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@CovidAnalysis

COVID-19 early treatment: real-time analysis of 4,775 studies

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@CovidAnalysis
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Analysis of 95 COVID-19 early treatments, approvals in 118 countries, database of 8,055 treatments  
Recently added (more..)  HCQ  Ivermectin  Metformin
Gortler
Review of a retracted study that claimed hydroxychloroquine (HCQ) for COVID-19 caused 17,000 deaths. Author highlights that the study was based on..
Joseph
In Vitro and mouse study showing benefit with PCANS (Pathogen Capture and Neutralizing Spray) in reducing viral load in respiratory infections...
Ulloa-Aguilar
Review of the interaction between viral proteins and the nucleolus during infection. The nucleolus is a crucial site for regulating cellular..
Harmon
11,993 patients metformin prophylaxis: 18% lower mortality (p<0.0001)
$0 $1,000 $2,000+ -25+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments Donidalorsen -151% >$2,000 Glenzocimab -60% >$2,000 PPIs -46% BMS mAbs -36% >$2,000 Acetaminophen -28% Lufotrelvir >$2,000 Trimodulin >$2,000 Losartan Sargramostim >$2,000 Cannabidiol Vitamin B9 Conv. Plasma $5,000 Remdesivir $3,120 Acebilustat >$2,000 Ibuprofen Aspirin Molnupiravir mutagenic/teratogenic Favipiravir Paxlovid Famotidine Amubarvimab/r.. Vitamin C NAC Vilobelimab $6,350 Sotrovimab $2,100 Colchicine Zinc Budesonide Probiotics HCQ Metformin Sleep Antiandro.. Nitric Oxide Azvudine Bebtelovimab Vitamin A Vitamin D Sunlight H. Peroxide Exercise Fluvox. H1RAs Curcumin Tixagevimab/c.. N. Sativa NaHCO₃ Casirivimab/i.. $2,100 Melatonin Ensovibep >$2,000 Bamlanivimab/e.. pH+ Quercetin Diet PVP-I Thermotherapy Ivermectin Regdanvimab $2,100 Lifestyle / free No prescription Prescription required High-cost Lowerrisk Higherrisk c19early.org September 2024 COVID-19 involves the interplay of 50+ host/viral proteins/factors, modulated by many treatments. 0.6% of 8,000+proposed treatments show efficacy with ≥3 studies.Protocols combine treatments, none are 100% effective.c19early analyzes over 4,700 studies for 95 treatments.
$0 $1,000 $2,000+ -20+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments Donidalorsen -151% Glenzocimab -60% PPIs -46% BMS mAbs -36% Acetaminophen -28% Lufotrelvir -22% Trimodulin Losartan Sargramostim CBD Vit. B9 C. Plasma Remdesivir Acebilustat Ibuprofen Aspirin Molnupiravir mutagenic/teratogenic Favipiravir Paxlovid Famotidine Amubarvimab/r.. Vitamin C NAC Vilobelimab Sotrovimab Colchicine Zinc Budesonide Probiotics HCQ Metformin Sleep Antiandro.. Nitric Oxide Azvudine Bebtelovimab Vitamin A Vitamin D Sunlight H. Peroxide Exercise Fluvox. H1RAs Curcumin Tixagevimab/c.. N. Sativa NaHCO₃ Casirivim.. Melatonin Ensovibep Bamlan.. pH+ Quercetin Diet PVP-I Thermotherapy Ivermectin Regdanvimab Lifestyle / free No prescription Prescription required High-cost Lowerrisk Higherrisk c19early.org September 2024 COVID-19 involves the interplay of50+ host/viral proteins/factors.0.6% of 8,000+ treatments showefficacy. Protocols combinetreatments. c19early analyzes4,700+ studies for 95 treatments.
Azvudine Evusheld Sodium Bicarbonate Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Famotidine Molnupiravir Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide Budesonide Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Melatonin Antihistamine H1RAs Acetaminophen ↑risk Exercise Vitamin D Antiandrogens Vitamin C PPIs ↑risk Colchicine Ivermectin Metformin Zinc HCQ 2020 2021 2023 2024 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org September 2024 Time when COVID-19 studies showed efficacy
Azvudine Evusheld Sodium Bicarb.. Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Famotidine Molnupiravir Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide Budesonide Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Melatonin H1RAs Acetaminophen ↑risk Exercise Vitamin D Antiandrogens Vitamin C PPIs ↑risk Colchicine Ivermectin Metformin Zinc HCQ 2020 2021 2023 2024 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org September 2024 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations. 0.6% of treatments show efficacy.
Top journals that accept positive studies for low cost treatments: PLOS ONE, Nutrients, International Journal of Infectious Diseases, Scientific Reports, Journal of Clinical Medicine, Cureus, more...
