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c19early.org COVID-19 treatment researchSelect treatment..Select..
Metformin Meta
Bromhexine Meta
Budesonide Meta
Colchicine Meta Nigella Sativa Meta
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Curcumin Meta PPIs Meta
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Melatonin Meta

COVID-19 early treatment: real-time analysis of 5,522 studies

 
COVID-19 involves the interplay of over 50 viral and host proteins and factors, providing many therapeutic targets. c19early analyzes over 5,500 studies for 119 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.
Direct treatment to the primary source of initial infection reduces progression and transmission. Many low-cost agents are widely available.
Exercise, sunlight, a healthy diet, and good sleep all reduce risk.
Vitamins A, C, D, and zinc show reduced risk, as with other viruses.
Methods for increasing internal body temperature reduce risk, comparable to natural fever, enhancing immune system function.
Many systemic agents reduce risk, and may be required when infection progresses beyond the upper respiratory tract.
High-profit systemic agents are also effective, but have greater access and cost barriers.
Highly effective for matching variants but rarely used, with high cost, variant dependence, and IV/subcutaneous administration.
Acetaminophen increases risk of severe outcomes and mortality.
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 Donidalorsen -151% >$2,000 Glenzocimab -60% >$2,000 Olokizumab -50% >$2,000 PPIs -46% BMS mAbs -36% >$2,000 Acetaminophen -28% Lufotrelvir >$2,000 Cannabidiol Trimodulin >$2,000 Plitidepsin >$2,000 Losartan Sargramostim >$2,000 Vitamin B9 Conv. Plasma $5,000 Remdesivir $3,120 Sarilumab >$2,000 Acebilustat >$2,000 Ibuprofen PPE Aspirin Molnupiravir mutagenic/teratogenic Paxlovid Favipiravir Famotidine Vitamin C Sotrovimab $2,100 Azvudine Amubarvimab/r.. 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 50+ 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 119 treatments.
$0 $1,000 $2,000+ -20+% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments Donidalorsen -151% Glenzocimab -60% Olokizumab -50% PPIs -46% BMS mAbs -36% Acetaminophen -28% Lufotrelvir -22% CBD -21% Trimodulin Plitidepsin Losartan Sargramostim Vit. B9 C. Plasma Remdesivir Sarilumab Acebilustat Ibuprofen PPE Aspirin Molnupiravir mutagenic/teratogenic Paxlovid Favipiravir Famotidine Vitamin C Sotrovimab Azvudine Amubarvimab/r.. 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 of50+ host/viral proteins/factors.0.5% of 8,000+ treatments showefficacy. Protocols combinetreatments. c19early analyzes5,500+ studies for 119 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 Nigeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela 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 Syria 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 Nigeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Egypt Bolivia Taiwan Zambia Fiji Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia CAR 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.
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
Colchicine
43
28%
  $26
Ivermectin
53
47%
  $26
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
24
28%
  $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
Paxlovid
40
23%
  $881,260
Remdesivir
66
1%
  $1,558,440
Molnupiravir
27
13%
  $2,400,867
Conv. Plasma
53
-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 27% [18-36%] 56 $1 33,066 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 Amubarv../r.. 25% [-70-66%] 4 $1,380 1,568 intravenous Azvudine 24% [14-33%] 33 $25 41,243 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 14% [10-17%] 79 $1,390 167,925 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%] 55 $5,000 31,327 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 Plitidepsin -16% [-356-71%] 2 $2,000 163 intravenous Trimodulin -17% [-116-37%] 1 $2,000 166 intravenous Cannabidiol -21% [-97-25%] 9 $25 17,978 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 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 27% 56 Ibuzatrelvir 27% 1 very limited data Andrographol.. 27% 7 Vilobelimab 26% 1 intravenous N-acetylcys.. 25% 24 Amubarv../r.. 25% 4 intravenous Azvudine 24% 33 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 14% 79 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% 55 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 Plitidepsin -16% 2 intravenous Trimodulin -17% 1 intravenous Cannabidiol -21% 9 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 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.
Baazim
In Vitro and animal study showing that inhibiting Fatty Acid-Binding Protein 4 (FABP4) reduces SARS-CoV-2 infection, viral replication, and lung..
Meng
In Vitro and mouse study showing that covalently engineered ACE2 nanovesicle spray (nanoSpray) effectively neutralizes SARS-CoV-2 wild-type and..
