COVID-19 treatment: real-time analysis of 6,404 studies

COVID-19 involves the interplay of 400+ viral and host proteins and factors, providing many therapeutic targets. c19early analyzes 6,400+ studies for 215 treatments—over 17 million hours of research. Only three high-profit early treatments are approved in the US. In reality, many treatments reduce risk, with 25 low-cost treatments approved across 163 countries.
  • Naso/oropharyngeal treatment Effective Treatment directly to the primary source of initial infection.
  • Healthy lifestyles Protective Exercise, sunlight, a healthy diet, and good sleep all reduce risk.
  • Immune support Effective Vitamins A, C, D, and zinc show reduced risk, as with other viruses.
  • Thermotherapy Effective Methods for increasing internal body temperature, enhancing immune system function.
  • Systemic agents Effective Many systemic agents reduce risk, and may be required when infection progresses.
  • High-profit systemic agents Conditional Effective, but with greater access and cost barriers.
  • Monoclonal antibodies Limited Utility Effective but rarely used—high cost, variant dependence, IV/SC admin.
  • Acetaminophen Harmful Increased risk of severe outcomes and mortality.
  • Remdesivir Harmful Increased mortality with longer followup. Increased kidney and liver injury, cardiac disorders.
$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 Losartan Sargramostim >$2,000 Cannabidiol Dexamethasone Lopinavir/ritonavir Ravulizumab >$2,000 Conv. Plasma $5,000 Remdesivir $3,120 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 Zinc HCQ Antiandro.. Sleep Ensitrelvir Metformin Vitamin A Melatonin Tixagevimab/c.. Bebtelovimab Nitric Oxide H1RAs Sunlight CPC Vitamin D H. Peroxide Exercise Fluvox. Curcumin N. Sativa NaHCO₃ Casirivimab/i.. $2,100 Bamlanivimab/e.. Quercetin Ensovibep >$2,000 pH+ PVP-I Diet Regdanvimab $2,100 Thermotherapy Ivermectin Lifestyle / free No prescription Prescription required High-cost Lowerrisk Higherrisk c19early.org February 2026 USA official early treatments COVID-19 involves the interplay of 400+ host/viral proteins/factors, modulated by many treatments. 0.5% of 10,000+proposed treatments show efficacy with ≥3 studies.Protocols combine treatments, none are 100% effective.c19early analyzes over 6,400 studies for 215 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% Losartan Sargramostim CBD Dexame.. Lopinav.. Vit. B9 Ravulizumab C. Plasma Remdesivir 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 Zinc HCQ Antiandro.. Sleep Metformin Vitamin A Melatonin Tixagev.. Bebtelovimab Nitric Oxide H1RAs Sunlight CPC Vitamin D H. Peroxide Exercise Fluvox. Curcumin N. Sativa NaHCO₃ Casirivim.. Bamlan.. Quercetin Ensovibep pH+ PVP-I Diet Regdanvimab Thermotherapy Ivermectin Lifestyle / free No prescription Prescription required High-cost Lowerrisk Higherrisk c19early.org February 2026 USA official early treatments COVID-19 involves the interplay of400+ host/viral proteins/factors.0.5% of 10,000+ treatments showefficacy. Protocols combinetreatments. c19early analyzes6,400+ studies for 215 treatments.
c19early.org February 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 215 treatments 2020 2021 2022 2023 2024
c19early.org February 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 215 treatments 2020 2021 2022 2023 2024
Inhaled Heparin Cetylpyridinium Chloride Azelastine SA58 Azvudine Chlorpheniramine NaCl Tixagevimab/c.. Sodium Bicarbonate Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Molnupiravir Famotidine Budesonide Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide TMPRSS2 inhibitors Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Tocilizumab Melatonin 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 February 2026 Time when COVID-19 studies showed efficacy
Inhaled Heparin CPC Azelastine SA58 Azvudine Chlorpheniramine NaCl Tixagevimab/c.. Sodium Bicarb.. Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Molnupiravir Famotidine Budesonide Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide TMPRSS2 inhibitors Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Tocilizumab Melatonin 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 February 2026 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations. 0.5% of treatments show efficacy.
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...
February 2026
c19early.org
Cost per life saved from NNT in
studies to date
Melatonin
10
33%
  $8
Alkalinization
9
46%
  $9
Vitamin D
80
39%
  $11
Zinc
22
30%
  $16
Naso/orophar..
