retrospective 19,413 COVID-19 outpatient and hospitalized patients showing no overall reduction in long COVID risk with paxlovid. Stratification by organ system found a 37% reduction in gastrointestinal PASC (OR 0.63, p=0.002) - biologica..
Mar 23
 Berra et al., NCT04305457 Nitric Oxide Gas Inhalation Therapy in Spontaneous Breathing Patients With Mild/Moderate COVID-19: a Randomized Clinical Trial
65% lower mortality (p=1) and 14% higher ventilation (p=1). Early terminated RCT 62 hosptialized patients, showing no significant difference with nitric oxide treatment.
Mar 23
 di Filippo et al., Journal of Endocrinological Investigation, doi:10.1007/s40618-026-02858-8 Chronic cholecalciferol supplementation and adequate vitamin D status are associated with reduced risk of Long COVID
78% lower long COVID (p=0.02). Retrospective 132 COVID-19 patients showing lower long COVID risk with chronic cholecalciferol supplementation. The study compared patients receiving long-term cholecalciferol for at least 24 months to those without supplementation, track..
Mar 23
 Ataya et al., PLOS One, doi:10.1371/journal.pone.0345051 Identification of polyphenols as novel neuropilin-1 cendR pocket inhibitors to block SARS-CoV-2 entry and enhance variant resistance
In silico study showing that polyphenols, particularly 6"-O-acetyldaidzin and phloretin, bind to the neuropilin-1 (NRP-1) b1 domain CendR pocket with higher affinity than the synthetic inhibitor EG01377, potentially blocking SARS-CoV..
Mar 19
 Mokgokong et al., Health and Quality of Life Outcomes, doi:10.1186/s12955-026-02518-8 Health-related quality of life in immunocompromised adults with mild–moderate COVID-19 treated with nirmatrelvir-ritonavir: results from the randomized, double-blinded EPIC-IC trial
RCT 150 immunocompromised adults with mild-to-moderate COVID-19 comparing 5, 10, or 15 days of nirmatrelvir/ritonavir. There was no control group. No dose-response relationship was observed: HRQoL recovery patterns were statistically..
Mar 18
 Rowland et al., Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.70261 Optimal Dose and Safety of Intravenous Favipiravir in Hospitalized Patients With COVID-19: A Dose-Escalating, Randomized Controlled Phase Ib Study
Phase Ib dose-escalating RCT of 24 hospitalized COVID-19 patients showing safety and tolerability of intravenous (IV) favipiravir at doses up to 2,400 mg twice daily.
Mar 18
 Vahed et al., The Journal of Immunology, doi:10.1093/jimmun/vkag017 CXCL13/CXCR5 chemokine axis promotes antiviral CXCR5+CD19+ B Cells and follicular/effector CXCR5+CD4+ T Cells in the lungs associated with protection from severe and fatal COVID-19 following infection with pathogenic SARS-CoV-2 Delta variant
Mouse study showing that the CXCL13 chemokine plays a protective role against SARS-CoV-2 infection and COVID-19-like disease in K18-hACE2 transgenic mice. Authors suggest the CXCL13/CXCR5 axis as a potential immunotherapeutic target for C..
Mar 18
 Zaher et al., Medicina, doi:10.3390/medicina62030560 Testing the Possible Protective Effect of Ivermectin on Bleomycin-Induced Pulmonary Fibrosis in Albino Rats: Histological and Immunohistochemical Study
Rat study showing benefit with ivermectin against bleomycin-induced pulmonary fibrosis. Rats treated with both bleomycin (BLM) and ivermectin (0.6 mg/kg orally on days 0, 1, 7, and 8) showed significant histological and biochemical improv..
Mar 17
 Guo et al., BMC Medicine, doi:10.1186/s12916-026-04791-2 Effectiveness of nirmatrelvir/ritonavir and molnupiravir on post-COVID diabetes risk among an older adult cohort: a target trial emulation study
Retrospective analysis finding lower risk of post-COVID diabetes with nirmatrelvir/ritonavir but not molnupiravir. The effect may be entirely due to confounding. Authors excluded only 8% of non-diabetic patients for nirmatrelvir/ritonavir..
Mar 17
 Mierzejewska et al., Langmuir, doi:10.1021/acs.langmuir.6c00207 Effect of Cationic Surfactants on the Molecular Organization of the Simplified Model Lipid Envelope of SARS-CoV-2 Virus─Insights from the Langmuir Monolayer and Liposome Studies
In vitro study showing potential antiviral benefit with cetylpyridinium chloride (CPC) through the destabilization of simplified SARS-CoV-2 lipid envelope models. Authors found that CPC, a cationic surfactant commonly used in mouthwashes ..
Mar 16
 Filippini et al., Critical Care Explorations, doi:10.1097/cce.0000000000001392 Tocilizumab Efficacy Across Inflammatory Subphenotypes in COVID-19-Related Acute Respiratory Distress Syndrome
Retrospective 561 mechanically ventilated COVID-19 ARDS patients across three Dutch university hospital ICUs, showing significant reduction in 30-day mortality with tocilizumab, with no significant difference in efficacy between hypoinfla..
Mar 16
 Aktaruzzaman et al., Neuroglia, doi:10.3390/neuroglia7010010 Unraveling the Link Between COVID-19 and Memory Deficits: The Role of Brain Microglia Activation
Review of the link between COVID-19 and memory deficits, focusing on the role of brain microglial activation.
Mar 13
 Songvut et al., Frontiers in Pharmacology, doi:10.3389/fphar.2026.1781740 Exploratory pharmacokinetic-pharmacodynamic characterization and safety of standardized Andrographis paniculata aqueous extract capsules in patients with mild COVID-19
Exploratory open-label PK/PD clinical trial of 12 outpatients with mild COVID-19 showing a -2.96 log10 reduction in viral load over 5 days with standardized Andrographis paniculata aqueous extract capsules (90 mg/day andrographolide). The..