Drysdale
629,172 patients early treatment: 4% lower PASC (p=0.002)
Vukovikj
Review of SARS-CoV-2 variant mutations and their impact on susceptibility to monoclonal antibodies and antivirals. Mutations in the ORF1ab region..
Hawryłkowicz
366 patients: 77% lower hospitalization (p=0.001)
Brandão
Analysis of 2,065 Brazilian adults participating in the CUME study showing that higher intake of vitamin C, vitamin D, zinc, white meat, and..
Gayozo
In Silico study showing that ivermectin, the SARS-CoV-2 nucleocapsid (N) protein, and the ORF6 protein share binding sites on human importin α..
Vukovikj
Review of SARS-CoV-2 variant mutations and their impact on susceptibility to monoclonal antibodies and antivirals. Mutations in the ORF1ab region..
Vukovikj
Review of SARS-CoV-2 variant mutations and their impact on susceptibility to monoclonal antibodies and antivirals. Mutations in the ORF1ab region..
Vukovikj
Review of SARS-CoV-2 variant mutations and their impact on susceptibility to monoclonal antibodies and antivirals. Mutations in the ORF1ab region..
Vukovikj
Review of SARS-CoV-2 variant mutations and their impact on susceptibility to monoclonal antibodies and antivirals. Mutations in the ORF1ab region..
Vukovikj
Review of SARS-CoV-2 variant mutations and their impact on susceptibility to monoclonal antibodies and antivirals. Mutations in the ORF1ab region..
Brandão
2,065 patients prophylaxis: 34% lower PASC (p=0.01)
Brandão
2,065 patients prophylaxis: 19% lower PASC (p=0.04)
Brandão
2,065 patients prophylaxis: 22% lower PASC (p=0.01)
Recent studies (see the individual treatment pages for all studies):

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..
Mar 21
Geçkalan et al., Journal of Health Sciences and Medicine, doi:10.32322/jhsm.1625339 Can hydroxychloroquine and azithromycin combination cause cardiac rhythm disturbances in children with COVID-19 pneumonia?
Retrospective 24 pediatric COVID-19 pneumonia patients showing no cardiac rhythm disturbances or QTc prolongation with hydroxychloroquine and azithromycin combination therapy.
Mar 18
Iriyama et al., PNAS Nexus, doi:10.1093/pnasnexus/pgaf085 Clinical and molecular landscape of prolonged SARS-CoV-2 infection with resistance to remdesivir in immunocompromised patients
Clinical and virological study of 3 immunocompromised B-cell lymphoma patients with prolonged SARS-CoV-2 infection showing development of remdesivir and sotrovimab resistance. Through serial viral genome sequencing, authors identified NSP..
Mar 17
Offord et al., JACC: Case Reports, doi:10.1016/j.jaccas.2025.103238 Complete Heart Block Triggered by Nirmatrelvir-Ritonavir and Verapamil
Case report of a 58-year-old woman who developed complete heart block and shock due to a drug-drug interaction between paxlovid and verapamil, exacerbated by acute kidney injury and liver dysfunction. This case highlights potentially leth..
Mar 15
Zou et al., BMC Pulmonary Medicine, doi:10.1186/s12890-025-03524-0 Risk prediction and early intervention strategies for persistent SARS-CoV-2 infection in patients with non-Hodgkin lymphoma: a retrospective cohort study
5% worse viral clearance (p=0.83). Retrospective 660 patients with non-Hodgkin lymphoma (NHL) and SARS-CoV-2 infection, identifying risk factors for persistent COVID-19. There was no significant difference in persistent SARS-CoV-2 infection with paxlovid, molnupiravir, or ..
Mar 14
Brandão et al., Frontiers in Nutrition, doi:10.3389/fnut.2025.1549747 Vaccination and food consumption: association with Post-Acute COVID-19 Syndrome in Brazilian adults (CUME Study)
Analysis of 2,065 Brazilian adults participating in the CUME study showing that higher intake of vitamin C, vitamin D, zinc, white meat, and vegetables were associated with lower risk of long COVID.
Mar 14
Moustafa et al., Pharmaceuticals, doi:10.3390/ph18030412 Evaluating the Use of Inhaled Budesonide and Ipratropium Bromide Combination in Patients at High Risk of Acute Respiratory Distress Syndrome Development: A Randomized Controlled Trial
Non-COVID-19 RCT with 119 hospitalized patients at high risk of acute respiratory distress syndrome (ARDS) showing significantly lower rates of ARDS and mechanical ventilation with inhaled budesonide + ipratropium bromide treatment.
