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Home   COVID-19 treatment studies  COVID-19 treatment studies  COVID-19 studies   Select treatmentSelect treatmentTreatmentsTreatments
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Other Treatments Global Adoption
COVID-19 early treatment: real-time analysis of 2,475 studies
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All studies   Early treatment   Mortality   Early mortality   Prophylaxis   Prophylaxis mortality   Recent     Select treatment...
Analysis of 48 COVID early treatments, approvals in 80 countries, database of 2,214 treatments  
Recently added (more..)  Vitamin D  Favipiravir  Metformin  Molnupiravir  Quercetin
Rathod
Prospective study of 766 hospitalized patients in India, showing higher vitamin D levels associated with lower COVID-19 severity and mortality.
Vaezi
77 patient favipiravir early treatment RCT: 105% higher hospitalization [p=0.43]
Pinchera
43 patients metformin prophylaxis: 15% lower severe cases [p=0.05]
Sanderson
Identification of SARS-CoV-2 variants likely to have been created by molnupiravir treatment. Authors find a class of long phylogenetic branches..
Pastor-Fernández
K18-hACE2 mouse study showing reduced COVID-19 severity with quercetin and dasatinib, for both prophylaxis and early treatment.
Cost per life saved from NNT in
studies to date c19early.org Feb 2023
Melatonin
9
48%
  $8
Vitamin D
59
37%
  $11
Vitamin C
33
27%
  $12
Ivermectin
48
51%
  $22
Colchicine
35
36%
  $26
HCQ
229
22%
  $30
Zinc
18
28%
  $30
Vitamin A
6
42%
  $30
Curcumin
7
63%
  $40
Aspirin
54
12%
  $41
Probiotics
8
61%
  $99
Famotidine
18
17%
  $105
Metformin
44
31%
  $172
Antiandrogens
31
40%
  $175
Quercetin
4
59%
  $188
Fluvoxamine
5
37%
  $240
Nigella Sativa
4
73%
  $279
Nitazoxanide
6
42%
  $680
Favipiravir
30
13%
  $928
Paxlovid
11
63%
  $59,777
Molnupiravir
13
25%
  $137,653
Casirivimab/i..
8
40%
  $181,694
Remdesivir
40
16%
  $208,615
Bamlaniv../e..
10
56%
  $301,549
Sotrovimab
8
56%
  $499,044
Tixagev../c..
5
38%
  $740,002
Conv. Plasma
38
-5%
N/A
Acetaminophen
12
-25%
N/A
Treatment cost times median NNT - details and limitations
Evusheld Paxlovid Fluvoxamine Famotidine Molnupiravir Quercetin Bamlanivimab/e.. Acetaminophen ↑risk Budesonide Probiotics Curcumin REGEN-COV Aspirin Povidone-Iodine Nigella Sativa Melatonin Favipiravir Vitamin D Vitamin C Colchicine Remdesivir Antiandrogens Ivermectin Metformin Zinc HCQ 2020 2021 2022 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org Feb 2023 Time when COVID-19 studies showed efficacy
Evusheld Paxlovid Fluvoxamine Famotidine Molnupiravir Quercetin Bamlanivimab/e.. Acetaminophen ↑risk Budesonide Probiotics Curcumin REGEN-COV Aspirin Povidone-Iodine Nigella Sativa Melatonin Favipiravir Vitamin D Vitamin C Colchicine Remdesivir Antiandrogens Ivermectin Metformin Zinc HCQ 2020 2021 2022 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org Feb 2023 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations
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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% [11-96%] 1 $1 394 very limited data Cost Studies Patients Improvement Relative Risk Proxalutamide 78% [70-83%] 4 $500 1,953 limited data Indomethacin 74% [-20-94%] 4 $5 605 limited data Ivermectin 62% [54-69%] 95 $1 134,554 Bamlaniv../e.. 55% [30-71%] 14 $1,250 24,423 variant dependent Nigella Sativa 53% [27-70%] 11 $5 2,959 Casirivimab/i.. 53% [33-66%] 26 $2,100 54,453 variant dependent Diet 51% [40-59%] 20 $0 686,190 Povidone-Iod.. 51% [37-61%] 20 $1 3,226 Quercetin 