2
88%
  $18
Vitamin C
46
20%
  $18
HCQ
253
27%
  $26
Ivermectin
53
47%
  $26
Vitamin A
4
46%
  $30
Colchicine
41
22%
  $36
Aspirin
68
8%
  $45
Curcumin
8
63%
  $59
Nitric Oxide
6
11%
  $90
Famotidine
21
18%
  $94
Metformin
71
37%
  $109
Quercetin
5
61%
  $127
Probiotics
10
59%
  $172
Antiandrogens
32
37%
  $179
Nigella Sativa
5
57%
  $187
Fluvoxamine
10
44%
  $411
Budesonide
11
25%
  $887
Inhaled Heparin
3
50%
  $1,111
Azvudine
28
30%
  $1,248
Favipiravir
42
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
Remdesivir
68
1%
  $1,558,440
Molnupiravir
28
9%
  $2,400,867
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.
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All clinical results for selected treatments. 0.5% of treatments show efficacy.
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0 1000 2000 3000 4000 Age-adjusted cumulativeexcess deaths per million Cumulative excess mortalityduring the COVID-19 pandemic c19early.org February 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
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 Povidone-Iod.. 49% [38-58%] 22 $1 3K Alkalinization 49% [36-59%] 14 $1 6K HH-120 49% [-60-84%] 2 $500 345 very limited data Ensovibep 47% [-108-87%] 2 $2,100 885 limited data Quercetin 46% [20-64%] 12 $5 1K 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 39% [21-52%] 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%] 136 $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 Sunlight 37% [22-50%] 5 $0 19K H1RAs 37% [22-50%] 17 $5 70K Nitric Oxide 37% [10-56%] 12 $11 2K Sentinox 37% [-238-88%] 1 $25 39 very limited data 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%] 19 $1 14K Vitamin A 33% [12-49%] 14 $2 22K Metformin 32% [28-35%] 107 $10 350K Ensitrelvir 32% [7-50%] 8 $500 6K Bemnifosbuvir 32% [-74-73%] 4 $500 2K very limited data 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 Hydroxychlor.. 28% [25-31%] 424 $1 590K Zinc 28% [18-36%] 47 $1 50K 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 26% [18-33%] 39 $25 40K 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% [15-28%] 75 $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 17% [8-24%] 30 $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 13% [9-16%] 86 $1,390 170K independent trials refused Deuremidevir 11% [-1-21%] 2 $112 1K very limited data Favipiravir 10% [3-18%] 76 $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 Remdesivir -2% [-11-6%] 83 $3,120 200K worse w/longer followup 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 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 Lopinavir/r.. -11% [-28-4%] 17 $50 15K Dexamethas.. -11% [-29-4%] 13 $1 13K 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 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 February 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 Povidone-Iod.. 49% 22 Alkalinization 49% 14 HH-120 49% 2 very limited data Ensovibep 47% 2 limited data Quercetin 46% 12 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 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% 136 Cetylpyridin.. 38% 4 limited data Phthalocyan.. 38% 4 Xiannuoxin 38% 2 very limited data Epigallocatec.. 38% 1 very limited data Sunlight 37% 5 H1RAs 37% 17 Nitric Oxide 37% 12 Sentinox 37% 1 very limited data Nitazoxanide 35% 14 Selenium 34% 4 Bebtelovimab 34% 6 intravenous Tixagev../c.. 34% 19 variant dependent Artemisinin 34% 3 very limited data Melatonin 34% 19 Vitamin A 33% 14 Metformin 32% 107 Ensitrelvir 32% 8 Bemnifosbuvir 32% 4 very limited data Sleep 31% 16 Spironolactone 31% 12 Antiandrogens 30% 49 Nafamostat 30% 7 very limited data Vitamin B12 30% 4 Hydroxychlor.. 28% 424 Zinc 28% 47 Niclosamide 28% 7 very limited data Probiotics 27% 29 Ibuzatrelvir 27% 1 very limited data Andrograph.. 27% 7 Budesonide 27% 14 Azvudine 26% 39 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% 75 Leritrelvir 21% 2 very limited data UDCA 19% 21 Camostat 18% 16 SNS812 17% 1 very limited data Famotidine 17% 30 Ratutrelvir 14% 1 very limited data Vitamin K 14% 2 very limited data Atilotrelvir 13% 1 very limited data Paxlovid 13% 86 independent trials refused Deuremidevir 11% 2 very limited data Favipiravir 10% 76 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 Remdesivir -2% 83 worse w/longer followup 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 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 Lopinavir/r.. -11% 17 Dexamethas.. -11% 13 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 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 February 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.