Mar 12
 Ganmaa et al., The Journal of Nutrition, doi:10.1016/j.tjnut.2026.101398 A Randomized Trial of Vitamin D Supplementation and COVID-19 Clinical Outcomes and Long COVID: The Vitamin D for COVID-19 Trial
4% improvement (p=0.76), 17% lower long COVID (p=0.24), and 71% higher transmission (p=0.21). VIVID trial - results were withheld without explanation for over 3 years, until long after the end of the pandemic. There is no scientific or ethical justification for withholding results this long. There are many serious anomolies in the..
Mar 12
 Kayar Çalılı et al., Journal of Health Sciences and Medicine, doi:10.32322/jhsm.1854699 Vitamin B12 status and outcomes in patients admitted to intensive care unit with COVID-19: a three-group comparative analysis
32% higher mortality (p=0.38). Retrospective 665 COVID-19 ICU patients in Turkey showing no significant association between vitamin B12 levels at ICU admission and disease severity, ICU length of stay, or mortality. Authors rely exclusively on total serum vitamin B12 r..
Mar 11
 Castro et al., International Journal of Molecular Sciences, doi:10.3390/ijms27062587 Stalling the Enemy: Targeting Nsp13 for Next-Generation SARS-CoV-2 Antivirals
In vitro study showing antiviral benefit with avasimibe, candesartan cilexetil, and ursolic acid against SARS-CoV-2 by targeting the viral nsp13 helicase.
Mar 11
 Zhang et al., Frontiers in Immunology, doi:10.3389/fimmu.2026.1781447 Convergent hub pathways targeted by IAV, SARS-CoV-2, and RSV in type II alveolar epithelial cells: molecular mechanisms and therapeutic implications
Review synthesizing cross-virus evidence for convergent pathogenic mechanisms of IAV, SARS-CoV-2, and RSV in type II alveolar epithelial cells (AEC2s), with therapeutic implications for COVID-19.
Mar 10
 Zhu et al., Scientific Reports, doi:10.1038/s41598-026-42215-6 A real-world retrospective analysis comparing the effectiveness of Azvudine and Nirmatrelvir/Ritonavir in COVID-19 patients with diabetes
Retrospective study of 400 hospitalized COVID-19 patients with diabetes in China showing no significant difference in the composite endpoint of disease progression (all-cause mortality, ICU admission, or invasive mechanical ventilation) b..
Mar 10
 Chu et al., Frontiers in Public Health, doi:10.3389/fpubh.2026.1760355 Analysis of Long COVID characteristics and risk factors in individuals infected with COVID-19: a follow-up study based on a cohort of 2,792 participants
24% higher long COVID (p=0.65). Prospective study of 2,792 COVID-19 patients in China. After propensity score matching, neither paxlovid nor azvudine showed a statistically significant association with long COVID.
Mar 8
 Maltezou et al., Research Square, doi:10.21203/rs.3.rs-9009421/v1 Effectiveness of a sustained-release ammonium chloride formulation in reducing the viral load of patients with COVID-19 or influenza: A prospective, randomized, double-blind, placebo-controlled study
RCT 32 outpatients (28 with COVID-19) showing potential virological benefit with ammonium chloride. All participants experienced mild illness with no progression to severe disease, hospitalization, or death in either cohort. There was a s..
Mar 6
 Nicholson et al., Am. J. Health-Syst. Pharm., doi:10.1093/ajhp/zxaf258 Impact of Implementing More Restrictive Remdesivir Criteria Across a Multi-Hospital Health System
Retrospective 2,249 hospitalized COVID-19 patients showing lower mortality after restricting remdesivir use. Mortality reduced from 7.6% to 5.6% (p = 0.12) after restriction. No baseline details are provided and results are subject to con..
Mar 6
 Ruan et al., BMC Infectious Diseases, doi:10.1186/s12879-026-12637-8 A bidimensional early intervention strategy of standard of care in combination with corticosteroids in elderly patients with mild to moderate COVID-19 (BEAT-COV study): a multicentre, open-label, randomized controlled trial
RCT 188 elderly patients with mild to moderate COVID-19 showing no significant reduction in progression to severe or critical COVID-19 with oral corticosteroids (dexamethasone 3 mg, 210 prednisolone 20 mg, or methylprednisolone 16 mg).
Mar 5
 Yang et al., Frontiers in Cellular and Infection Microbiology, doi:10.3389/fcimb.2026.1765502 Lipid metabolism, viral infection, and antiviral immunity: a new host-pathogen interface
Review of lipid metabolism as a host-pathogen interface in viral infections, with focus on SARS-CoV-2/COVID-19. Authors detail how SARS-CoV-2 exploits host lipid pathways at multiple stages of its lifecycle, including utilizing lipid raft..
Mar 4
 Li et al., BMC Cancer, doi:10.1186/s12885-026-15800-1 Azvudine for the treatment of cancer patients with COVID-19: a multicenter, real-world, retrospective, cohort study
35% lower mortality (p=0.02) and 30% lower progression (p=0.02). Retrospective 1,829 hospitalized cancer patients with COVID-19 in China showing lower mortality and disease progression with azvudine treatment. While the authors used a PSM-matched cohort for efficacy, they used 'Available data' (unmatch..
Mar 3
 Lim et al., Annals of Internal Medicine, doi:10.7326/ANNALS-25-04883 Neither Metformin nor Ursodeoxycholic Acid Effectively Treats Postacute Sequelae of COVID-19
RCT 396 patients with existing long COVID, showing no significant benefit with metformin or UDCA.
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