September 2024
c19early.org
Cost per life saved from NNT in
studies to date
Melatonin
9
48%
  $8
Vitamin D
69
36%
  $11
Alkalinization
8
46%
  $11
Zinc
21
30%
  $15
Vitamin C
43
19%
  $18
Colchicine
43
28%
  $26
HCQ
248
26%
  $26
Ivermectin
53
47%
  $26
Aspirin
64
11%
  $33
Vitamin A
5
30%
  $45
Curcumin
8
63%
  $59
Famotidine
21
18%
  $94
Quercetin
5
61%
  $127
Metformin
67
35%
  $133
Probiotics
10
59%
  $172
Antiandrogens
32
37%
  $179
Nigella Sativa
5
57%
  $187
Fluvoxamine
10
44%
  $411
Budesonide
12
26%
  $574
Azvudine
16
36%
  $1,248
Favipiravir
40
11%
  $1,935
Tixagev../c..
10
42%
  $74,506
Regdanvimab
7
63%
  $139,860
Paxlovid
37
25%
  $206,705
Bamlaniv../e..
13
54%
  $301,549
Sotrovimab
11
49%
  $355,740
Casirivimab/..
10
26%
  $452,469
Bebtelovimab
4
60%
  $737,601
Remdesivir
65
2%
  $1,558,440
Molnupiravir
24
15%
  $2,400,867
Conv. Plasma
51
-1%
N/A
Acetaminophen
14
-24%
N/A
PPIs
20
-40%
N/A
Brensocatib
1
-41%
N/A
Treatment cost times median NNT - details and limitations. 0.6% of treatments show efficacy.
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All clinical results for selected treatments. 0.6% of treatments show efficacy.
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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% [22-95%] 1 $1 394 very limited data Cost Studies Patients Improvement Relative Risk Chlorhexidine 79% [66-87%] 3 $1 509 limited data Proxalutamide 78% [70-83%] 4 $500 1,953 limited data Indomethacin 74% [-20-94%] 4 $5 605 limited data Cetylpyridin.. 68% [-620-99%] 1 $1 23 very limited data Regdanvimab 63% [51-71%] 11 $2,100 7,430 Ivermectin 60% [52-67%] 105 $1 220,423 Chlorpheniram.. 56% [46-64%] 3 $5 806 very limited data Thermotherapy 56% [9-78%] 4 $0 217 very limited data Povidone-Iod.. 51% [38-61%] 21 $1 3,249 Diet 50% [41-58%] 28 $0 693,236 Quercetin 49% [21-68%] 11 $5 1,436 Alkalinization 49% [36-59%] 14 $1 6,383 HH-120 49% [-60-84%] 2 $500 345 very limited data Bemnifosbuvir 47% [-57-82%] 3 $500 359 very limited data Bamlaniv../e.. 47% [25-62%] 21 $1,250 35,320 variant dependent Ensovibep 46% [-173-89%] 2 $2,100 885 limited data Adintrevimab 43% [-169-88%] 2 $2,100 2,483 intramuscular Melatonin 43% [30-54%] 18 $1 14,301 Bromhexine 43% [-5-69%] 7 $5 875 very limited data Casirivimab/i.. 43% [24-57%] 31 $2,100 59,449 variant dependent Sodium Bicarb.. 43% [24-57%] 7 $1 1,092 Nigella Sativa 43% [24-57%] 14 $5 3,333 Tixagev../c.. 43% [26-56%] 17 $855 29,530 variant dependent Propolis 41% [-13-69%] 3 $1 410 very limited data Curcumin 41% [30-51%] 27 $5 14,886 H1RAs 39% [23-52%] 15 $5 71,705 Fluvoxamine 39% [21-52%] 21 $4 38,283 Montelukast 39% [14-56%] 9 $2 2,943 limited data Exercise 39% [33-44%] 67 $0 1,938,965 Hydrogen Per.. 38% [5-59%] 7 $1 835 very limited data Phthalocyanine 38% [20-51%] 4 $5 5,245 Xiannuoxin 38% [-46-73%] 2 $106 1,027 very limited data Sunlight 37% [22-50%] 5 $0 19,665 Vitamin D 37% [31-42%] 122 $1 195,710 Vitamin A 36% [6-56%] 14 $2 22,297 Nitazoxanide 35% [-8-61%] 14 $4 3,632 Selenium 34% [-40-69%] 4 $1 21,452 Bebtelovimab 34% [-24-65%] 6 $1,200 13,329 intravenous Azvudine 33% [18-44%] 22 $25 12,652 Spironolactone 31% [15-44%] 12 $5 28,019 Nitric Oxide 31% [-1-52%] 12 $11 2,236 Antiandrogens 30% [21-38%] 49 $5 120,172 Sleep 30% [22-38%] 15 $0 429,001 Vitamin B12 30% [5-48%] 4 $1 11,407 Metformin 30% [26-33%] 95 $10 292,491 Hydroxychlor.. 28% [24-31%] 421 $1 542,343 Probiotics 28% [18-36%] 28 $5 19,646 Budesonide 28% [18-36%] 15 $4 28,194 Zinc 28% [18-36%] 45 $1 55,380 Colchicine 27% [18-36%] 56 $1 33,066 Andrographol.. 27% [-8-50%] 7 $5 1,245 Ensitrelvir 26% [-14-52%] 3 $500 1,450 very limited data Sotrovimab 26% [10-39%] 24 $2,100 54,452 variant dependent Vilobelimab 26% [-4-48%] 1 $6,350 368 intravenous N-acetylcys.. 