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c19early.org COVID-19 treatment researchSelect treatment..Select..
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@CovidAnalysis

COVID-19 early treatment: real-time analysis of 5,571 studies
@CovidAnalysis
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COVID-19 involves the interplay of over 100 viral and host proteins and factors, providing many therapeutic targets. c19early analyzes over 5,500 studies for 121 treatments—over 17 million hours of research. US authorities believe only three high-profit early treatments reduce risk (remdesivir, paxlovid, molnupiravir). In reality, many treatments reduce risk, and 25 low-cost treatments have been approved across 163 countries. 0.5% of 8,000+ proposed treatments show reduced risk.
Naso/oropharyngeal treatment
Direct treatment to the primary source of initial infection reduces progression and transmission. Many low-cost agents are widely available.
Healthy lifestyles
Exercise, sunlight, a healthy diet, and good sleep all reduce risk.
Immune support
Vitamins A, C, D, and zinc show reduced risk, as with other viruses.
Thermotherapy
Methods for increasing internal body temperature reduce risk, comparable to natural fever, enhancing immune system function.
Systemic agents
Many systemic agents reduce risk, and may be required when infection progresses beyond the upper respiratory tract.
High-profit systemic agents
High-profit systemic agents are also effective, but have greater access and cost barriers.
Monoclonal antibodies
Highly effective for matching variants but rarely used, with high cost, variant dependence, and IV/subcutaneous administration.
Acetaminophen
Acetaminophen increases the risk of severe outcomes and mortality.
Remdesivir
Antiviral efficacy is offset by serious side effects, resulting in increased mortality with longer followup.
c19early.org
We do not provide medical advice. No treatment is 100% effective, and all may have side effects. Protocols combine multiple treatments. Consult a qualified physician for personalized risk/benefit analysis.
$0 $1,000 $2,000+ -25+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments +19 more high-profit -ve drugs Glenzocimab -60% >$2,000 Olokizumab -50% >$2,000 PPIs -46% BMS mAbs -36% >$2,000 Acetaminophen -28% Cenicriviroc -28% >$2,000 Lufotrelvir >$2,000 Cannabidiol Plitidepsin >$2,000 Losartan Sargramostim >$2,000 Vitamin B9 Ravulizumab >$2,000 Conv. Plasma $5,000 Remdesivir $3,120 Sarilumab >$2,000 Ibuprofen PPE Aspirin Molnupiravir mutagenic/teratogenic Paxlovid Favipiravir Famotidine Vitamin C Sotrovimab $2,100 Amubarvimab/r.. Azvudine NAC Vilobelimab $6,350 Colchicine Budesonide Probiotics Zinc HCQ Nitric Oxide Antiandro.. Metformin Sleep Vitamin A Bebtelovimab H1RAs Sunlight H. Peroxide Vitamin D Exercise Fluvox. Tixagevimab/c.. Curcumin N. Sativa Casirivimab/i.. $2,100 NaHCO₃ Melatonin Quercetin Bamlanivimab/e.. Ensovibep >$2,000 pH+ Diet PVP-I Thermotherapy Ivermectin Regdanvimab $2,100 Lifestyle / free No prescription Prescription required High-cost Lowerrisk Higherrisk c19early.org April 2025 COVID-19 involves the interplay of 100+ host/viral proteins/factors, modulated by many treatments. 0.5% of 8,000+proposed treatments show efficacy with ≥3 studies.Protocols combine treatments, none are 100% effective.c19early analyzes over 5,500 studies for 121 treatments.
