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COVID-19 early treatment: real-time analysis of 3,339 studies

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Analysis of 56 COVID early treatments, approvals in 102 countries, database of 5,680 treatments  
Recently added (more..)  HCQ  Paxlovid  Curcumin  Vitamin D  Metformin
Meeus
3,885 patients HCQ late treatment: 36% lower mortality (p=0.005)
Dormuth
6,866 patients paxlovid early treatment: 29% lower combined mortality/hospitalization (p=0.02) and 8% lower progression (p=0.37)
Septisetyani
In Vitro study showing that curcumin inhibits SARS-CoV-2 pseudovirus cell entry and syncytia formation at 1-10μM in cells overexpressing ACE2 and..
Bogomaz
70 patients vitamin D sufficiency: 70% lower mortality (p=0.24), 75% lower ventilation (p=0.23), 62% lower progression (p=0.3), and 27% lower need for oxygen therapy (p=0.24)
Farah
1,039 patients metformin prophylaxis: 3% more cases (p=0.87)
Evolution of COVID-19 clinical evidence Povidone-Iodine p=0.000000037 early treatment Acetaminophen p=0.0000018 2020 2021 2022 2023 Effective Harmful c19early.org October 2023 meta analysis results (pooled effects) 100% 50% 0% -50%
Cost per life saved from NNT in
studies to date c19early.org Oct 2023
Melatonin
9
48%
  $8
Vitamin D
66
36%
  $10
Vitamin C
38
20%
  $14
Zinc
20
29%
  $16
Ivermectin
51
49%
  $24
HCQ
246
24%
  $27
Alkalinization
5
42%
  $28
Vitamin A
6
42%
  $30
Colchicine
39
33%
  $31
Aspirin
59
11%
  $41
Curcumin
8
63%
  $59
Probiotics
8
61%
  $99
Famotidine
19
18%
  $104
Quercetin
5
61%
  $127
Metformin
55
32%
  $163
Antiandrogens
33
38%
  $175
Nigella Sativa
4
73%
  $279
Fluvoxamine
8
41%
  $411
Nitazoxanide
6
42%
  $680
Favipiravir
36
14%
  $1,258
Paxlovid
18
45%
  $46,111
Molnupiravir
15
23%
  $137,653
Casirivimab/i..
8
40%
  $181,694
Bamlaniv../e..
11
59%
  $269,237
Sotrovimab
10
49%
  $352,800
Remdesivir
51
11%
  $549,014
Bebtelovimab
4
60%
  $737,601
Tixagev../c..
6
36%
  $14,894,456
Conv. Plasma
41
-0%
N/A
Acetaminophen
14
-24%
N/A
Treatment cost times median NNT - details and limitations. 0.7% of treatments show efficacy.
Evusheld Paxlovid Alkalinization Phthalocyanine Fluvoxamine Famotidine Molnupiravir Quercetin Bamlanivimab/e.. Hydrogen Peroxide Budesonide Aspirin Probiotics Casirivimab/i.. Curcumin Povidone-Iodine Nigella Sativa Melatonin Acetaminophen ↑risk Vitamin D Vitamin C Colchicine Antiandrogens Ivermectin Metformin Zinc HCQ 2020 2021 2022 2023 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org Oct 2023 Time when COVID-19 studies showed efficacy
Evusheld Paxlovid Alkalinization Phthalocyanine Fluvoxamine Famotidine Molnupiravir Quercetin Bamlanivimab/e.. Hydrogen Peroxide Budesonide Aspirin Probiotics Casirivimab/i.. Curcumin Povidone-Iodine Nigella Sativa Melatonin Acetaminophen ↑risk Vitamin D Vitamin C Colchicine Antiandrogens Ivermectin Metformin Zinc HCQ 2020 2021 2022 2023 Pooled outcomes Specific outcome RCT pooled RCT specific Statistically significant ≥10% improvement ≥3 studies c19early.org Oct 2023 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations. 0.7% of treatments show efficacy.
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All clinical results for selected treatments. 0.7% of treatments show efficacy.