25% [14-35%] 24 $1 26,243 Lactoferrin 24% [-24-53%] 8 $5 1,419 Vitamin C 21% [14-27%] 72 $1 88,913 Leritrelvir 21% [3-35%] 2 $1,000 1,399 very limited data UDCA 18% [9-26%] 18 $15 43,512 Amubarv../r.. 18% [-156-74%] 3 $1,380 1,474 intravenous Camostat 17% [-3-34%] 15 $1 1,920 Famotidine 17% [8-24%] 30 $5 114,119 Paxlovid 16% [12-20%] 71 $1,390 160,897 independent trials refused Favipiravir 15% [5-24%] 70 $20 34,275 worse w/longer followup Vitamin K 14% [0-25%] 2 $1 7,806 very limited data Molnupiravir 11% [3-19%] 46 $707 151,398 mutagenic/teratogenic Deuremidevir 11% [-1-21%] 2 $112 1,432 very limited data Aspirin 11% [5-16%] 74 $1 187,088 Peg.. Lambda 7% [-138-63%] 4 $500 2,143 subcutaneous Ibuprofen 0% [-9-9%] 13 $1 54,707 Acebilustat 0% [-1462-94%] 1 $2,000 120 very limited data Remdesivir -0% [-9-8%] 77 $3,120 202,729 worse w/longer followup Conv. Plasma -1% [-5-3%] 53 $5,000 30,630 intravenous Ravulizumab -5% [-45-24%] 2 $2,000 481 intravenous Plasma-activ.. -9% [-234-64%] 1 $100 23 very limited data Vitamin B9 -11% [-47-15%] 11 $1 54,354 Cannabidiol -12% [-86-33%] 8 $25 16,883 Sargramostim -13% [-85-31%] 4 $2,000 870 very limited data Losartan -15% [-127-42%] 5 $5 665 very limited data Trimodulin -17% [-116-37%] 1 $2,000 166 intravenous Lufotrelvir -22% [-198-50%] 1 $2,000 58 intravenous Pacritinib -28% [-210-47%] 1 $2,000 200 very limited data Acetaminoph.. -28% [-41--17%] 27 $1 543,459 BMS mAbs -36% [-492-69%] 1 $2,100 210 subcutaneous Brensocatib -41% [-88--6%] 1 $2,000 404 very limited data PPIs -46% [-68--27%] 37 $5 221,083 Glenzocimab -60% [-236-24%] 1 $2,000 62 intravenous Siltuximab -64% [-252-23%] 1 $2,000 149 intravenous rNAPc2 -65% [-304-32%] 1 $2,000 156 very limited data Emvododstat -132% [-628-26%] 1 $2,000 187 very limited data Goflikicept -135% [-492-7%] 1 $2,000 247 subcutaneous Donidalorsen -151% [-602-11%] 1 $2,000 103 intravenous/subcutaneous Astodrimer So.. -205% [-7302-87%] 1 $10 197 very limited data All studies (pooled effects, all stages) c19early.org September 2024 Favors treatment Favors control
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% 1 very limited data Studies, Improvement Relative Risk Chlorhexidine 79% 3 limited data Proxalutamide 78% 4 limited data Indomethacin 74% 4 limited data Cetylpyridin.. 68% 1 very limited data Regdanvimab 63% 11 Ivermectin 60% 105 Chlorphenira.. 56% 3 very limited data Thermotherapy 56% 4 very limited data Povidone-Iod.. 51% 21 Diet 50% 28 Quercetin 49% 11 Alkalinization 49% 14 HH-120 49% 2 very limited data Bemnifosbuvir 47% 3 very limited data Bamlaniv../e.. 47% 21 variant dependent Ensovibep 46% 2 limited data Adintrevimab 43% 2 intramuscular Melatonin 43% 18 Bromhexine 43% 7 very limited data Casirivimab/.. 43% 31 variant dependent Sodium Bicar.. 43% 7 Nigella Sativa 43% 14 Tixagev../c.. 43% 17 variant dependent Propolis 41% 3 very limited data Curcumin 41% 27 H1RAs 39% 15 Fluvoxamine 39% 21 Montelukast 39% 9 limited data Exercise 39% 67 Hydrogen Per.. 38% 7 very limited data Phthalocyanine 38% 4 Xiannuoxin 38% 2 very limited data Sunlight 37% 5 Vitamin D 37% 122 Vitamin A 36% 14 Nitazoxanide 35% 14 Selenium 34% 4 Bebtelovimab 34% 6 intravenous Azvudine 33% 22 Spironolactone 31% 12 Nitric Oxide 31% 12 Antiandrogens 30% 49 Sleep 30% 15 Vitamin B12 30% 4 Metformin 30% 95 Hydroxychlor.. 28% 421 Probiotics 28% 28 Budesonide 28% 15 Zinc 28% 45 Colchicine 27% 56 Andrographol.. 27% 7 Ensitrelvir 26% 3 very limited data Sotrovimab 26% 24 variant dependent Vilobelimab 26% 1 intravenous N-acetylcys.. 