50% [20-69%] 10 $5 1,387 Tixagev../c.. 48% [27-64%] 9 $855 26,568 variant dependent Ensovibep 46% [-173-89%] 2 $2,100 885 limited data Spironolactone 45% [18-63%] 10 $5 3,137 Sunlight 45% [19-62%] 4 $0 19,635 Bebtelovimab 44% [-827-97%] 2 $1,200 1,134 intravenous Melatonin 43% [30-54%] 18 $1 14,301 Exercise 41% [34-47%] 50 $0 1,773,101 Vitamin A 40% [-10-67%] 11 $2 18,305 Bromhexine 39% [0-63%] 7 $5 834 very limited data Paxlovid 39% [28-47%] 22 $529 40,041 independent trial refused Curcumin 38% [26-47%] 23 $5 5,029 Vitamin D 37% [31-42%] 104 $1 182,181 Peg.. Lambda 35% [-132-82%] 3 $500 2,116 subcutaneous Colchicine 35% [24-44%] 43 $1 30,202 Lactoferrin 34% [-25-66%] 5 $5 995 Nitazoxanide 33% [-22-63%] 13 $4 3,606 Antiandrogens 31% [21-40%] 45 $5 94,222 Fluvoxamine 31% [17-43%] 13 $4 34,828 Sleep 31% [21-40%] 12 $0 273,377 Budesonide 31% [15-43%] 10 $4 26,104 Zinc 28% [16-38%] 38 $1 45,372 Ensitrelvir 27% [-19-55%] 2 $500 255 very limited data Nitric Oxide 27% [-11-52%] 9 $11 1,484 Metformin 27% [22-31%] 59 $10 207,647 Hydroxychlor.. 25% [21-29%] 375 $1 497,373 Sotrovimab 24% [-20-52%] 15 $2,100 32,637 variant dependent Probiotics 23% [13-32%] 21 $5 17,994 Vitamin C 22% [14-30%] 56 $1 58,331 Favipiravir 20% [9-30%] 57 $20 25,833 N-acetylcys.. 19% [8-29%] 19 $1 25,043 Molnupiravir 16% [-10-36%] 28 $707 81,101 mutagenic/teratogenic Famotidine 15% [5-25%] 25 $5 92,443 Remdesivir 15% [6-23%] 44 $3,120 133,239 intravenous Aspirin 12% [6-17%] 62 $1 172,519 Ibuprofen -1% [-10-8%] 12 $1 54,527 Conv. Plasma -5% [-19-7%] 38 $5,000 25,816 Acetaminoph.. -27% [-47--9%] 18 $1 93,885 Cannabidiol -45% [-167-21%] 6 $25 3,784 All studies (pooled effects, all stages) c19early.org Feb 2023 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 Ivermectin 62% 95 Bamlaniv../e.. 55% 14 variant dependent Nigella Sativa 53% 11 Casirivimab/.. 53% 26 variant dependent Diet 51% 20 Povidone-Iod.. 51% 20 Quercetin 50% 10 Tixagev../c.. 48% 9 variant dependent Ensovibep 46% 2 limited data Spironolactone 45% 10 Sunlight 45% 4 Bebtelovimab 44% 2 intravenous Melatonin 43% 18 Exercise 41% 50 Vitamin A 40% 11 Bromhexine 39% 7 very limited data Paxlovid 39% 22 independent trial refused Curcumin 38% 23 Vitamin D 37% 104 Peg.. Lambda 35% 3 subcutaneous Colchicine 35% 43 Lactoferrin 34% 5 Nitazoxanide 33% 13 Antiandrogens 31% 45 Fluvoxamine 31% 13 Sleep 31% 12 Budesonide 31% 10 Zinc 28% 38 Ensitrelvir 27% 2 very limited data Nitric Oxide 27% 9 Metformin 27% 59 Hydroxychlor.. 25% 375 Sotrovimab 24% 15 variant dependent Probiotics 23% 21 Vitamin C 22% 56 Favipiravir 20% 57 N-acetylcys.. 19% 19 Molnupiravir 16% 28 mutagenic/teratogenic Famotidine 15% 25 Remdesivir 15% 44 intravenous Aspirin 12% 62 Ibuprofen -1% 12 Conv. Plasma -5% 38 Acetaminoph.. -27% 18 Cannabidiol -45% 6 All studies (pooled effects, all stages) c19early.org Feb 23 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.
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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.
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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.
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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.
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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.
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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.
LATE TREATMENT
Physician / TeamLocationPatients HospitalizationHosp. MortalityDeath
Dr. David Uip (*) Brazil 2,200 38.6% (850) Ref. 2.5% (54) Ref.