Mar 13
İdikut et al., Journal of Clinical Medicine, doi:10.3390/jcm14061931 Association of Endothelial Nitric Oxide Synthase Polymorphisms with Clinical Severity in Patients with COVID-19
Retrospective 178 COVID-19 patients examining the association between NOS3 genetic polymorphisms (G894T and 27-bp VNTR 4b/a) and disease severity. Overall, no statistically significant associations were found between NOS3 genotypes and CO..
Mar 13
Ribeiro et al., Infectious Disease Reports, doi:10.3390/idr17020025 Unhealthy Food Consumption Is Associated with Post-Acute Sequelae of COVID-19 in Brazilian Elderly People
Cross-sectional study of 1,322 elderly adults in Brazil showing associations between food consumption patterns and post-acute sequelae of COVID-19 (PASC). Fruit consumption was associated with a lower risk of PASC, while consumption of..
Mar 13
Vukovikj et al., Eurosurveillance, doi:10.2807/1560-7917.ES.2025.30.10.2400252 Impact of SARS-CoV-2 variant mutations on susceptibility to monoclonal antibodies and antiviral drugs: a non-systematic review, April 2022 to October 2024
Review of SARS-CoV-2 variant mutations and their impact on susceptibility to monoclonal antibodies and antivirals. Mutations in the ORF1ab region led to decreased susceptibility to paxlovid, while nsp12 mutations reduced efficacy for remd..
Mar 13
Gayozo et al., Biotecnia, doi:10.18633/biotecnia.v27.2485 Binding affinities analysis of ivermectin, nucleocapsid and ORF6 proteins of SARS-CoV-2 to human importins α isoforms: A computational approach
In Silico study showing that ivermectin, the SARS-CoV-2 nucleocapsid (N) protein, and the ORF6 protein share binding sites on human importin α isoforms. Authors used molecular docking to analyze binding affinities between these molecules ..
Mar 12
Alqahtani et al., Journal of Clinical Medicine, doi:10.3390/jcm14061915 Outcomes of COVID-19 During the First Wave in Saudi Arabia: An Observational Study of ICU Cases from a Single Hospital
134% higher mortality (p=0.03). Retrospective 185 COVID-19 ICU patients in Saudi Arabia showing higher mortality with HCQ in unadjusted results, and no significant difference with azithromycin.
Mar 11
Al Krad et al., bioRxiv, doi:10.1101/2025.03.09.642200 The protease inhibitor Nirmatrelvir synergizes with inhibitors of GRP78 to suppress SARS-CoV-2 replication
In Vitro and animal study showing strong synergistic effects when combining nirmatrelvir with GRP78 inhibitors.
Mar 11
Pacnejer et al., Journal of Clinical Medicine, doi:10.3390/jcm14061886 Comparative Analysis of Neuropsychiatric Adverse Reactions Associated with Remdesivir and Nirmatrelvir/Ritonavir in COVID-19 Treatment: Insights from EudraVigilance Data
Pharmacovigilance analysis of 8,078 paxlovid 3,934 remdesivir case safety reports from the EudraVigilance database, showing paxlovid associated with significantly higher incidence of neuropsychiatric adverse drug reactions. Paxlovid repor..
Mar 10
Wang et al., BMC Infectious Diseases, doi:10.1186/s12879-025-10684-1 Development and validation of a nomogram to assess the occurrence of liver dysfunction in patients with COVID-19 pneumonia in the ICU
40% worse results (p<0.0001). Retrospective 286 critically ill COVID-19 ICU patients developing a predictive model for liver dysfunction, showing significantly higher risk with azvudine and paxlovid use.
Mar 8
Ponphaiboon et al., Pharmaceutics, doi:10.3390/pharmaceutics17030349 In Vitro Development of Local Antiviral Formulations with Potent Virucidal Activity Against SARS-CoV-2 and Influenza Viruses
In Vitro study showing potent virucidal activity of D-limonene (DLM), monolaurin (ML), and cetylpyridinium chloride (CPC) formulations against SARS-CoV-2 and influenza viruses. Authors developed two optimized formulations: an oral formula..