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% [22-95%] 1 $1 394 very limited data Cost Studies Patients Improvement Relative Risk Proxalutamide 78% [70-83%] 4 $500 1,953 limited data Indomethacin 74% [-20-94%] 4 $5 605 limited data Ivermectin 62% [54-68%] 99 $1 137,255 Casirivimab/i.. 52% [34-65%] 27 $2,100 58,886 variant dependent Bamlaniv../e.. 50% [27-66%] 17 $1,250 31,839 variant dependent Povidone-Iod.. 50% [37-61%] 20 $1 3,226 Diet 50% [41-58%] 27 $0 688,039 Quercetin 49% [21-68%] 11 $5 1,436 Nigella Sativa 49% [27-64%] 12 $5 3,132 Ensovibep 46% [-173-89%] 2 $2,100 885 limited data Sunlight 45% [19-62%] 4 $0 19,635 Tixagev../c.. 44% [24-58%] 12 $855 27,448 variant dependent Adintrevimab 43% [-169-88%] 2 $5,000 2,483 intramuscular Melatonin 43% [30-54%] 18 $1 14,301 Bromhexine 43% [-5-69%] 7 $5 875 very limited data Alkalinization 43% [24-57%] 8 $1 1,148 Curcumin 42% [30-52%] 26 $5 14,736 Exercise 40% [34-46%] 61 $0 1,801,085 Vitamin A 38% [4-60%] 13 $2 22,277 Phthalocyanine 38% [20-51%] 4 $5 5,245 Fluvoxamine 38% [20-51%] 19 $4 37,033 Hydrogen Per.. 38% [4-59%] 7 $1 835 limited data Selenium 36% [-59-74%] 3 $1 21,330 limited data Vitamin D 36% [30-41%] 116 $1 184,103 Spironolactone 36% [17-51%] 11 $5 28,019 Bebtelovimab 34% [-24-65%] 6 $1,200 13,329 intravenous Nitazoxanide 33% [-22-63%] 13 $4 3,606 Sleep 31% [22-40%] 13 $0 354,908 Colchicine 30% [20-39%] 49 $1 32,401 Budesonide 30% [16-42%] 12 $4 27,682 Antiandrogens 30% [21-38%] 49 $5 119,838 Zinc 29% [18-38%] 43 $1 55,200 Paxlovid 28% [20-36%] 38 $529 79,907 independent trials refused Metformin 28% [24-32%] 76 $10 263,496 Ensitrelvir 26% [-14-52%] 3 $500 1,450 very limited data Hydroxychlor.. 26% [22-29%] 411 $1 527,764 Sotrovimab 26% [9-40%] 21 $2,100 42,808 variant dependent Nitric Oxide 26% [-12-50%] 10 $11 2,008 Probiotics 25% [15-34%] 23 $5 18,214 Lactoferrin 22% [-33-54%] 7 $5 1,369 Vitamin C 21% [14-28%] 64 $1 72,629 N-acetylcys.. 21% [11-30%] 22 $1 25,933 Favipiravir 18% [8-27%] 66 $20 30,456 worse w/longer followup Famotidine 16% [5-26%] 28 $5 114,060 Molnupiravir 15% [-2-29%] 34 $707 109,506 mutagenic/teratogenic Aspirin 11% [6-17%] 69 $1 185,894 Remdesivir 10% [3-16%] 60 $3,120 156,800 worse w/longer followup Peg.. Lambda 7% [-138-63%] 4 $500 2,143 subcutaneous Ibuprofen 0% [-9-9%] 13 $1 54,707 Conv. Plasma -1% [-5-4%] 42 $5,000 24,249 intravenous Vitamin B9 -10% [-49-19%] 10 $1 44,354 Cannabidiol -19% [-128-38%] 7 $25 16,883 Acetaminoph.. -28% [-41--16%] 24 $1 542,361 All studies (pooled effects, all stages) c19early.org Oct 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% 99 Casirivimab/.. 52% 27 variant dependent Bamlaniv../e.. 50% 17 variant dependent Povidone-Iod.. 50% 20 Diet 50% 27 Quercetin 49% 11 Nigella Sativa 49% 12 Ensovibep 46% 2 limited data Sunlight 45% 4 Tixagev../c.. 44% 12 variant dependent Adintrevimab 43% 2 intramuscular Melatonin 43% 18 Bromhexine 43% 7 very limited data Alkalinization 43% 8 Curcumin 42% 26 Exercise 40% 61 Vitamin A 38% 13 Phthalocyanine 38% 4 Fluvoxamine 38% 19 Hydrogen Per.. 38% 7 limited data Selenium 36% 3 limited data Vitamin D 36% 116 Spironolactone 36% 11 Bebtelovimab 34% 6 intravenous Nitazoxanide 33% 13 Sleep 31% 13 Colchicine 30% 49 Budesonide 30% 12 Antiandrogens 30% 49 Zinc 29% 43 Paxlovid 28% 38 independent trials refused Metformin 28% 76 Ensitrelvir 26% 3 very limited data Hydroxychlor.. 26% 411 Sotrovimab 26% 21 variant dependent Nitric Oxide 26% 10 Probiotics 25% 23 Lactoferrin 22% 7 Vitamin C 21% 64 N-acetylcys.. 21% 22 Favipiravir 18% 66 worse w/longer followup Famotidine 16% 28 Molnupiravir 15% 34 mutagenic/teratogenic Aspirin 11% 69 Remdesivir 10% 60 worse w/longer followup Peg.. Lambda 7% 4 subcutaneous Ibuprofen 0% 13 Conv. Plasma -1% 42 intravenous Vitamin B9 -10% 10 Cannabidiol -19% 7 Acetaminoph.. -28% 24 All studies (pooled effects, all stages) c19early.org Oct 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. 0.7% 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. 0.7% 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. 0.7% 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. 0.7% 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. 0.7% 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. 0.7% 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 - 39 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%