EARLY TREATMENT - 36 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. 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. 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. Vladimir Zelenko USA 2,200 0.5% (12) 98.6% 0.1% (2) 96.3%
Mean improvement with early treatment protocols 235,394 HospitalizationHosp. 93.8% MortalityDeath 94.5%
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.
Treatment
Improvement
  (early)
Studies
  (early)
BUBudesonide 82% 1
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PXProxalutamide 71% 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
BLBamlaniv../e.. 69% 8
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(H)CQHydroxychlor.. 62% 36
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IVMIvermectin 62% 37
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
RDRemdesivir 61% 4
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
V.DVitamin D 60% 11
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FVFluvoxamine 56% 6
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CICasirivimab/i.. 47% 20
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PLPaxlovid 44% 21
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ZnZinc 41% 6
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SSotrovimab 33% 13
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FPVFavipiravir 26% 17
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
V.CVitamin C 24% 5
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MPMolnupiravir 19% 25
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ACEAcetaminophen -17% 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IBIbuprofen -52% 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Early treatments approved by >2 countries. 80 countries have officially approved treatments. Details.
Vitamin D
Rathod
Prospective study of 766 hospitalized patients in India, showing higher vitamin D levels associated with lower COVID-19 severity and mortality.
Batur
194 patients ICU: 72% lower mortality [p<0.0001] and 23% improvement [p=0.03]
Argano
Meta analysis: 51% lower mortality [p=0.0002] and 72% lower ICU admission [p<0.0001]
Mostafa
186 patients sufficiency: 93% lower mortality [p<0.0001], 95% lower ventilation [p<0.0001], and 91% lower ICU admission [p<0.0001]
Din Ujjan
50 patient early treatment RCT: 29% improved recovery [p=0.11] and 91% improved viral clearance [p=0.05]
Favipiravir
Vaezi
77 patient early treatment RCT: 105% higher hospitalization [p=0.43]
Metformin
Pinchera
43 patients prophylaxis: 15% lower severe cases [p=0.05]
Molnupiravir
Sanderson
Identification of SARS-CoV-2 variants likely to have been created by molnupiravir treatment. Authors find a class of long phylogenetic branches..
Quercetin
Pastor-Fernández
K18-hACE2 mouse study showing reduced COVID-19 severity with quercetin and dasatinib, for both prophylaxis and early treatment.
Din Ujjan
50 patient early treatment RCT: 29% improved recovery [p=0.11] and 91% improved viral clearance [p=0.05]
Vitamin C
Viglione
Retrospective 479 high risk outpatients in the USA treated with a protocol including intravenous vitamin C, vitamin D, zinc, quercetin, bromelain,..
Paxlovid
Evans
5,575 patients early treatment: 41% lower combined mortality/hospitalization [p=0.04]
Colchicine
Sáenz-Aldea
86,692 patients prophylaxis: 8% higher hospitalization [p=0.68] and 12% more cases [p=0.68]
Sunil Naik
105 patient late treatment RCT: 7% improved recovery [p=0.21]
Kasiri
110 patient late treatment RCT: 7% lower mortality [p=1], 7% lower ventilation [p=1], 24% higher ICU admission [p=0.63], and 28% improved recovery [p=0.59]
Sotrovimab
Zheng
7,683 patients early treatment: 4% lower combined mortality/hospitalization [p=0.91]
HCQ
Naggie
1,359 patient prophylaxis RCT: 24% fewer symptomatic cases [p=0.18]
Curcumin
Din Ujjan
50 patient early treatment RCT: 29% improved recovery [p=0.11] and 91% improved viral clearance [p=0.05]
Recent studies (see the individual treatment pages for all studies):
Jan 28
 Vaezi et al., Advances in Respiratory Medicine, doi:10.3390/arm91010004 Favipiravir in the Treatment of Outpatient COVID-19: A Multicenter, Randomized, Triple-Blind, Placebo-Controlled Clinical Trial
105% higher hospitalization [p=0.43]. RCT 77 outpatients in Iran, showing increased hospitalization with treatment, without statistical significance. Favipiravir 1600mg daily for five days. 21% of favipiravir patients did not complete treatment.
Jan 27
 Sanderson et al., medRxiv, doi:10.1101/2023.01.26.23284998 (Preprint) Identification of a molnupiravir-associated mutational signature in SARS-CoV-2 sequencing databases
Identification of SARS-CoV-2 variants likely to have been created by molnupiravir treatment. Authors find a class of long phylogenetic branches almost exclusively matching the time period, location, and age groups of widespread molnupirav..