$0 $1,000 $2,000+ -20+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments +19 more high-profit -ve drugs Glenzocimab -60% Olokizumab -50% PPIs -46% BMS mAbs -36% Acetaminophen -28% Cenicriviroc -28% Lufotrelvir -22% CBD Plitidepsin Losartan Sargramostim Vit. B9 Ravulizumab C. Plasma Remdesivir Sarilumab Ibuprofen PPE Aspirin Molnupiravir mutagenic/teratogenic Paxlovid Favipiravir Famotidine Vitamin C Sotrovimab Amubarvimab/r.. Azvudine NAC Vilobelimab Colchicine Budesonide Probiotics Zinc HCQ Nitric Oxide Antiandro.. Metformin Sleep Vitamin A Bebtelovimab H1RAs Sunlight H. Peroxide Vitamin D Exercise Fluvox. Tixagevimab/c.. Curcumin N. Sativa Casirivim.. NaHCO₃ Melatonin Quercetin Bamlan.. Ensovibep pH+ Diet PVP-I Thermotherapy Ivermectin Regdanvimab Lifestyle / free No prescription Prescription required High-cost Lowerrisk Higherrisk c19early.org April 2025 COVID-19 involves the interplay of100+ host/viral proteins/factors.0.5% of 8,000+ treatments showefficacy. Protocols combinetreatments. c19early analyzes5,500+ studies for 121 treatments.
$0 $500 $1,000+ COVID-19 treatment protocols efficacy vs. cost United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Pakistan Argentina Vietnam Peru Philippines Spain Brazil Italy France Japan China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR Treatment protocols varied widely around the world.Low-cost and non-prescription treatments reduce barriersto treatment—especially early treatment—and providecomplementary and synergistic benefits. More effective More expensive c19early.org April 2025 75% 50% 25% ≤0%
$0 $500 $1,000+ C19 treatment protocols avg. efficacy/cost United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Pakistan Argentina Vietnam Peru Philippines Spain Brazil Italy France Japan China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria Treatment protocols varied widely.Low-cost and non-prescription treatmentsreduce barriers to treatment—especiallyearly treatment—and provide complementaryand synergistic benefits. More effective More expensive c19early.org April 2025 75% 50% 25% ≤0%
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 April 2025 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 April 2025 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, PLOS ONE, Frontiers in Medicine, Cureus, Journal of Clinical Medicine, Scientific Reports, more...
April 2025
c19early.org
Cost per life saved from NNT in
studies to date
Melatonin
9
48%
  $8
Alkalinization
9
46%
  $9
Vitamin D
72
38%
  $10
Zinc
21
30%
  $15
Vitamin C
45
19%
  $18
HCQ
254
27%
  $26
Ivermectin
53
47%
  $26
Colchicine
43
28%
  $31
Aspirin
68
8%
  $45
Vitamin A
5
30%
  $45
Curcumin
8
63%
  $59
Famotidine
21
18%
  $94
Metformin
71
37%
  $121
Quercetin
5
61%
  $127
Probiotics
10
59%
  $172
Antiandrogens
32
37%
  $179
Nigella Sativa
5
57%
  $187
Fluvoxamine
10
44%
  $411
Budesonide
12
26%
  $574
Azvudine
25
29%
  $1,259
Favipiravir
40
11%
  $1,935
Tixagev../c..
10
40%
  $74,506
Regdanvimab
7
63%
  $139,860
Sotrovimab
14
46%
  $299,464
Bamlaniv../e..
13
54%
  $301,549
Casirivimab/..
11
20%
  $452,469
Bebtelovimab
4
60%
  $737,601
Remdesivir
66
1%
  $1,558,440
Paxlovid
41
22%
  $1,901,782
Molnupiravir
27
13%
  $2,400,867
Conv. Plasma
54
-2%