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 237,521 HospitalizationHosp. 94.1% MortalityDeath 94.7%
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)
PXProxalutamide 71% 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(H)CQHydroxychlor.. 62% 38
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IVMIvermectin 62% 37
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
V.DVitamin D 60% 11
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
BLBamlaniv../e.. 59% 11
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
BUBudesonide 49% 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CICasirivimab/i.. 47% 21
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FVFluvoxamine 42% 10
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
RDRemdesivir 41% 7
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ZnZinc 41% 6
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
V.CVitamin C 37% 6
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PLPaxlovid 32% 33
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SSotrovimab 29% 19
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NACN-acetylcys.. 21% 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FPVFavipiravir 20% 19
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MPMolnupiravir 16% 29
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ACEAcetaminophen -17% 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TCTixagev../c.. -29% 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IBIbuprofen -52% 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Early treatments approved by >2 countries. 102 countries have officially approved treatments. Details.
HCQ
Meeus
3,885 patients late treatment: 36% lower mortality (p=0.005)
Burhan
559 patients ICU: 1% higher mortality (p=0.91)
Paxlovid
Dormuth
6,866 patients early treatment: 29% lower combined mortality/hospitalization (p=0.02) and 8% lower progression (p=0.37)
Curcumin
Septisetyani
In Vitro study showing that curcumin inhibits SARS-CoV-2 pseudovirus cell entry and syncytia formation at 1-10μM in cells overexpressing ACE2 and..
Vitamin D
Bogomaz
70 patients sufficiency: 70% lower mortality (p=0.24), 75% lower ventilation (p=0.23), 62% lower progression (p=0.3), and 27% lower need for oxygen therapy (p=0.24)
Sanecka
Prospective study of 171 hospitalized COVID-19 patients in Ireland, showing significantly lower mortality and ICU admission with sufficient vitamin..
Qiu
Retrospective 399 hospitalized patients in China, showing that lower vitamin D levels and higher IL-5 levels were independent risk factors for COVID..
Metformin
Farah
1,039 patients prophylaxis: 3% more cases (p=0.87)
Petrelli
Meta analysis: 31% lower mortality (p<0.0001) and 20% lower severe cases (p=0.03)
Quercetin
Ziaei
Systematic review and meta analysis of 5 studies, showing significantly lower mortality, ICU admission, and hospitalization with quercetin treatment.
Remdesivir
Burhan
559 patients ICU: 15% higher mortality (p=0.23)
Hagman
318 patients late treatment: no change in mortality (p=0.97), 40% higher progression (p=0.31), and 29% improved viral clearance (p=0.11)
Molnupiravir
Marikawa
Analysis of molnupiravir active metabolite N4-hydroxycytidine's effects on mouse preimplantation embryos in vitro, showing embryotoxicity at..