Jan 26
 Pastor-Fernández et al., Aging Cell, doi:10.1111/acel.13771 Treatment with the senolytics dasatinib/quercetin reduces SARS‐CoV ‐2‐related mortality in mice
K18-hACE2 mouse study showing reduced COVID-19 severity with quercetin and dasatinib, for both prophylaxis and early treatment.
Jan 25
 Turobkulovich et al., Emergent: Journal of Educational Discoveries and Lifelong Learning Applications of quercetin for the prevention of COVID-19 in healthcare workers
73% lower mortality [p=0.11] and 33% fewer symptomatic cases [p=0.03]. Prospective study of healthcare workers in Uzbekistan showing lower cases with vitamin C prophylaxis. Very minimal details are provided, there is no baseline information, and control mortality is very high.
Jan 25
 Evans et al., medRxiv, doi:10.1101/2023.01.24.23284916 (Preprint) Real-world effectiveness of molnupiravir, nirmatrelvir-ritonavir, and sotrovimab on preventing hospital admission among higher-risk patients with COVID-19 in Wales: a retrospective cohort study
51% lower combined mortality/hospitalization [p=0.008]. Retrospective high risk outpatients in the UK, showing lower hospitalization/death with molnupiravir treatment. Residual confounding is likely with adjustments having no detail on specific comorbidities.
Jan 22
 Zheng et al., medRxiv, doi:10.1101/2023.01.20.23284849 (Preprint) Comparative effectiveness of Paxlovid versus sotrovimab and molnupiravir for preventing severe COVID-19 outcomes in non-hospitalised patients: observational cohort study using the OpenSAFELY platform
285% higher combined mortality/hospitalization [p=0.004]. OpenSAFELY retrospective 5,638 outpatients in the UK, showing significantly higher hospitalization/death for molnupiravir compared with paxlovid.
Jan 21
 Sunil Naik et al., Contemporary Clinical Trials Communications, doi:10.1016/j.conctc.2023.101070 Effect of colchicine and aspirin given together in patients with moderate COVID-19
7% improved recovery [p=0.21]. RCT 122 hospitalized patients in India, showing improved recovery with colchicine treatment. All patients received aspirin. There was one death and higher progression in the colchicine arm, however 3 patients in the colchicine arm had bas..
Jan 19
 Lombardi et al., MDPI AG, doi:10.20944/preprints202301.0359.v1 (Preprint) Preliminary Evidence of Good Safety Profile and Outcomes of Early Treatment With Tixagevimab/Cilgavimab Compared to Previously Employed Monoclonal Antibodies for COVID-19 in Immunocompromised Patients
368% higher mortality [p=0.32], 33% lower hospitalization [p=1], and 24% worse viral clearance [p=0.3]. Retrospective immunocompromised patients, showing no significant difference between tixagevimab/cilgavimab and other mAbs.
Jan 18
 Socia et al., medRxiv, doi:10.1101/2023.01.16.23284634 (Preprint) Prediction of Long COVID Based on Severity of Initial COVID-19 Infection: Differences in predictive feature sets between hospitalized versus non-hospitalized index infections
N3C retrospective identifying plant hardiness zone as a predictive variable for long COVID. Authors note that this may be due to sunlight/climate affecting the risk of long COVID, and plan more detailed analysis in future work.
Jan 18
 Din Ujjan et al., Frontiers in Nutrition, doi:10.3389/fnut.2022.1023997 The possible therapeutic role of curcumin and quercetin in the early-stage of COVID-19—Results from a pragmatic randomized clinical trial
29% improved recovery [p=0.11] and 91% improved viral clearance [p=0.05]. Small RCT with 50 outpatients, 25 treated with curcumin, quercetin, and vitamin D, showing improved recovery and viral clearance with treatment. 168mg curcumin, 260mg, 360IU vitamin D3 daily for 14 days.
Jan 16
 Viglione et al., The Gazette of Medical Sciences, doi:10.46766/thegms.pubheal.22120905 Intravenous high dose vitamin C and ozonated saline effective treatment for Covid -19: The Evolution of Local Standard of Care
Retrospective 479 high risk outpatients in the USA treated with a protocol including intravenous vitamin C, vitamin D, zinc, quercetin, bromelain, lactoferrin, HCQ, ivermectin, ozonated saline, azithromycin, ceftriaxone, methylprednisolon..