25% 24 Lactoferrin 24% 8 Vitamin C 21% 72 Leritrelvir 21% 2 very limited data UDCA 18% 18 Amubarv../r.. 18% 3 intravenous Camostat 17% 15 Famotidine 17% 30 Paxlovid 16% 71 independent trials refused Favipiravir 15% 70 worse w/longer followup Vitamin K 14% 2 very limited data Molnupiravir 11% 46 mutagenic/teratogenic Deuremidevir 11% 2 very limited data Aspirin 11% 74 Peg.. Lambda 7% 4 subcutaneous Ibuprofen 0% 13 Acebilustat 0% 1 very limited data Remdesivir -0% 77 worse w/longer followup Conv. Plasma -1% 53 intravenous Ravulizumab -5% 2 intravenous Plasma-activ.. -9% 1 very limited data Vitamin B9 -11% 11 Cannabidiol -12% 8 Sargramostim -13% 4 very limited data Losartan -15% 5 very limited data Trimodulin -17% 1 intravenous Lufotrelvir -22% 1 intravenous Pacritinib -28% 1 very limited data Acetaminoph.. -28% 27 BMS mAbs -36% 1 subcutaneous Brensocatib -41% 1 very limited data PPIs -46% 37 Glenzocimab -60% 1 intravenous Siltuximab -64% 1 intravenous rNAPc2 -65% 1 very limited data Emvododstat -132% 1 very limited data Goflikicept -135% 1 subcutaneous Donidalorsen -151% 1 intravenous/subcutaneous Astodrimer S.. -205% 1 very limited data All studies (pooled effects, all stages) c19early.org September 2024 Rotate device for details Favors treatment Favors control
Random effects meta-analysis of all studies (pooled effects, all stages). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all stages and outcomes depend on the distribution of stages and outcomes tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage and outcome analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of early treatment studies (pooled effects). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all outcomes are affected by the distribution of outcomes tested, please see detail pages for specific outcome analysis. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of all mortality results (all stages). Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Pooled results across all stages depend on the distribution of stages tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of early treatment mortality results. Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of prophylaxis studies (pooled effects). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all outcomes are affected by the distribution of outcomes tested, please see detail pages for specific outcome analysis. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of prophylaxis mortality results. Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
LATE TREATMENT
Physician / TeamLocationPatients HospitalizationHosp. MortalityDeath
Dr. David Uip (*) Brazil 2,200 38.6% (850) Ref. 2.5% (54) Ref.
EARLY TREATMENT - 40 physicians/teams
Physician / TeamLocationPatients HospitalizationHosp. ImprovementImp. MortalityDeath ImprovementImp.
Dr. Roberto Alfonso Accinelli
0/360 deaths for treatment within 3 days		 Peru 1,265 0.6% (7) 77.5%
Dr. Mohammed Tarek Alam
patients up to 84 years old		 Bangladesh 100 0.0% (0) 100.0%
Dr. Oluwagbenga Alonge Nigeria 310 0.0% (0) 100.0%
Dr. Raja Bhattacharya
up to 88yo, 81% comorbidities		 India 148 1.4% (2) 44.9%
Dr. Flavio Cadegiani Brazil 3,450 0.1% (4) 99.7% 0.0% (0) 100.0%
Dr. Alessandro Capucci Italy 350 4.6% (16) 88.2%
Dr. Shankara Chetty South Africa 8,000 0.0% (0) 100.0%
Dr. Deborah Chisholm USA 100 0.0% (0) 100.0%
Dr. Ryan Cole USA 400 0.0% (0) 100.0% 0.0% (0) 100.0%
Dr. Marco Cosentino
vs. 3-3.8% mortality during period; earlier treatment better		 Italy 392 6.4% (25) 83.5% 0.3% (1) 89.6%
Dr. Jeff Davis USA 6,000 0.0% (0) 100.0%
Dr. Dhanajay India 500 0.0% (0) 100.0%
Dr. Bryan Tyson & Dr. George Fareed USA 20,000 0.0% (6) 99.9% 0.0% (4) 99.2%
Dr. Raphael Furtado Brazil 170 0.6% (1) 98.5% 0.0% (0) 100.0%
Rabbi Yehoshua Gerzi Israel 860 0.1% (1) 99.7% 0.0% (0) 100.0%
Dr. Heather Gessling USA 1,500 0.1% (1) 97.3%
Dr. Ellen Guimarães Brazil 500 1.6% (8) 95.9% 0.4% (2) 83.7%
Dr. Syed Haider USA 4,000 0.1% (5) 99.7% 0.0% (0) 100.0%
Dr. Mark Hancock USA 24 0.0% (0) 100.0%