Nigella Sativa
Elrosasy
Systematic review and meta-analysis of 6 RCTs showing significantly lower mortality and symptom severity with nigella sativa treatment in 1,595..
Paxlovid
Hosseini
Secondary analysis of the CanTreatCOVID paxlovid RCT comparing adherence and symptom reporting between a 9-item abbreviated diary and 34-item FLU..
Chen
2,415 patients early treatment PSM: 11% lower mortality (p=0.21)
Pridgen
Case series of 24 long COVID outpatients showing greater symptom improvement with a combination of IMC-2 (valacyclovir + celecoxib) plus 15-day..
Prager
102,647 patients early treatment: 22% worse viral clearance (p<0.0001)
Hong Choi
56,680 patients early treatment: 3% lower mortality (p=0.8), 21% lower ventilation (p=0.39), and 28% higher ICU admission (p=0.46)
Miscellaneous
Ekmen
In vitro study showing that extracellular vesicles (EVs) can transmit SARS-CoV-2 replicon RNA between cells independently of infectious virus..
Felix-Lopez
In vitro and mouse study showing that inhibitors of neddylation (MLN4924, TAS4464) and FGFR signaling (BGJ398, binimetinib) significantly reduce..
Grunst
Review article examining class 1 viral fusion glycoproteins in HIV-1 and SARS-CoV-2, focusing on viral entry mechanisms and antibody-mediated..
Alvarez
In vitro study showing that compound C19 significantly reduces SARS-CoV-2 replication by targeting the interaction between viral E protein and host..
Colunga-Biancatelli
Mouse study showing that KVX-053, a PTP4A3 inhibitor, reduces SARS-CoV-2-induced inflammation and acute lung injury in K18-hACE2 transgenic mice.
Lee
In vitro and mouse study showing broad neutralizing activity and protective efficacy with TRI2-2, a computationally-designed homotrimeric..
Ivanisenko
In silico study showing that five compounds may interact with the SARS-CoV-2 ORF3a protein using graph neural networks and molecular docking..
Nitric Oxide
Martins
In vitro study showing broad-spectrum virucidal activity of nitric oxide nasal spray (NONS) against SARS-CoV-2 variants and major respiratory..
Vitamin A
Yeap
45 patient late treatment RCT: 50% worse recovery (p=0.54)
Molnupiravir
Prager
101,233 patients early treatment: 12% worse viral clearance (p<0.0001)
Hong Choi
56,783 patients early treatment: 61% higher mortality (p<0.0001), 12% higher ventilation (p=0.66), and 28% higher ICU admission (p=0.44)
Tixagevimab/cilgavimab
Martin-Blondel
Prospective cohort study of 114 high-risk COVID-19 outpatients showing that monoclonal antibody treatments with suboptimal neutralizing activity..
Sotrovimab
Martin-Blondel
Prospective cohort study of 114 high-risk COVID-19 outpatients showing that monoclonal antibody treatments with suboptimal neutralizing activity..
Casirivimab/imdevimab
Martin-Blondel
Prospective cohort study of 114 high-risk COVID-19 outpatients showing that monoclonal antibody treatments with suboptimal neutralizing activity..
Aspirin
Perico
In vitro and mouse study showing that acetylsalicylic acid (ASA/aspirin) inhibits SARS-CoV-2 spike protein S1 subunit binding to ACE2 in a dose..
Curcumin
Grüneberg
In vitro study in A549-AT cells showing that curcumin and glycyrrhizin effectively inhibit SARS-CoV-2 D614G, Omicron BA.5, and Omicron XBB.1..
Epigallocatechin Gallate
Zhu
114 patient late treatment RCT: 38% greater improvement (p=0.002)
Ratutrelvir
Dokukina
50 patient early treatment RCT: 14% improved recovery (p=0.01)
Melatonin
Behl
Review of the cluster of differentiation 147 (CD147) transmembrane protein as an entry route for SARS-CoV-2, correlation with observed..