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. 0.5% 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 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 Chlorphenira.. 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 3,202 Diet 51% [42-58%] 30 $0 693,870 Alkalinization 49% [36-59%] 14 $1 6,320 HH-120 49% [-60-84%] 2 $500 345 very limited data Ensovibep 47% [-108-87%] 2 $2,100 885 limited data pHOXWELL 47% [29-62%] 1 $10 556 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 Quercetin 46% [20-64%] 12 $5 1,496 Resveratrol 44% [-4-70%] 3 $1 360 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 Sodium Bicar.. 43% [23-58%] 6 $1 1,013 Casirivimab/i.. 43% [24-57%] 33 $2,100 59,746 variant dependent Nigella Sativa 43% [24-57%] 14 $5 3,333 Propolis 41% [-13-69%] 3 $1 410 very limited data Curcumin 41% [30-51%] 27 $5 14,886 Tixagev../c.. 40% [21-54%] 18 $855 29,862 variant dependent Fluvoxamine 39% [21-52%] 21 $4 38,283 Montelukast 39% [14-56%] 9 $2 2,943 limited data Exercise 39% [33-44%] 68 $0 1,939,060 Vitamin D 38% [32-43%] 125 $1 195,984 Hydrogen Per.. 38% [5-59%] 7 $1 835 very limited data Phthalocyan.. 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 H1RAs 36% [20-48%] 17 $5 72,015 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 Artemisinin 34% [11-51%] 3 $1 217 very limited data Vitamin A 31% [11-47%] 15 $2 22,297 Sleep 31% [23-39%] 16 $0 429,222 Spironolactone 31% [15-44%] 12 $5 28,019 Metformin 31% [27-34%] 104 $10 358,299 Antiandrogens 30% [21-38%] 49 $5 120,172 Vitamin B12 30% [5-48%] 4 $1 11,407 Nitric Oxide 30% [1-50%] 13 $11 2,366 Hydroxychlor.. 28% [25-31%] 423 $1 593,922 Zinc 28% [18-36%] 46 $1 55,762 Probiotics 28% [18-36%] 28 $5 19,646 Budesonide 28% [18-36%] 15 $4 28,194 Colchicine 28% [18-36%] 57 $1 33,162 Ibuzatrelvir 27% [15-38%] 1 $1,390 126 very limited data Andrographol.. 27% [-8-50%] 7 $5 1,245 Vilobelimab 26% [-4-48%] 1 $6,350 368 intravenous N-acetylcys.. 25% [14-35%] 24 $1 26,243 Azvudine 25% [16-33%] 34 $25 42,905 Amubarv../r.. 25% [-70-66%] 4 $1,380 1,568 intravenous Lactoferrin 24% [-24-53%] 8 $5 1,419 Ensitrelvir 23% [-19-50%] 4 $500 3,535 very limited data Sotrovimab 22% [10-32%] 28 $2,100 56,351 variant dependent Niclosamide 21% [-47-57%] 6 $50 2,091 very limited data Vitamin C 21% [14-27%] 74 $1 89,000 Leritrelvir 21% [3-35%] 2 $50 1,399 very limited data Azelastine 21% [-3-39%] 3 $5 310 very limited data UDCA 19% [-3-36%] 21 $15 45,286 Camostat 18% [-3-34%] 16 $1 2,020 Famotidine 17% [8-24%] 30 $5 114,119 Favipiravir 15% [5-24%] 71 $20 36,281 worse w/longer followup Vitamin K 14% [0-25%] 2 $1 7,806 very limited data Paxlovid 13% [10-17%] 80 $1,390 168,027 independent trials refused Atilotrelvir 13% [1-23%] 1 $65 1,213 very limited data Deuremidevir 11% [-1-21%] 2 $112 1,432 very limited data Molnupiravir 10% [2-17%] 50 $707 184,383 mutagenic/teratogenic Aspirin 8% [2-13%] 79 $1 188,049 Peg.. Lambda 7% [-138-63%] 4 $500 2,143 subcutaneous PPE 2% [-25-24%] 4 $5 351,091 Ibuprofen 0% [-9-9%] 13 $1 54,707 Acebilustat 0% [-1462-94%] 1 $2,000 120 very limited data Levilimab 0% [-289-74%] 1 $2,000 206 subcutaneous Sarilumab -0% [-21-17%] 11 $2,000 2,231 intravenous/subcutaneous Pomotrelvir -1% [-104-50%] 1 $1,390 230 very limited data Remdesivir -2% [-10-7%] 80 $3,120 202,908 worse w/longer followup Conv. Plasma -2% [-6-2%] 56 $5,000 31,387 intravenous Vadadustat -3% [-89-44%] 1 $596 448 very limited data Apremilast -3% [-42-25%] 2 $2,000 594 limited data Ravulizumab -5% [-45-24%] 2 $2,000 481 intravenous Lanadelumab -7% [-135-52%] 1 $10,000 55 very limited data Vitamin B9 -8% [-41-18%] 12 $1 54,954 Plasma-activ.. -9% [-234-64%] 1 $100 23 very limited data Razuprotafib -10% [-116-44%] 2 $2,000 134 subcutaneous Sargramostim -13% [-85-31%] 4 $2,000 870 very limited data Brexanolone -14% [-129-43%] 1 $34,000 28 very limited data Losartan -15% [-127-42%] 5 $5 665 very limited data Dolutegravir -15% [-71-22%] 2 $130 1,600 intravenous Plitidepsin -16% [-356-71%] 2 $2,000 163 intravenous Cannabidiol -17% [-89-28%] 10 $25 17,988 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 Cenicriviroc -28% [-66-1%] 3 $2,000 1,000 limited data Acetaminoph.. -28% [-41--17%] 27 $1 543,459 Crizanlizumab -29% [-103-18%] 2 $2,500 463 intravenous BMS mAbs -36% [-492-69%] 1 $2,100 210 subcutaneous Brensocatib -41% [-88--6%] 1 $2,000 404 very limited data Danicopan -43% [-168-24%] 1 $2,000 201 very limited data PPIs -46% [-67--28%] 40 $5 228,512 Olokizumab -50% [-309-45%] 1 $2,000 248 subcutaneous TRV027 -54% [-202-22%] 2 $2,000 318 intravenous 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 Posaconazole -131% [-200--78%] 1 $2,000 249 very limited data Emvododstat -132% [-628-26%] 1 $2,000 187 very limited data Goflikicept -135% [-492-7%] 1 $2,000 247 subcutaneous Pemivibart -150% [-6014-90%] 1 $5,775 477 intravenous Donidalorsen -151% [-602-11%] 1 $2,000 103 intravenous/subcutaneous Zenuzolac -200% [-2732-68%] 1 $500 90 very limited data Astodrimer So.. -205% [-7302-87%] 1 $10 197 very limited data All studies (pooled effects, all stages) c19early.org April 2025 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 51% 30 Alkalinization 49% 14 HH-120 49% 2 very limited data Ensovibep 47% 2 limited data pHOXWELL 47% 1 very limited data Bemnifosbuvir 47% 3 very limited data Bamlaniv../e.. 47% 21 variant dependent Quercetin 46% 12 Resveratrol 44% 3 limited data Adintrevimab 43% 2 intramuscular Melatonin 43% 18 Bromhexine 43% 7 very limited data Sodium Bicar.. 43% 6 Casirivimab/.. 43% 33 variant dependent Nigella Sativa 43% 14 Propolis 41% 3 very limited data Curcumin 41% 27 Tixagev../c.. 40% 18 variant dependent Fluvoxamine 39% 21 Montelukast 39% 9 limited data Exercise 39% 68 Vitamin D 38% 125 Hydrogen Per.. 38% 7 very limited data Phthalocyan.. 38% 4 Xiannuoxin 38% 2 very limited data Sunlight 37% 5 H1RAs 36% 17 Nitazoxanide 35% 14 Selenium 34% 4 Bebtelovimab 34% 6 intravenous Artemisinin 34% 3 very limited data Vitamin A 31% 15 Sleep 31% 16 Spironolactone 31% 12 Metformin 31% 104 Antiandrogens 30% 49 Vitamin B12 30% 4 Nitric Oxide 30% 13 Hydroxychlor.. 28% 423 Zinc 28% 46 Probiotics 28% 28 Budesonide 28% 15 Colchicine 28% 57 Ibuzatrelvir 27% 1 very limited data Andrographol.. 27% 7 Vilobelimab 26% 1 intravenous N-acetylcys.. 25% 24 Azvudine 25% 34 Amubarv../r.. 25% 4 intravenous Lactoferrin 24% 8 Ensitrelvir 23% 4 very limited data Sotrovimab 22% 28 variant dependent Niclosamide 21% 6 very limited data Vitamin C 21% 74 Leritrelvir 21% 2 very limited data Azelastine 21% 3 very limited data UDCA 19% 21 Camostat 18% 16 Famotidine 17% 30 Favipiravir 15% 71 worse w/longer followup Vitamin K 14% 2 very limited data Paxlovid 13% 80 independent trials refused Atilotrelvir 13% 1 very limited data Deuremidevir 11% 2 very limited data Molnupiravir 10% 50 mutagenic/teratogenic Aspirin 8% 79 Peg.. Lambda 7% 4 subcutaneous PPE 2% 4 Ibuprofen 0% 13 Acebilustat 0% 1 very limited data Levilimab 0% 1 subcutaneous Sarilumab -0% 11 intravenous/subcutaneous Pomotrelvir -1% 1 very limited data Remdesivir -2% 80 worse w/longer followup Conv. Plasma -2% 56 intravenous Vadadustat -3% 1 very limited data Apremilast -3% 