Dr. Sabine Hazan USA 1,000 0.0% (0) 100.0%
Dr. Mollie James USA 3,500 1.1% (40) 97.0% 0.0% (1) 98.8%
Dr. Roberta Lacerda Brazil 550 1.5% (8) 96.2% 0.4% (2) 85.2%
Dr. Katarina Lindley USA 100 5.0% (5) 87.1% 0.0% (0) 100.0%
Dr. Ben Marble USA 150,000 0.0% (4) 99.9%
Dr. Edimilson Migowski Brazil 2,000 0.3% (7) 99.1% 0.1% (2) 95.9%
Dr. Abdulrahman Mohana Saudi Arabia 2,733 0.0% (0) 100.0%
Dr. Carlos Nigro Brazil 5,000 0.9% (45) 97.7% 0.5% (23) 81.3%
Dr. Benoit Ochs Luxembourg 800 0.0% (0) 100.0%
Dr. Ortore Italy 240 1.2% (3) 96.8% 0.0% (0) 100.0%
Dr. Valerio Pascua
one death for a patient presenting on the 5th day in need of supplemental oxygen		 Honduras 415 6.3% (26) 83.8% 0.2% (1) 90.2%
Dr. Sebastian Pop Romania 300 0.0% (0) 100.0%
Dr. Brian Proctor USA 869 2.3% (20) 94.0% 0.2% (2) 90.6%
Dr. Anastacio Queiroz Brazil 700 0.0% (0) 100.0%
Dr. Didier Raoult France 8,315 2.6% (214) 93.3% 0.1% (5) 97.6%
Dr. Karin Ried
up to 99yo, 73% comorbidities, av. age 63		 Turkey 237 0.4% (1) 82.8%
Dr. Roman Rozencwaig
patients up to 86 years old		 Canada 80 0.0% (0) 100.0%
Dr. Vipul Shah India 8,000 0.1% (5) 97.5%
Dr. Silvestre Sobrinho Brazil 116 8.6% (10) 77.7% 0.0% (0) 100.0%
Dr. Unknown Brazil 957 1.7% (16) 95.7% 0.2% (2) 91.5%
Dr. Vladimir Zelenko USA 2,200 0.5% (12) 98.6% 0.1% (2) 96.3%
Mean improvement with early treatment protocols 238,381 HospitalizationHosp. 94.4% MortalityDeath 94.9%
Physician results with early treatment protocols compared to no early treatment. These results are subject to selection and ascertainment bias and more accurate analysis requires details of the patient populations and followup, however results are consistently better across many teams, and consistent with the extensive controlled trial evidence that shows a significant reduction in risk with many early treatments, and improved results with the use of multiple treatments in combination.
HCQ
Gortler
Review of a retracted study that claimed hydroxychloroquine (HCQ) for COVID-19 caused 17,000 deaths. Author highlights that the study was based on..
Miscellaneous
Joseph
In Vitro and mouse study showing benefit with PCANS (Pathogen Capture and Neutralizing Spray) in reducing viral load in respiratory infections...
Trender
Human challenge study inoculating 34 patients with SARS-CoV-2 and showing significantly lower cognitive scores in infected patients that persisted..
Ivermectin
Ulloa-Aguilar
Review of the interaction between viral proteins and the nucleolus during infection. The nucleolus is a crucial site for regulating cellular..
Metformin
Harmon
11,993 patients prophylaxis: 18% lower mortality (p<0.0001)
Johnson
N3C/PCORnet retrospective adults with type 2 diabetes in the USA showing lower incidence of mortality or long COVID with metformin use.
Bebtelovimab
Kumar
In Vitro selection study identifying SARS-CoV-2 spike mutations that confer resistance to therapeutic antibodies. Using a Wuhan-like strain and..
Tixagevimab/cilgavimab
Kumar
In Vitro selection study identifying SARS-CoV-2 spike mutations that confer resistance to therapeutic antibodies. Using a Wuhan-like strain and..
Sotrovimab
Kumar
In Vitro selection study identifying SARS-CoV-2 spike mutations that confer resistance to therapeutic antibodies. Using a Wuhan-like strain and..
Bamlanivimab/etesevimab
Kumar
In Vitro selection study identifying SARS-CoV-2 spike mutations that confer resistance to therapeutic antibodies. Using a Wuhan-like strain and..
Molnupiravir
Kumar
In Vitro selection study identifying SARS-CoV-2 spike mutations that confer resistance to therapeutic antibodies. Using a Wuhan-like strain and..
Curcumin
Emam
In Vitro study showing that curcumin, quercetin, gallic acid, and silymarin inhibit SARS-CoV-2 spike protein binding to the ACE2 receptor. Authors..