Mar 7
Lumlertgul et al., Intensive Care Medicine Experimental, doi:10.1186/s40635-025-00739-7 The effects of urine alkalinization on kidney function in critically ill patients with COVID-19: a proof-of-concept randomized clinical trial
67% lower mortality (p=0.57) and 40% improvement (p=0.62). Early terminated RCT 16 critically ill COVID-19 patients showing no significant difference in AKI development or mortality with alkalinization using intravenous sodium bicarbonate. The intervention group achieved higher urine pH (75% vs 3..
Mar 5
Domènech-Montoliu et al., MDPI AG, doi:10.20944/preprints202503.0299.v1 Vitamin D Status and Incidence of SARS-CoV-2 Reinfections in the Borriana COVID-19 Cohort: A Population-Based Prospective Cohort Study
38% fewer cases (p=0.02). Prospective cohort study of 378 confirmed SARS-CoV-2 cases in Spain showing increased risk of SARS-CoV-2 reinfection with insufficient vitamin D status.
Mar 4
Kafeshani et al., Journal of Health System Research, doi:10.48305/jhsr.v21i1.1579 Investigating the Relationship between Food Intake and Severity of COVID-19 Disease: A Cross-Sectional Study
Cross-sectional study of 3,018 hospitalized (moderate and severe) and 717 outpatient (mild) COVID-19 patients showing differences in nutritional intake associated with disease severity. Patients requiring hospitalization had significantly..
Mar 4
He et al., Frontiers of Medicine, doi:10.1007/s11684-025-1123-9 Low dose of hydroxychloroquine is associated with reduced COVID-19 mortality: a multicenter study in China
66% lower mortality (p<0.0001), 25% lower ventilation (p=0.05), 41% lower progression (p=0.21), and 31% improvement (p=0.005). PSM retrospective 53,030 hospitalized patients in China showing low dose HCQ treatment associated with significantly lower all-cause mortality, mechanical ventilation, acute heart injury, and acute kidney injury, with benefits consistent ..
Mar 4
Granvik et al., medRxiv, doi:10.1101/2025.02.28.25323075 Identifying DNA Methylation Patterns in Post COVID-19 Condition: Insights from a One-Year Prospective Cohort Study
Prospective cohort study with 22 Post COVID-19 condition (PCC+) patients and 22 matched COVID-19 convalescents (PCC-), showing distinct DNA methylation patterns diminishing over time. The study identified TXNRD1 methylation changes associ..
Mar 3
Mirzababaei et al., Frontiers in Nutrition, doi:10.3389/fnut.2025.1542449 The association between nutrient patterns and hospital stay duration and symptoms in COVID-19 in Iranian patients: cross-sectional study
Cross-sectional study of 95 hospitalized COVID-19 patients showing poor nutrient patterns associated with longer hospitalization, reduced appetite, and increased likelihood of headaches, fever, and respiratory distress syndrome.
Mar 3
Seifi Skishahr et al., Jentashapir Journal of Cellular and Molecular Biology, doi:10.5812/jjcmb-159606 Evaluation of Glutathione Redox Status and Inflammatory Markers in ICU Patients with Acute Respiratory Syndrome due to COVID-19
Rerospective 16 COVID-19 ICU patients and 16 healthy controls, showing significantly lower vitamin D levels in COVID-19 patients.
Mar 3
He et al., BMC Infectious Diseases, doi:10.1186/s12879-025-10666-3 Prognostic factors in hospitalized patients with COVID-19 pneumonia and effectiveness of prophylactic anticoagulant therapy: a single-center retrospective study
48% higher mortality (p<0.0001). Retrospective 2,520 hospitalized COVID-19 pneumonia patients focusing on prophylactic anticoagulation but also reporting results for azvudine and paxlovid.
Mar 3
Brouqui et al., Center for Open Science, doi:10.31219/osf.io/tc8hk_v2 Expression of concern regarding the notice of retraction of the article "Hydroxychloroquine and azithromycin as a treatment for COVID-19: results from an open-label, non-randomized clinical trial.
Response to the retraction of $[refi('gautretjaa')}. Authors note the study followed proper protocols and that concerns about patient enrollment timing, control group selection, and PCR interpretation methods do not justify retraction. Au..
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 5,522 studies, 2,610 present results comparing with a control group, 2,395 are treatment studies, and 215 analyze outcomes based on serum levels. There are 103 animal studies, 200 in silico studies, 377 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. FLCCC and WCH provide treatment protocols.
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