Sanderson
Identification of SARS-CoV-2 variants created by molnupiravir treatment, including cases of onwards transmission. Authors find a class of long..
Lactoferrin
Alves
In Vitro study showing that iron-free and iron-saturated bovine lactoferrin inhibited SARS-CoV-2 ancestral and omicron Vero cell infection...
Selenium
Yuan
Review of cell death pathways in SARS-CoV-2 infection. Authors note that studies show lower selenium levels are associated with higher COVID-19..
N-acetylcysteine
Yuan
Review of cell death pathways in SARS-CoV-2 infection. Authors note that N-acetylcysteine (NAC) is a precursor to glutathione that may inhibit..
Vitamin C
Albóniga
Plasma metabolomic analysis showing significantly lower threonic acid levels for severe and mild COVID-19 cases compared with moderate cases...
Ivermectin
Liu
In Vitro study showing that ivermectin and meclizine mitigated cardiac cell death and dysfunction caused by SARS-CoV-2 viral genes. Authors found..
Fluvoxamine
Naggie
Late treatment low risk population RCT showing lower progression to hospitalization or urgent care/ER visits with fluvoxamine, without statistical..
Exercise
Graydon
Analysis of 88 COVID+ patients in the USA showing that a higher frequency of natural killer (NK) cells was associated with asymptomatic infection...
Recent studies (see the individual treatment pages for all studies):
Oct 2
 Dormuth et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2023.36678 Nirmatrelvir-Ritonavir and COVID-19 Mortality and Hospitalization Among Patients With Vulnerability to COVID-19 Complications
29% lower combined mortality/hospitalization (p=0.02) and 8% lower progression (p=0.37). Retrospective 3,433 high-risk patients and matched controls in Canada showing lower mortality with paxlovid use. Patients were divided into four groups based on risk, with improved results as risk increased. Authors did not exclude all..
Sep 30
 Meeus et al., New Microbes and New Infections, doi:10.1016/j.nmni.2023.101172 Efficacy and safety of in-hospital treatment of Covid-19 infection with low-dose hydroxychloroquine and azithromycin in hospitalized patients: A retrospective controlled cohort study
36% lower mortality (p=0.005). Retrospective 3,885 hospitalized COVID-19 patients in Belgium, 352 treated with one or more doses of HCQ, showing significantly lower mortality with HCQ treatment. Most patients also received AZ. Adjusted results are only provided for all..
Sep 29
 Septisetyani et al., bioRxiv, doi:10.1101/2023.09.28.560070 Curcumin and turmeric extract inhibited SARS-CoV-2 pseudovirus cell entry and Spike mediated cell fusion
In Vitro study showing that curcumin inhibits SARS-CoV-2 pseudovirus cell entry and syncytia formation at 1-10μM in cells overexpressing ACE2 and TMPRSS2. Authors find that both curcumin and turmeric extract are potential inhibitors of SA..
Sep 26
 Hagman et al., Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkad295 Effects of remdesivir on SARS-CoV-2 viral dynamics and mortality in viraemic patients hospitalized for COVID-19
no change in mortality (p=0.97), 40% higher progression (p=0.31), and 29% improved viral clearance (p=0.11). Retrospective 318 hospitalized COVID-19 patients in Sweden, showing improvements in viral clearance but no improvement for mortality with remdesivir treatment.
Sep 26
 Ziaei et al., Food Science & Nutrition, doi:10.1002/fsn3.3715 The effect of quercetin supplementation on clinical outcomes in COVID‐19 patients: A systematic review and meta‐analysis
Systematic review and meta analysis of 5 studies, showing significantly lower mortality, ICU admission, and hospitalization with quercetin treatment.
Sep 25
 Burhan et al., PLOS ONE, doi:10.1371/journal.pone.0290964 Characteristics and outcomes of patients with severe COVID-19 in Indonesia: Lessons from the first wave
1% higher mortality (p=0.91). Retrospective 559 COVID-19 ICU patients in Indonesia, showing no difference in mortality with HCQ in unadjusted results.