Quercetin
Emam
In Vitro study showing that curcumin, quercetin, gallic acid, and silymarin inhibit SARS-CoV-2 spike protein binding to the ACE2 receptor. Authors..
Amubarvimab/romlusevimab
Evering
780 patient early treatment RCT: 91% lower mortality (p=0.006), 20% higher PASC (p=0.39), 61% lower hospitalization (p=0.0008), and 67% lower combined mortality/hospitalization (p<0.0001)
Plasma-activated water
Zhao
23 patient late treatment RCT: 9% higher progression (p=1), 73% greater improvement (p=0.04), 28% shorter hospitalization (p=0.16), and 30% higher hospital discharge (p=0.24)
Recent studies (see the individual treatment pages for all studies):
Sep 24
 Grosman-Dziewiszek et al., Nutrients, doi:10.3390/nu16193225 Patterns of Dietary Supplement Use during the COVID-19 Pandemic in Poland: Focus on Vitamin D and Magnesium
Survey of 926 Polish pharmacy patients showing a high prevalence of dietary supplemention during the COVID-19 pandemic, with vitamin D and magnesium being the most commonly used. Supplement use was significantly higher among women, those ..
Sep 21
 Ulloa-Aguilar et al., Cells, doi:10.3390/cells13181591 The Nucleolus and Its Interactions with Viral Proteins Required for Successful Infection
Review of the interaction between viral proteins and the nucleolus during infection. The nucleolus is a crucial site for regulating cellular functions and viral proteins can interact with nucleolar components to facilitate viral replicati..
Sep 19
 Harmon et al., Journal of General Internal Medicine, doi:10.1007/s11606-024-08864-x Preadmission Metformin Use Is Associated with Reduced Mortality in Patients with Diabetes Mellitus Hospitalized with COVID-19
18% lower mortality (p<0.0001). Retrospective 11,993 hospitalized COVID-19 patients with diabetes mellitus but without chronic kidney disease or need for hemodialysis, showing lower mortality with metformin use.
Sep 19
 Kumar et al., Antiviral Research, doi:10.1016/j.antiviral.2024.106006 Identification of antibody-resistant SARS-CoV-2 mutants via N4-Hydroxycytidine mutagenesis
In Vitro selection study identifying SARS-CoV-2 spike mutations that confer resistance to therapeutic antibodies. Using a Wuhan-like strain and omicron B.1.1.529, the authors used sequential mutagenesis with the molnupiravir active compou..
Sep 18
 Kaushal, A., Journal of Translational Medicine, doi:10.1186/s12967-024-05587-9 Nutraceuticals and pharmacological to balance the transitional microbiome to extend immunity during COVID-19 and other viral infections
Review of nutraceuticals and pharmacological interventions to balance the microbiome and boost immunity during COVID-19 and other viral infections. Authors propose that optimal usage of probiotics, dietary fibers, vitamins, minerals, omeg..
Sep 17
 Johnson et al., Diabetes Care, doi:10.2337/DCa24-0032 Prevalent Metformin Use in Adults With Diabetes and the Incidence of Long COVID: An EHR-Based Cohort Study From the RECOVER Program
N3C/PCORnet retrospective adults with type 2 diabetes in the USA showing lower incidence of mortality or long COVID with metformin use.
Sep 17
 Zhu et al., The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.23-0710 Circulation of COVID-19-Related Medicines on Japanese Websites during the COVID-19 Pandemic and Their Quality and Authenticity
Investigation of the circulation and quality of COVID-19-related medicines sold online in Japan showing poor-quality ivermectin and dexamethasone. Four dexamethasone samples and two ivermectin samples failed quantitative analysis, and thr..
Sep 16
 Mu et al., Journal of Agriculture and Food Research, doi:10.1016/j.jafr.2024.101422 Anti-inflammatory and Nutritional Interventions Against SARS-CoV-2: A Comprehensive Review
Review of anti-inflammatory and nutritional interventions against SARS-CoV-2. Authors emphasize the importance of a healthy immune response in reducing the severity of COVID-19, especially in high-risk groups like the elderly and those wi..
Sep 16
 Emam et al., AMB Express, doi:10.1186/s13568-024-01739-8 Establishment of in-house assay for screening of anti-SARS-CoV-2 protein inhibitors
In Vitro study showing that curcumin, quercetin, gallic acid, and silymarin inhibit SARS-CoV-2 spike protein binding to the ACE2 receptor. Authors developed a novel immunofluorescent assay to screen potential inhibitors of the spike-ACE2 ..
Sep 13
 Gandhi et al., The Laryngoscope, doi:10.1002/lary.31761 Washing Illness Away: A Systematic Review of the Impact of Nasal Irrigation and Spray on COVID‐19
Review of the efficacy of nasal irrigation with saline, povidone-iodine (PVP-I), and intranasal corticosteroids (INCS) at reducing SARS-CoV-2 nasopharyngeal viral load (NVL) and transmissibility. Saline nasal irrigation (SNI) showed the g..