Jan 16
 Argano et al., Pharmaceuticals, doi:10.3390/ph16010130 Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis
51% lower mortality [p=0.0002] and 72% lower ICU admission [p<0.0001]. Meta analysis and trial sequential analysis of 5 vitamin D RCTs, showing significantly lower mortality and ICU admission with treatment.
Jan 16
 Asadi et al., Journal of Pharmaceutical Policy and Practice, doi:10.1186/s40545-023-00511-w Effectiveness of different treatment regimens on patients with COVID-19, hospitalized in Sanandaj hospitals: a retrospective cohort study
Retrospective 660 hospitalized patients in Iran comparing 6 different drug regimens: 1. HCQ or CQ+AZ, 2. interferons (ReciGen/Ziphron) or interferon + Kaletra (lopinavir/ritonavir), 3. atazanavir, 4. remdesivir, 5. favipiravir, and 6. cor..
Jan 16
 Kasiri et al., Journal of Investigative Medicine, doi:10.1177/10815589221141815 The effects of colchicine on hospitalized COVID-19 patients: A randomized, double-blind, placebo-controlled clinical trial
7% lower mortality [p=1], 7% lower ventilation [p=1], 24% higher ICU admission [p=0.63], and 28% improved recovery [p=0.59]. Very late treatment (10 days from onset) RCT 110 patients in Iran, showing no significant difference in outcomes with colchicine. Colchicine 2mg loading dose followed by 0.5mg bid for 7 days.
Jan 15
 Inaba et al., Research Square, doi:10.21203/rs.3.rs-2451986/v1 (Preprint) Real-world data concerning the efficacy of molnupiravir in patients vaccinated against COVID-19 during the Omicron surge in Japan
127% higher combined mortality/hospitalization [p=0.22] and 127% higher hospitalization [p=0.22]. Retrospective 294 consecutive patients in Japan, showing higher risk of hospitalization/death with molnupiravir, without statistical significance.
Jan 14
 Deng et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2023.01.010 Efficacy and safety of selective serotonin reuptake inhibitors in COVID-19 management: A systematic review and meta-analysis
28% lower mortality [p<0.0001] and 21% lower hospitalization [p=0.03]. Meta analysis of 6 fluvoxamine RCTs showing fluvoxamine associated with lower mortality and hospitalization. 100mg bid showed lower mortality and hospitalization, but 50mg bid did not. Authors use the Hartung-Knapp adjustment and they inc..
Jan 14
 Shafiee et al., Phytotherapy Research, doi:10.1002/ptr.7724 Curcumin for the treatment of COVID-19 patients: A meta-analysis of randomized controlled trials
62% lower mortality [p=0.003]. Meta analysis of 13 curcumin RCTs showing lower mortality with treatment. Authors note that subgroup analysis suggested improved efficacy with early treatment and with combined treatment.
Jan 13
 Hawari et al., Journal of Aerosol Medicine and Pulmonary Drug Delivery, doi:10.1089/jamp.2022.0062 Safety, Tolerability, and Pharmacokinetics of Nebulized Hydroxychloroquine: A Pilot Study in Healthy Volunteers
Analysis of a nebulized HCQ formulation with 12 healthy patients, showing low systemic concentrations and supporting efficacy, safety, and tolerability.
Jan 13
 Sáenz-Aldea et al., Journal of Medical Virology, doi:10.1002/jmv.28496 Colchicine and risk of hospitalisation due to COVID-19: a population-based study
8% higher hospitalization [p=0.68] and 12% more cases [p=0.68]. Retrospective 86,652 patients in Spain, showing no significant difference in cases and hospitalization with colchicine use. The different risk for patients prescribed colchicine may not be fully adjusted for.
Jan 13
 Di Pierro et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.1096853 Quercetin as a possible complementary agent for early-stage COVID-19: Concluding results of a randomized clinical trial
37% improved recovery [p=0.007] and 58% improved viral clearance [p<0.0001]. RCT 100 outpatients in Pakistan, 50 treated with quercetin phytosome, showing faster viral clearance and improved recovery with treatment. Patients in the treatment group were significantly younger (41 vs. 54).
Jan 11
 Heilmann et al., Science Translational Medicine, doi:10.1126/scitranslmed.abq7360 (In Vitro) SARS-CoV-2 3CLpro mutations selected in a VSV-based system confer resistance to nirmatrelvir, ensitrelvir, and GC376
In Vitro and In Silico study showing selection of resistant mutations with nirmatrelvir use. Several mutations were identified that confer resistance to 3CLpro inhibitors nirmatrelvir, ensitrelvir, and GC376. Authors note that most of the..