2 limited data Ravulizumab -5% 2 intravenous Lanadelumab -7% 1 very limited data Vitamin B9 -8% 12 Plasma-activ.. -9% 1 very limited data Razuprotafib -10% 2 subcutaneous Sargramostim -13% 4 very limited data Brexanolone -14% 1 very limited data Losartan -15% 5 very limited data Dolutegravir -15% 2 intravenous Plitidepsin -16% 2 intravenous Cannabidiol -17% 10 Trimodulin -17% 1 intravenous Lufotrelvir -22% 1 intravenous Pacritinib -28% 1 very limited data Cenicriviroc -28% 3 limited data Acetaminoph.. -28% 27 Crizanlizumab -29% 2 intravenous BMS mAbs -36% 1 subcutaneous Brensocatib -41% 1 very limited data Danicopan -43% 1 very limited data PPIs -46% 40 Olokizumab -50% 1 subcutaneous TRV027 -54% 2 intravenous Glenzocimab -60% 1 intravenous Siltuximab -64% 1 intravenous rNAPc2 -65% 1 very limited data Posaconazole -131% 1 very limited data Emvododstat -132% 1 very limited data Goflikicept -135% 1 subcutaneous Pemivibart -150% 1 intravenous Donidalorsen -151% 1 intravenous/subcutaneous Zenuzolac -200% 1 very limited data Astodrimer S.. -205% 1 very limited data All studies (pooled effects, all stages) c19early.org April 2025 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) 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.
Probiotics
Martino
In Vitro study showing that certain gut bacteria can modulate SARS-CoV-2 infection by degrading heparan sulfate (HS) on cell surfaces. Authors found..
Vitamin B9
Morello
Retrospective 1,243 children with COVID-19 showing lower risk of long COVID at 6 months when treated with a Multi-Element Product (MEP) containing..
Vitamin D
Morello
Retrospective 1,243 children with COVID-19 showing lower risk of long COVID at 6 months when treated with a Multi-Element Product (MEP) containing..
Hossain
100 patients sufficiency: 58% lower severe cases (p=0.002)
Zinc
Morello
Retrospective 1,243 children with COVID-19 showing lower risk of long COVID at 6 months when treated with a Multi-Element Product (MEP) containing..
Muniz
Non-COVID-19 specific RCT with 150 participants in Brazil showing reduced frequency (21.5% lower) and severity (11% lower) of upper respiratory..
Selenium
Morello
Retrospective 1,243 children with COVID-19 showing lower risk of long COVID at 6 months when treated with a Multi-Element Product (MEP) containing..
Curcumin
Morello
Retrospective 1,243 children with COVID-19 showing lower risk of long COVID at 6 months when treated with a Multi-Element Product (MEP) containing..
Quercetin
Morello
Retrospective 1,243 children with COVID-19 showing lower risk of long COVID at 6 months when treated with a Multi-Element Product (MEP) containing..
Bano
In Vitro study showing that scopoletin inhibits SARS-CoV-2 main protease (Mpro) with an IC50 of 15.75 μM. Authors employed virtual screening to..
Lactoferrin
Morello
Retrospective 1,243 children with COVID-19 showing lower risk of long COVID at 6 months when treated with a Multi-Element Product (MEP) containing..
Cetylpyridinium Chloride
Muniz
Non-COVID-19 specific RCT with 150 participants in Brazil showing reduced frequency (21.5% lower) and severity (11% lower) of upper respiratory..
Ivermectin
Madawi
In Vitro and rabbit study showing that rapidly disintegrating lyophilized dry‑emulsion tablets (IVM‑LDET) markedly improve oral ivermectin delivery...
N-acetylcysteine
Reis
In Vitro and Ex Vivo study showing that BromAc (bromelain and N-acetylcysteine) exhibits antiviral activity against SARS-CoV-2 Omicron variant...