Sep 25
 Sanderson et al., Nature, doi:10.1038/s41586-023-06649-6 A molnupiravir-associated mutational signature in global SARS-CoV-2 genomes
Identification of SARS-CoV-2 variants created by molnupiravir treatment, including cases of onwards transmission. Authors find a class of long phylogenetic branches almost exclusively matching the time period, location, and age groups of ..
Sep 25
 Alves et al., Pharmaceuticals, doi:10.3390/ph16101352 Inhibition of SARS-CoV-2 Infection in Vero Cells by Bovine Lactoferrin under Different Iron-Saturation States
In Vitro study showing that iron-free and iron-saturated bovine lactoferrin inhibited SARS-CoV-2 ancestral and omicron Vero cell infection. Treatment before or during infection was effective, while treatment after infection showed no sign..
Sep 23
 Marikawa et al., Reproductive Toxicology, doi:10.1016/j.reprotox.2023.108475 An active metabolite of the anti-COVID-19 drug molnupiravir impairs mouse preimplantation embryos at clinically relevant concentrations
Analysis of molnupiravir active metabolite N4-hydroxycytidine's effects on mouse preimplantation embryos in vitro, showing embryotoxicity at clinically relevant concentrations. The researchers found that N4-hydroxycytidine impaired blasto..
Sep 22
 Seely et al., BMJ Open, doi:10.1136/bmjopen-2023-073761 Dietary supplements to reduce symptom severity and duration in people with SARS-CoV-2: a double-blind randomised controlled trial
14% improved recovery (p=0.41). Early terminated low-risk population (no hospitalization) very late treatment (mean 8 days) RCT with 44 patients treated with vitamin C, D, K, and zinc, and 46 control patients, showing no significant differences. Authors acknowledge that..
Sep 22
 Taha et al., Advances in Medical Sciences, doi:10.1016/j.advms.2023.09.007 Safety and efficacy of melatonin as an adjuvant therapy in COVID-19 patients: Systematic review and meta-analysis
Systematic review and meta analysis of 11 COVID-19 studies showing significantly higher clinical improvement and shorter hospitalization and mechanical ventilation time with melatonin treatment.
Sep 21
 Kobayashi-Sakamoto et al., International Dairy Journal, doi:10.1016/j.idairyj.2023.105805 Bovine lactoferrin suppresses the cathepsin-dependent pathway of SARS-CoV-2 entry in vitro
In Vitro study showing variant dependent inhibition of SARS-CoV-2 with bovine lactoferrin (bLF). Authors found that bLF did not suppress entry of wild-type pseudoviruses into cells that express both ACE2 and TMPRSS2, but did suppress entr..
Sep 20
 Farah et al., Journal of International Medical Research, doi:10.1177/03000605231198413 Prevalence and risk factors of COVID-19 infection, mortality, and post-infection lung fibrosis in patients with type 2 diabetes: a cross-sectional study
3% more cases (p=0.87). Retrospective 1,039 diabetes patients in Jordan, showing no significant difference in COVID-19 cases with metformin use in unadjusted results. Severity outcomes are not provided for metformin.
Sep 20
 Yuan et al., Signal Transduction and Targeted Therapy, doi:10.1038/s41392-023-01580-8 The role of cell death in SARS-CoV-2 infection
Review of cell death pathways in SARS-CoV-2 infection. Authors note that studies show lower selenium levels are associated with higher COVID-19 mortality. Through preserving glutathione peroxidase 4 activity and countering oxidative stres..
Sep 19
 Thapa et al., Makara Journal of Science, doi:10.7454/mss.v27i3.1609 In-silico Approach for Predicting the Inhibitory Effect of Home Remedies on Severe Acute Respiratory Syndrome Coronavirus-2
In Silico analysis showing that curcumin and quercetin may be beneficial for COVID-19 by binding to the main protease (Mpro), spike protein, and ACE2 receptor. Both compounds had suitable ADME properties and minimal predicted toxicity.
Sep 13
 Liu et al., Stem Cell Research & Therapy, doi:10.1186/s13287-023-03485-3 SARS-CoV-2 viral genes Nsp6, Nsp8, and M compromise cellular ATP levels to impair survival and function of human pluripotent stem cell-derived cardiomyocytes
In Vitro study showing that ivermectin and meclizine mitigated cardiac cell death and dysfunction caused by SARS-CoV-2 viral genes. Authors found that SARS-CoV-2 viral genes Nsp6, Nsp8, and M had harmful effects on human cardiomyocytes (h..