Recent studies (see the individual treatment pages for all studies):
Jan 30
 Chen et al., Acta Cardiol Sin, doi:10.6515/ACS.202601_42(1).20250726A Cardiovascular Outcomes in COVID-19 Patients Treated with Paxlovid: A Multicenter Retrospective Study
11% lower mortality (p=0.21). Retrospective 606 COVID-19 patients treated with paxlovid and 1,809 propensity score-matched controls in Taiwan, showing short-term mortality benefits at 3 months, but reduced benefit at 6 months, and no significant benefit at 12 months. ..
Jan 28
 Hosseini et al., medRxiv, doi:10.64898/2026.01.23.26343617 Balancing data quality and participant burden: A comparative analysis of abbreviated vs extended symptom diaries in the CanTreatCOVID trial
Secondary analysis of the CanTreatCOVID paxlovid RCT comparing adherence and symptom reporting between a 9-item abbreviated diary and 34-item FLU-PRO Plus diary in 712 COVID-19 outpatients, showing no significant difference in compliance,..
Jan 28
 Elrosasy et al., Journal of Emergency and Disaster Medicine, doi:10.1007/s44467-025-00004-7 Efficacy of Nigella sativa in COVID-19 patients: a systematic review and meta-analysis
Systematic review and meta-analysis of 6 RCTs showing significantly lower mortality and symptom severity with nigella sativa treatment in 1,595 COVID-19 patients.
Jan 22
 Grüneberg et al., BMC Complementary Medicine and Therapies, doi:10.1186/s12906-026-05253-1 Dose-dependent antiviral effects of glycyrrhizin, curcumin, and harmaline against clinical SARS-CoV-2 isolates, including D614G, Omicron BA.5, and Omicron XBB.1
In vitro study in A549-AT cells showing that curcumin and glycyrrhizin effectively inhibit SARS-CoV-2 D614G, Omicron BA.5, and Omicron XBB.1 variants, while harmaline effectively inhibits only the Omicron variants, all at subtoxic concent..
Jan 22
 Ekmen et al., Viruses, doi:10.3390/v18010145 Virion-Independent Extracellular Vesicle (EV)-Dependent Transmission of SARS-CoV-2 as a Potential New Mechanism of Viral RNA Spread in Human Cells
In vitro study showing that extracellular vesicles (EVs) can transmit SARS-CoV-2 replicon RNA between cells independently of infectious virus particles.
Jan 20
 Yeap et al., Chemical Senses, doi:10.1093/chemse/bjag001 The APOLLO Trial: A Proof-of-Concept Study for Vitamin A Nasal Drops in COVID-19 Related Post-Infectious Olfactory Dysfunction
50% worse recovery (p=0.54). RCT 57 COVID-19 patients with post-infectious olfactory dysfunction showing no significant difference with intranasal vitamin A versus placebo drops. Authors hypothesize that COVID-19's mechanism of damaging sustentacular cells rather tha..
Jan 19
 Zhu et al., BMC Cancer, doi:10.1186/s12885-026-15553-x Efficacy and safety of 7-day aerosolized epigallocatechin-3-gallate in oncologic patients with COVID-19 pneumonia
38% greater improvement (p=0.002). RCT 108 hospitalized oncologic patients with COVID-19 pneumonia showing significant benefit with aerosolized epigallocatechin-3-gallate (EGCG). The EGCG group showed significantly greater CT imaging improvement (64.8% vs 40.5%, P=0.004) a..
Jan 14
 Siripongboonsitti et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2026.103150 Post-Exposure Prophylaxis with Favipiravir among Household Close Contacts to Confirmed COVID-19 Cases: A Cluster-Randomized Trial (PEPfavi)
50% fewer symptomatic cases (p=0.37) and 36% fewer cases (p=0.46). RCT 168 household close contacts showing no significant difference in SARS-CoV-2 infection with favipiravir post-exposure prophylaxis. The primary endpoint of laboratory-confirmed infection by day 14 occurred in 7.3% of the favipiravir gr..