Jan 10
 Ubaldi et al., Work, doi:10.3233/WOR-220387 Vitamin D status and COVID-19 prevention in a worker subgroup in Italy
Report on vitamin D supplementation with 139 employees in Italy from April to June 2021, showing only one confirmed COVID-19 case (0.7%) and 4 cases of flu-like symptoms, compared to ~7-9% COVID-19 incidence for the same Italian district ..
Jan 10
 Almasaud et al., Nutrients, doi:10.3390/nu15020340 Association of Serum Zinc and Inflammatory Markers with the Severity of COVID-19 Infection in Adult Patients
Prospective study of 123 COVID+ patients and 48 controls, showing significantly lower zinc levels in COVID-19 patients, and a negative correlation between zinc levels and COVID-19 severity. Moderate and severe cases were significantly old..
Jan 10
 Jochmans et al., mBio, doi:10.1128/mbio.02815-22 (In Vitro) The Substitutions L50F, E166A, and L167F in SARS-CoV-2 3CLpro Are Selected by a Protease Inhibitor In Vitro and Confer Resistance To Nirmatrelvir
In Vitro study showing selection of nirmatrelvir-resistant mutations with a protease inhibitor.
Jan 7
 Dhibar et al., Scientific Reports, doi:10.1038/s41598-022-26053-w The ‘myth of Hydroxychloroquine (HCQ) as post-exposure prophylaxis (PEP) for the prevention of COVID-19’ is far from reality
27% fewer symptomatic cases [p=0.32] and 21% fewer cases [p=0.21]. Low dose low-risk patient HCQ PEP RCT, showing lower symptomatic cases with treatment, without statistical significance. There were no moderate or severe cases. HCQ 800mg on day one followed by 400mg once weekly for 3 weeks.
Jan 6
 Pinchera et al., Microorganisms, doi:10.3390/microorganisms11010145 Diabetes and SARS-CoV-2 Infection: The Potential Role of Antidiabetic Therapy in the Evolution of COVID-19
15% lower severe cases [p=0.05]. Retrospective 43 diabetes patients hospitalized for COVID-19 in Italy, showing lower risk of severe cases with metformin vs. insulin.
Jan 5
 MedInCell Press Release (Preprint) MedinCell announces positive results for the SAIVE clinical study in prevention of Covid-19 infection in a contact-based population
72% fewer cases [p<0.0001]. PEP RCT 399 patients in Bulgaria showing significantly lower COVID-19 cases with ivermectin prophylaxis. Limited information is currently available.
Jan 4
 Mitjà et al., Clinical and Translational Science, doi:10.1111/cts.13468 Hydroxychloroquine for treatment of non‐hospitalized adults with COVID-19: A meta-analysis of individual participant data of randomized trials
33% improved viral clearance [p=0.02]. Extremely high COI (includes authors of trials playing a key role in the suppression of treatment, and funded by the Gates Foundation) IPD meta analysis of 11 HCQ outpatient treatment and prophylaxis trials, showing significantly improved..
Jan 3
 Ghayour et al., Research Square, doi:10.21203/rs.3.rs-2309373/v1 (Preprint) Evaluation of the recovery rate and prevention of hospitalization among covid-19 outpatients: a randomized clinical trial comparing N-acetylcysteine with Bromhexine
83% higher hospitalization [p=0.3] and 18% slower recovery [p=0.09]. RCT 150 outpatients in Iran comparing N-acetylcysteine and bromhexine, showing lower hospitalization and faster recovery with bromhexine, without statistical significance. Baseline information per group is not provided, and Figure 1 appea..
Jan 3
 Ram et al., Research Square, doi:10.21203/rs.3.rs-2418159/v1 (Preprint) Analysis of trace elements (Zn and Cu) levels in COVID-19 patients with ICU and Non-ICU hospitalization
Prospective analysis of 122 hospitalized COVID-19 patients, showing significantly lower zinc levels in ICU patients compared with non-ICU patients. Zinc levels were lower in non-survivors compared with survivors, without statistical signi..
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 2,475 studies, 1,640 present results comparing with a control group, 1,495 are treatment studies, and 145 analyze outcomes based on serum levels. There are 29 animal studies, 60 in silico studies, 125 in vitro studies, and 124 meta analyses.
Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, 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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