Niclosamide
Bath
Discussion of a planned COVID-19 platform trial (PROTECT-CH) in care homes that failed to start recruitment. The trial was designed to test..
Miscellaneous
Ilyas
In Silico study showing that intrinsically disordered regions (IDRs) in SARS-CoV-2 proteins are promising targets for small-molecule drug discovery.
Bajaj
High-throughput screen of 2,640 acrylamide-based compounds, identifying 10 covalent inhibitors of SARS-CoV-2 Nsp15 with IC₅₀ values under 5 μM...
Baazim
In Vitro and animal study showing that inhibiting Fatty Acid-Binding Protein 4 (FABP4) reduces SARS-CoV-2 infection, viral replication, and lung..
Azvudine
Yu
4,192 patients late treatment PSM: 38% lower mortality (p<0.0001) and 21% lower progression (p=0.03)
Vitamin K
Liu
Meta-analysis of 6 studies examining vitamin K status in COVID-19 patients showing that infected patients have significantly higher levels of..
Xiannuoxin
Zhao
In Vitro and clinical study showing potent antiviral activity of simnotrelvir against SARS-CoV-2 variants with a high resistance barrier. Authors..
Melatonin
Qin
Meta-analysis of 3 RCTs (451 patients) showing significantly lower in-hospital mortality with melatonin treatment in severe-to-critical COVID-19..
Cannabidiol
Kuntzman
10 patient late treatment RCT: 77% lower mortality (p=0.3), 57% lower ICU admission (p=1), and 22% shorter hospitalization (p=0.61)
Recent studies (see the individual treatment pages for all studies):
Apr 30
 Bath et al., Health Technology Assessment, doi:10.3310/MTRS8833 Lessons from the PROTECT-CH COVID-19 platform trial in care homes
Discussion of a planned COVID-19 platform trial (PROTECT-CH) in care homes that failed to start recruitment. The trial was designed to test prophylactic antiviral interventions (initially ciclesonide and niclosamide) to reduce SARS-CoV-2 ..
Apr 30
 Madawi et al., Journal of Drug Delivery Science and Technology, doi:10.1016/j.jddst.2025.106941 Development and Optimization of Lyophilized Dry Emulsion Tablet for Improved Oral Delivery of Ivermectin
In Vitro and rabbit study showing that rapidly disintegrating lyophilized dry‑emulsion tablets (IVM‑LDET) markedly improve oral ivermectin delivery. Authors applied a quality‑by‑design approach to oil‑in‑water emulsions..
Apr 16
 Morello et al., Italian Journal of Pediatrics, doi:10.1186/s13052-025-01961-5 Role of nutrient supplements in children with post-COVID condition: a retrospective preliminary observation and narrative review
Retrospective 1,243 children with COVID-19 showing lower risk of long COVID at 6 months when treated with a Multi-Element Product (MEP) containing antioxidants and anti-inflammatory compounds (magnesium 200 mg, quercetin 150 mg, curcumin ..
Apr 11
 Kane et al., NCT04590547 Safety, Tolerability and Efficacy and Dose Response of GLS-1027 in the Prevention of Severe Pneumonitis Caused by SARS-CoV-2 Infection
200% higher mortality (p=0.34), 1% worse recovery (p=0.99), and 1% shorter hospitalization (p=0.87). RCT 132 hospitalized COVID-19 patients showing no significant difference in outcomes with zenuzolac (GLS-1027) treatment.
Apr 11
 Raspado et al., JMIR Formative Research, doi:10.2196/66509 Oxidative Stress Markers and Prediction of Severity With a Machine Learning Approach in Hospitalized Patients With COVID-19 and Severe Lung Disease: Observational, Retrospective, Single-Center Feasibility Study
Retrospective 28 hospitalized COVID-19 patients showing an association between oxidative stress biomarkers and disease severity. Lower zinc and thiol levels, higher Cu/Zn ratios, and increased high-sensitivity C-reactive protein (hs-CRP) ..