Jan 14
 Gupta et al., Phytochemistry Letters, doi:10.1016/j.phytol.2025.104105 Harnessing phytoconstituents to treat COVID-19 triggered acute respiratory distress syndrome: Insights from network pharmacology, and molecular modeling
In silico study showing that phytoconstituents apigenin-7-glucoside and quercetin bind strongly to inflammatory targets EGFR, JAK2, and RELA associated with COVID-19-triggered acute respiratory distress syndrome (ARDS).
Jan 14
 Ozhan et al., Scientific Reports, doi:10.1038/s41598-025-31048-4 Evaluation of the cardiopulmonary effects of repurposed COVID-19 therapeutics in healthy rats
Animal study analyzing potential cardiopulmonary harm with molnupiravir (MOL), favipiravir (FAVI), hydroxychloroquine (HCQL), and dexamethasone (DEX) in healthy Wistar albino rats. In summary: Data suggests molnupiravir may have the highe..
Jan 13
 Dokukina et al., NCT07157007 Traws Pharma Files Tivoxavir Marboxil Investigational New Drug (IND) Application for Influenza Therapy, and Provides Updated Results from the Ongoing Clinical Study of Ratutrelvir in PAXLOVID®-Eligible and Ineligible COVID-19 Patients
14% improved recovery (p=0.01). Interim results showing improved time-to-sustained symptom alleviation and resolution with ratutrelvir.
Jan 13
 Dong et al., Mammalian Genome, doi:10.1007/s00335-026-10194-8 Exploration of shared gene signatures and molecular mechanisms between psoriasis and COVID-19: evidence from transcriptome data
In silico study showing shared molecular mechanisms between COVID-19 and psoriasis through transcriptomic analysis. Authors identified 66 common upregulated genes between the two conditions, with eight hub genes (OAS2, MX1, IRF7, RSAD2, O..
Jan 12
 Zendehdel et al., Research Square, doi:10.21203/rs.3.rs-8254002/v1 Investigation of the prevalence of vitamin D deficiency in hospitalized COVID-19 patients and its association with disease severity, outcome, and mortality
66% lower mortality (p=0.04), 26% lower ventilation (p=0.67), and 48% lower ICU admission (p=0.16). Retrospective 276 hospitalized COVID-19 patients showing higher mortality with vitamin D deficiency. The main analysis found no significant differences in ICU admission, mechanical ventilation, or mortality, however comparing severely def..
Jan 11
 Siby et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaf695.1825 Temporal Trends in Serious Adverse Events Associated with Oral Antivirals During the COVID-19 Pandemic: Insights from the FAERS Database (2020–2023)
Retrospective 11,547 serious adverse event reports from the FDA database (2020-2023) showing significant safety signals with oral COVID-19 antivirals. Paxlovid showed the strongest signals for drug-drug interactions (ROR: 4.83) and liver ..
Jan 11
 Campion et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaf695.1809 Disparities in the Use of nirmatrelvir/ritonavir for COVID-19: A Retrospective Cohort Study
Retrospective 3,498 patients receiving COVID-19 antivirals showing that female patients were significantly more likely to receive treatment. Studies show that female patients are significantly more likely to be "health-conscious"..
Jan 11
 Chen-Xu et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaf695.340 Sotrovimab for Pre-exposure Prophylaxis against SARS-CoV2 in a Vulnerable Patient Population: Results from the PROTECT-V trial
66% lower mortality (p=1), 66% lower hospitalization (p=0.62), and 20% fewer symptomatic cases (p=0.51). RCT 619 vulnerable patients showing no significant difference in symptomatic COVID-19 infections at 12 weeks with sotrovimab pre-exposure prophylaxis.
Jan 11
 Hong Choi et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaf695.1812 Comparative Effectiveness of Combination Therapy with Nirmatrelvir-Ritonavir and Molnupiravir versus Monotherapy with Molnupiravir or Nirmatrelvir-Ritonavir in Hospitalised COVID-19 Patients: A Target Trial Emulation Study
61% higher mortality (p<0.0001), 12% higher ventilation (p=0.66), and 28% higher ICU admission (p=0.44). IPTW retrospective target trial emulation of 28,355 hospitalized COVID-19 patients in Hong Kong showing no benefit and potential harm (higher mortality) with combined nirmatrelvir-ritonavir and molnupiravir compared to nirmatrelvir-ritona..