Sep 13
 Rachman et al., Medicine, doi:10.1097/MD.0000000000039252 Adequate serum 25-hydroxy-vitamin D levels are correlated with low anti-PF4 levels in mild COVID-19 Patients: An observational study
52% lower severe cases (p=0.37). Retrospective 160 COVID-19 patients in Indonesia showing a significant negative correlation between vitamin D levels and anti-PF4 antibodies in mild COVID-19 patients. Severe COVID-19 patients were more likely to have vitamin D deficiency..
Sep 12
 Schilling et al., PLOS Medicine, doi:10.1371/journal.pmed.1004428 Evaluation of hydroxychloroquine or chloroquine for the prevention of COVID-19 (COPCOV): A double-blind, randomised, placebo-controlled trial
57% fewer symptomatic cases (p=0.0004). RCT 4,652 low-risk participants, published days after completion, showing significantly lower PCR+ COVID-19 cases with HCQ/CQ prophylaxis, p = 0.0004. Authors include a meta-analysis of this and 11 other RCTs confirming significantly low..
Sep 12
 Zhao et al., BMC Infectious Diseases, doi:10.1186/s12879-024-09886-w Nebulized inhalation of plasma-activated water in the treatment of progressive moderate COVID-19 patients with antiviral treatment failure: a randomized controlled pilot trial
9% higher progression (p=1), 73% greater improvement (p=0.04), 28% shorter hospitalization (p=0.16), and 30% higher hospital discharge (p=0.24). RCT 23 moderate COVID-19 patients with antiviral treatment failure, showing nebulized plasma-activated water (PAW) improved chest CT and accelerated cough resolution compared to saline control, however there was no significant difference ..
Sep 11
 Paull et al., Scientific Reports, doi:10.1038/s41598-024-72262-w Astodrimer sodium nasal spray forms a barrier to SARS-CoV-2 in vitro and preserves normal mucociliary function in human nasal epithelium
In Vitro study showing that astodrimer sodium nasal spray forms an effective barrier against SARS-CoV-2 infection while preserving normal mucociliary function in human nasal epithelium. Authors demonstrated a 96.6% reduction in infectious..
Sep 9
 Harris et al., The Lancet Infectious Diseases, doi:10.1016/S1473-3099(24)00431-6 Health outcomes 3 months and 6 months after molnupiravir treatment for COVID-19 for people at higher risk in the community (PANORAMIC): a randomised controlled trial
27% higher mortality (p=0.5), 7% lower hospitalization (p=1), 1% improved recovery (p<0.0001), and 14% worse results (p=0.01). PRINCIPLE molnupiravir long-term followup showing improvements in time off work, healthcare use, severe symptoms, and quality of life over 6 months, however there was higher mortality (without statistical significance) and no difference i..
Sep 9
 Gortler et al., Brownstone Journal Trump’s 63 Million Doses of Hydroxychloroquine Could Have Been Great for America
Review of the safety and efficacy of HCQ for the treatment and prevention of COVID-19, with a focus on the political and media landscape surrounding its use. Author reports that the FDA's decision to revoke HCQ's emergency use authorizati..
Sep 9
 Gentile et al., medRxiv, doi:10.1101/2024.09.09.24313305 Efficacy of Molnupiravir in reducing the risk of severe outcome in patients with SARS-CoV-2 infection: a real-life full-matched case-control study (SAVALO Study).
4% lower mortality (p=0.79), 26% lower hospitalization (p=0.74), and 65% lower progression (p=0.01). PSM retrospective case-control study with 1,382 SARS-CoV-2 positive outpatients in Italy, showing lower risk for a composite outcome of hospitalization, ICU admission, or death with molnupiravir, but no significant difference for mortalit..
Sep 9
 Kawther et al., Advanced medical journal, doi:10.56056/amj.2024.273 Antiviral drug treatment profiles and clinical outcomes of COVID-19 patients at public hospitals in Erbil city
9% higher mortality (p=0.86). Retrospective 451 hospitalized COVID-19 patients in Iraq showing no significant difference in mortality with remdesivir treatment.
Sep 8
 Xu et al., Scientific Reports, doi:10.1038/s41598-024-71569-y Quercetin inhibited LPS-induced cytokine storm by interacting with the AKT1-FoxO1 and Keap1-Nrf2 signaling pathway in macrophages
In Silico, In Vitro, and mouse study showing that quercetin inhibits LPS-induced cytokine storm by interacting with the AKT1-FoxO1 and Keap1-Nrf2 signaling pathways in macrophages. Authors found quercetin effectively suppressed the overex..
Sep 7
 Mozaffari et al., Clinical Therapeutics, doi:10.1016/j.clinthera.2024.08.004 Prevalence of Potential Drug Interactions With Direct-Acting Antivirals for COVID-19 Among Hospitalized Patients
Retrospective 788,238 hospitalized COVID-19 patients in the US, showing a very high prevalence of drug-drug interactions with paxlovid, with higher prevalence for older patients, patients with more comorbidities, and patients at high-risk..