Sep 13
 Albóniga et al., Scientific Reports, doi:10.1038/s41598-023-40999-5 Differential abundance of lipids and metabolites related to SARS-CoV-2 infection and susceptibility
Plasma metabolomic analysis showing significantly lower threonic acid levels for severe and mild COVID-19 cases compared with moderate cases. Threonic acid is a metabolite of vitamin C. The expected relationship in non-linear and depends ..
Sep 13
 Naggie et al., medRxiv, doi:10.1101/2023.09.12.23295424 Effect of Higher-Dose Fluvoxamine vs Placebo on Time to Sustained Recovery in Outpatients with Mild to Moderate COVID-19: A Randomized Clinical Trial
Late treatment low risk population RCT showing lower progression to hospitalization or urgent care/ER visits with fluvoxamine, without statistical significance. There was no mortality and only three hospitalizations. Authors provide no de..
Sep 13
 Qiu et al., Virology Journal, doi:10.1186/s12985-023-02165-1 Vitamin D status in hospitalized COVID‑19 patients is associated with disease severity and IL-5 production
Retrospective 399 hospitalized patients in China, showing that lower vitamin D levels and higher IL-5 levels were independent risk factors for COVID-19 severity.
Sep 8
 Sun et al., Nutrition Reviews, doi:10.1093/nutrit/nuad105 Therapeutic effects of high-dose vitamin C supplementation in patients with COVID-19: a meta-analysis
66% lower progression (p=0.03). Meta analysis of 14 studies showing lower COVID-19 progression with high-dose vitamin C treatment.
Sep 8
 Alpizar et al., Journal of Infection, doi:10.1016/j.jinf.2023.08.016 Molnupiravir for Intra-Household Prevention of COVID-19: the MOVe-AHEAD Randomized, Placebo-Controlled Trial
24% fewer symptomatic cases (p=0.06). PEP RCT 1,527 patients showing lower COVID-19 cases with molnupiravir, without statistical significance.
Sep 6
 Desai et al., Crohn's & Colitis 360, doi:10.1093/crocol/otad047 Tixagevimab and Cilgavimab (Evusheld) as Pre-exposure Prophylaxis for COVID-19 in Patients With Inflammatory Bowel Disease: A Propensity Matched Cohort Study
12% lower hospitalization (p=0.81) and 35% more cases (p=0.18). TriNetX PSM retrospective 408 IBD patients receiving tixagevimab/cilgavimab and matched controls, showing no significant difference in COVID-19 cases or hospitalization.
Sep 5
 Xu et al., Proceedings of the National Academy of Sciences, doi:10.1073/pnas.2309870120 Reply to Yan et al.: Quercetin possesses a fluorescence quenching effect but is a weak inhibitor against SARS-CoV-2 main protease
In Vitro study [Yan] and associated response from the original authors [Xu], collectively showing that quercetin and echinatin had weak SARS-CoV-2 protease inhibition in SDS-PAGE assays [Xu], despite false positive FRET results from MCA-A..
Sep 5
 Yan et al., Proceedings of the National Academy of Sciences, doi:10.1073/pnas.2309289120 Reframing quercetin as a promiscuous inhibitor against SARS-CoV-2 main protease
In Vitro study [Yan] and associated response from the original authors [Xu], collectively showing that quercetin and echinatin had weak SARS-CoV-2 protease inhibition in SDS-PAGE assays [Xu], despite false positive FRET results from MCA-A..
Sep 4
 Zhao et al., Frontiers in Immunology, doi:10.3389/fimmu.2023.1197752 Identification of the shared gene signatures between pulmonary fibrosis and pulmonary hypertension using bioinformatics analysis
In Silico study identifying IGF1 as a shared gene between pulmonary fibrosis and hypertension that promotes inflammation, fibrosis, and cell proliferation when overactivated. Molecular docking analysis demonstrated ivermectin directly bin..
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 3,339 studies, 1,936 present results comparing with a control group, 1,750 are treatment studies, and 186 analyze outcomes based on serum levels. There are 42 animal studies, 85 in silico studies, 171 in vitro studies, 201 reviews, and 144 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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