Apr 9
 Yu et al., VIEW, doi:10.1002/VIW.20240075 The effectiveness and safety of azvudine treatment in COVID‐19 patients with kidney disease based on a multicenter retrospective cohort study
38% lower mortality (p<0.0001) and 21% lower progression (p=0.03). PSM retrospective 4,192 hospitalized COVID-19 patients with kidney disease showing significantly reduced all-cause mortality and disease progression with azvudine.
Apr 9
 Martino et al., mBio, doi:10.1128/mbio.04015-24 SARS-CoV-2 infectivity can be modulated through bacterial grooming of the glycocalyx
In Vitro study showing that certain gut bacteria can modulate SARS-CoV-2 infection by degrading heparan sulfate (HS) on cell surfaces. Authors found that the abundance of HS-modifying bacteria inversely correlates with age, sex, and COVID..
Apr 8
 Joshi et al., Clinical and Translational Medicine, doi:10.1002/ctm2.70275 Severe SARS‐CoV‐2 infection in diabetes was rescued in mice supplemented with metformin and/or αKG, and patients taking metformin, via HIF1α‐IFN axis
In Vitro and mouse study showing that metformin and/or alpha-ketoglutarate (αKG) supplementation reduces SARS-CoV-2 infection severity in diabetic mice by modulating the HIF1α–interferon axis. Diabetic mice exhibited elevated viral loads,..
Apr 7
 Liu et al., Frontiers in Nutrition, doi:10.3389/fnut.2025.1476622 Low vitamin K status is a potential risk factor for COVID-19 infected patients: a systematic review and meta-analysis
Meta-analysis of 6 studies examining vitamin K status in COVID-19 patients showing that infected patients have significantly higher levels of dephosphorylated-uncarboxylated Matrix Gla Protein (dp-ucMGP), indicating lower vitamin K status..
Apr 7
 Reis et al., Scientific Reports, doi:10.1038/s41598-025-92242-y Antiviral effect of Bromelain combined with acetylcysteine against SARS-CoV-2 Omicron variant
In Vitro and Ex Vivo study showing that BromAc (bromelain and N-acetylcysteine) exhibits antiviral activity against SARS-CoV-2 Omicron variant. Authors demonstrate that BromAc at 250 μg/mL significantly reduces infectious viral particles ..
Apr 6
 Cenikli et al., Talanta, doi:10.1016/j.talanta.2025.128084 Does Favipiravir interact with DNA? Design of electrochemical DNA nanobiosensor to investigate the interaction between DNA and Favipiravir used in the treatment of COVID-19
Favipiravir exhibits a direct interaction with DNA, as detected by a novel electrochemical nanobiosensor. Authors observed a decrease in guanine oxidation signals that suggests favipiravir may bind to or alter DNA structure, raising conce..
Apr 4
 Olubiyi et al., Food Chemistry Advances, doi:10.1016/j.focha.2025.100969 Novel dietary herbal preparations with inhibitory activities against multiple SARS-CoV-2 targets: A multidisciplinary investigation into antiviral activities
In Vitro and In Silico study showing potent inhibition of SARS-CoV-2 main protease (3CLpro) by novel polyherbal dietary preparations. Curcumin was used as a positive control and inhibited protease activity by >95% at 50 μM.
Apr 4
 Nishimura et al., Biomedical Research, doi:10.2220/biomedres.46.37 Possible involvement of neuropeptide Y sub-receptor 1 (NPY-Y1) in the anti-viral response of SARS-CoV-2 infection in Syrian hamster
Animal study showing that molnupiravir and remdesivir co-administration reduces SARS-CoV-2 viral load and inflammatory responses in Syrian hamsters, with involvement of neuropeptide Y sub-receptor 1 (NPY-Y1). Authors found that SARS-CoV-2..
Apr 2
 Zhao et al., Antimicrobial Agents and Chemotherapy, doi:10.1128/aac.01556-24 Potent antiviral activity of simnotrelvir against key epidemic SARS-CoV-2 variants with a high resistance barrier
In Vitro and clinical study showing potent antiviral activity of simnotrelvir against SARS-CoV-2 variants with a high resistance barrier. Authors demonstrated simnotrelvir's efficacy against multiple Omicron variants including BA.1, BA.4,..