Jan 10
 Lee et al., Communications Biology, doi:10.1038/s42003-025-09499-2 The computationally designed TRI2-2 miniprotein inhibitor protects against multiple SARS-CoV-2 Omicron variants
In vitro and mouse study showing broad neutralizing activity and protective efficacy with TRI2-2, a computationally-designed homotrimeric miniprotein inhibitor against SARS-CoV-2 Omicron variants.
Jan 10
 Prager et al., Virology Journal, doi:10.1186/s12985-025-03057-2 Viral kinetics in adults with Covid-19 treated with nirmatrelvir-ritonavir or molnupiravir: a population-based, observational cohort study
12% worse viral clearance (p<0.0001). Observational cohort study of 113,399 COVID-19 outpatients in Vienna showing viral kinetics patterns with nirmatrelvir-ritonavir and molnupiravir treatment. Both antivirals showed improved viral clearance at 7 days, but worse viral cleara..
Jan 9
 Shah et al., The Lancet Microbe, doi:10.1016/j.lanmic.2025.101227 SARS-CoV-2 infectious shedding and rebound among adults with and without oral antiviral use: two case-ascertained prospective household studies
218% worse results (p=0.01). Prospective study of 160 non-hospitalized adults at high risk for severe COVID-19 showing paxlovid or molnupiravir associated with increased risk of viral rebound with infectious virus. Among treated participants, 25% experienced culture ..
Jan 9
 Grunst et al., Frontiers in Immunology, doi:10.3389/fimmu.2025.1733684 Viral glycoprotein-mediated entry and antibody-mediated immunity in HIV-1 and SARS-CoV-2 infection
Review article examining class 1 viral fusion glycoproteins in HIV-1 and SARS-CoV-2, focusing on viral entry mechanisms and antibody-mediated neutralization strategies.
Jan 9
 Martins et al., Viruses, doi:10.3390/v18010091 Broad-Spectrum Virucidal Activity of Nitric Oxide Nasal Spray (NONS) Against SARS-CoV-2 Variants and Major Respiratory Viruses
In vitro study showing broad-spectrum virucidal activity of nitric oxide nasal spray (NONS) against SARS-CoV-2 variants and major respiratory viruses. Authors found that NONS achieved >3 log10 reductions (>99.9% reduction) in viral infect..
Jan 8
 Lefebvre et al., Biomolecules, doi:10.3390/biom16010111 The Enigmatic Conserved Q134-F135-N137 Triad in SARS-CoV-2 Spike Protein: A Conformational Transducer?
Computational and structural study of the SARS-CoV-2 spike protein identifying a conserved amino acid triad (Q134-F135-N137) that remains unchanged across variants despite extensive mutations in surrounding regions. The study proposes thi..
Jan 7
 Perico et al., Frontiers in Immunology, doi:10.3389/fimmu.2025.1706997 Acetylsalicylic acid disrupts SARS-CoV-2 spike protein glycosylation and selectively impairs binding to ACE2
In vitro and mouse study showing that acetylsalicylic acid (ASA/aspirin) inhibits SARS-CoV-2 spike protein S1 subunit binding to ACE2 in a dose-dependent manner.
Jan 6
 Reich, S., Center for Open Science, doi:10.31222/osf.io/h5kc8_v1 Methodological Analysis of Bias Risks in Adaptive Multi-Arm Platform Trials: A Case-Series from Three COVID-19 Studies
Review of methodological biases in three major adaptive platform trials (ACTIV-6, PRINCIPLE, and TOGETHER) evaluating ivermectin for COVID-19. Author finds that these influential studies were compromised by extensive post-enrollment proto..
Jan 5
 Pridgen et al., Frontiers in Immunology, doi:10.3389/fimmu.2025.1698271 Patient-reported improvements from use of IMC-2 alone and IMC-2 and Paxlovid® in a Long COVID cohort: a case series
Case series of 24 long COVID outpatients showing greater symptom improvement with a combination of IMC-2 (valacyclovir + celecoxib) plus 15-day paxlovid compared to IMC-2 alone over 120 days.
Jan 1
 Putrino et al., NCT06511063 Investigating the Feasibility of Repurposing HIV Antivirals in Adults With Long Covid
Estimated 90 patient miscellaneous late treatment RCT with results expected soon (estimated completion over 1 month ago).
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