Sep 6
 Winchester et al., Pharmaceutics, doi:10.3390/pharmaceutics16091173 Astodrimer Sodium Nasal Spray versus Placebo in Non-Hospitalised Patients with COVID-19: A Randomised, Double-Blinded, Placebo-Controlled Trial
19% improved recovery (p=0.41) and 24% improved viral clearance (p=0.3). RCT 222 non-hospitalized low risk COVID-19 patients showing lower SARS-CoV-2 viral load, faster viral clearance, and improvements in symptoms, particularly anosmia, with astodrimer sodium nasal spray compared to placebo. The reduction in ..
Sep 3
 Kow et al., Inflammopharmacology, doi:10.1007/s10787-024-01564-2 The impact of vitamin D administration on mortality in COVID-19 patients: a systematic review and meta-analysis of randomized controlled trials
28% lower mortality (p=0.04). Systematic review and meta analysis of 19 RCTs with 2,495 patients, showing significantly lower mortality with vitamin D treatment.
Sep 2
 Isa et al., The Lancet Infectious Diseases, doi:10.1016/S1473-3099(24)00421-3 Effect of timing of casirivimab and imdevimab administration relative to mRNA-1273 COVID-19 vaccination on vaccine-induced SARS-CoV-2 neutralising antibody responses: a prospective, open-label, phase 2, randomised controlled trial
37% more symptomatic cases (p=0.65). RCT 293 healthy adults focusing on the timing of casirivimab and imdevimab administration relative to mRNA-1273, but also showing the incidence of COVID-19 for each group, with higher incidence in the casirivimab and imdevimab groups (wit..
Sep 1
 Shah et al., Journal of the Association of Physicians of India, doi:10.59556/japi.72.0646 A Retrospective Cohort Observational Study to Assess the Efficacy of Monoclonal Antibody in Coronavirus Disease 2019 Patients
14% higher mortality (p=1), no change in ventilation (p=1), 14% lower ICU admission (p=0.68), and 4% lower need for oxygen therapy (p=1). PSM retrospective 100 hospitalized COVID-19 patients in India showing no benefit with casirivimab/imdevimab treatment. There were no significant differences between groups in need for oxygen therapy, high-flow nasal cannula, noninvasive v..
Aug 31
 Hobbs et al., Journal of Infection, doi:10.1016/j.jinf.2024.106248 Favipiravir for COVID-19 in adults in the community in PRINCIPLE, an open-label, randomised, controlled, adaptive platform trial of short- and longer-term outcomes
86% lower mortality (p=0.11), 1% lower combined mortality/hospitalization (p=0.51), and 17% improved recovery (p=0.003). RCT 3,622 (concurrent and eligible) COVID-19 outpatients in the UK showing significantly faster recovery with favipiravir, and significantly greater full recovery at 3, 6, and 12 months. Authors note: "From 16 Dec 2021, a minority..
Aug 31
 Ali et al., Current Therapeutic Research, doi:10.1016/j.curtheres.2024.100759 In vitro inhibitory effect of Nigella sativa L. extracts on SARS-COV-2 spike protein-ACE2 interaction
In Vitro study showing nigella sativa extracts inhibit the interaction between the S1 subunit of the SARS-CoV-2 spike protein and ACE2 in a dose-dependent manner, with chloroform extract having the highest inhibition of 98.9% at 10 mg/ml...
Aug 31
 Deng et al., Translational Cancer Research, doi:10.21037/tcr-24-70 Effectiveness of Paxlovid in the treatment of the SARS-CoV-2 Omicron variant infection in children with hematologic malignancies: a retrospective cohort study
Retrospective 42 children with hematologic malignancies (HMs) and SARS-CoV-2 omicron infection showing no significant difference in clinical outcomes or viral clearance with paxlovid after propensity score matching.
Aug 27
 Moon et al., Virology Journal, doi:10.1186/s12985-024-02464-1 Association between ursodeoxycholic acid use and COVID-19 in individuals with chronic liver disease: a nationwide case-control study in South Korea
33% lower severe cases (p=0.04) and 20% fewer cases (p<0.0001). Retrospective 74,074 individuals with chronic liver disease in South Korea, showing lower risk of COVID-19 infection and related severe outcomes with ursodeoxycholic acid (UDCA) use. The risk reduction was dose-dependent, with greater ben..
We aim to cover the most promising early treatments for COVID-19. We use pre-specified effect extraction criteria that prioritizes more serious outcomes, for details see methods. For specific outcomes and different treatment stages see the individual pages. Not all treatments are covered here, effectiveness has been reported for many other treatments in studies. Of the 4,775 studies, 2,395 present results comparing with a control group, 2,192 are treatment studies, and 203 analyze outcomes based on serum levels. There are 87 animal studies, 167 in silico studies, 296 in vitro studies, 341 reviews, and 217 meta analyses.
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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