Apr 1
 Hossain et al., National Journal of Medical Research, doi:10.55489/njmr.150220251070 A Study on Serum Vitamin D3 Level in Patients with Covid-19: A Cross-Sectional Study in Kolkata
58% lower severe cases (p=0.002). Analysis of 100 hospitalized COVID-19 patients in India showing strong association between vitamin D deficiency and COVID-19 severity.
Mar 31
 Shaheen et al., Saudi Journal of Medicine, doi:10.36348/sjm.2025.v10i03.00X Phase-II RCT Convalescent Plasma Transfusion in Severe COVID-19 Patients -Evaluation of Efficacy and Tolerability
no change in mortality (p=1). RCT 60 severe COVID-19 patients showing no benefit with convalescent plasma.
Mar 31
 Jia et al., Scientific Reports, doi:10.1038/s41598-025-85677-w Efficacy and safety of azvudine versus nirmatrelvir/ritonavir in cancer patients with COVID-19
PSM retrospective 596 cancer patients with COVID-19 showing that azvudine significantly reduced all-cause mortality and composite disease progression compared to paxlovid.
Mar 28
 Hazan et al., Medical Hypotheses, doi:10.1016/j.mehy.2025.111613 Cholinergic eubiosis: A hypothesis on Ivermectin-upregulated Bifidobacterium
Hypothesis that ivermectin may increase beneficial Bifidobacterium populations in the gut through a "cholinergic eubiosis" mechanism. Authors theorize that ivermectin acts as a positive allosteric regulator of alpha-7 nicotinic..
Mar 26
 Makoana et al., PLOS ONE, doi:10.1371/journal.pone.0320415 Integration of metabolomics and chemometrics with in-silico and in-vitro approaches to unravel SARS-Cov-2 inhibitors from South African plants
In Silico and In Vitro study showing that quercetin derivatives from South African plants effectively inhibit SARS-CoV-2 main protease (3CLpro). Authors integrated metabolomics and chemometrics with computational approaches to identify bi..
Mar 25
 Bobrow et al., NCT04478071 Vadadustat for the Prevention and Treatment of Acute Respiratory Distress Syndrome (ARDS) in Hospitalized Patients With Coronavirus Disease 2019 (COVID-19)
3% higher mortality (p=1), 16% lower progression (p=0.36), and 8% improved recovery (p=0.6). RCT 448 hospitalized COVID-19 patients in the USA showing no significant differences with vadadustat.
Mar 25
 Perestiuk et al., Frontiers in Nutrition, doi:10.3389/fnut.2025.1566505 Association of zinc deficiency and clinical symptoms, inflammatory markers, severity of COVID-19 in hospitalized children
280% higher severe cases (p=1). Prospective study of 140 hospitalized children with COVID-19 in Ukraine showing that zinc deficiency associated with higher inflammatory markers. While there was a trend toward more frequent fever (p=0.0654) with deficiency, there was no ..
Mar 25
 Gkioulekas et al., The Japanese Journal of Antibiotics, doi:10.11553/antibiotics.78.1_35 Critical appraisal of multidrug therapy in the ambulatory management of patients with COVID-19 and hypoxemia Part II: Causal inference using the Bradford Hill criteria
Critical appraisal of three case series totaling 119 COVID-19 patients with hypoxemia treated with ivermectin-based multidrug protocols in the United States, Zimbabwe, and Nigeria, showing reduced hospitalization and mortality. Authors ap..
Mar 22
 Drysdale et al., Infection, doi:10.1007/s15010-025-02505-z Impact of treatment of COVID-19 with sotrovimab on post-acute sequelae of COVID-19 (PASC): an analysis of National COVID Cohort Collaborative (N3C) data
4% lower PASC (p=0.002). N3C retrospective 9,504 sotrovimab-treated high-risk COVID-19 patients versus 619,668 untreated high-risk controls showing reduced risk of post-acute sequelae of COVID-19 (PASC) with treatment. ATT weighting failed to adjust for "hea..
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 5,571 studies, 2,623 present results comparing with a control group, 2,407 are treatment studies, and 216 analyze outcomes based on serum levels. There are 107 animal studies, 201 in silico studies, 386 in vitro studies, 442 reviews, and 235 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. IMA and WCH provide treatment protocols.
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