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c19early.org COVID-19 treatment researchSelect treatment..Select..
Melatonin Meta
Metformin Meta
Azvudine Meta
Bromhexine Meta Molnupiravir Meta
Budesonide Meta
Colchicine Meta
Conv. Plasma Meta Nigella Sativa Meta
Curcumin Meta Nitazoxanide Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

COVID-19 early treatment: real-time analysis of 4,216 studies

Analysis of 72 COVID-19 early treatments, approvals in 105 countries, database of 7,606 treatments  
Yang
Meta analysis of 19 RCTs with 2,435 total participants showing significantly lower ICU admission and mechanical ventilation with vitamin D treatment..
Bessi
In Vitro study showing that NHC, the active form of molnupiravir, can base pair with both G and A in two different tautomeric forms. This ambiguous..
Zhang
Retrospective 440 counties/districts across 7 countries in the Americas, showing solar radiation exhibited an overall negative association with..
Guan
2,621 patients vitamin C prophylaxis: 31% fewer symptomatic cases (p=0.007)
Horby
137 patient paxlovid early treatment RCT: 1% higher mortality (p=1), 35% lower hospital discharge (p=0.33), and 19% improved viral clearance (p<0.0001)
$0 $1,000 $2,000+ -25% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments Acetaminophen Lufotrelvir $2,000+ Cannabidiol Losartan Vitamin B9 Conv. Plasma $5,000 Ibuprofen Remdesivir $3,120 Ambavirumab/r.. Aspirin Molnupiravir mutagenic/teratogenic Favipiravir Famotidine Paxlovid Vitamin C NAC Zinc HCQ Probiotics Sotrovimab $2,100 Colchicine Budesonide Metformin Sleep Antiandro.. Azvudine Bebtelovimab Vitamin A Vitamin D Sunlight H. Peroxide Fluvox. Exercise Curcumin N. Sativa Melatonin Tixagevimab/c.. Ensovibep $2,000+ Bamlanivimab/e.. pH+ Quercetin Casirivimab/i.. $2,100 Diet PVP-I Thermotherapy Ivermectin Regdanvimab $2,100 Lifestyle / free No prescription Prescription required High-cost Lower risk Higher risk c19early.org May 2024 COVID-19 involves the interplay of 50+ host and viral proteinsand other factors, many treatments are known to modulate these.0.6% of 7,000+ proposed treatments show efficacy with ≥3 studies.Protocols combine treatments, none are 100% effective.c19early analyzes over 4,200 studies for 72 treatments.
$0 $1,000 $2,000+ -25% 0% 25% 50% Treatment cost (US$) Efficacy vs. cost for COVID-19 treatments Acetaminophen Lufotrelvir Cannabidiol Losartan Vitamin B9 Conv. Plasma Ibuprofen Remdesivir Ambavirumab/r.. Aspirin Molnupiravir mutagenic/teratogenic Favipiravir Famotidine Paxlovid Vitamin C NAC Zinc HCQ Probiotics Sotrovimab Colchicine Budesonide Metformin Sleep Antiandro.. Azvudine Bebtelovimab Vitamin A Vitamin D Sunlight H. Peroxide Fluvox. Exercise Curcumin N. Sativa Melatonin Tixagevimab/c.. Ensovibep Bamlaniv.. pH+ Quercetin Casirivim.. Diet PVP-I Thermotherapy Ivermectin Regdanvimab Lifestyle / free No prescription Prescription required High-cost Lower risk Higher risk c19early.org May 2024 COVID-19 involves the interplay of 50+ host and viralproteins and other factors, many treatments are knownto modulate these. 0.6% of 7,000+ proposed treatmentsshow efficacy with ≥3 studies. Protocols combinetreatments, none are 100% effective. c19early analyzesover 4,200 studies for 72 treatments.
Azvudine Evusheld Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Famotidine Aspirin Molnupiravir Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide Budesonide Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Melatonin Acetaminophen ↑risk Exercise Vitamin D Antiandrogens Vitamin C 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 May 2024 Time when COVID-19 studies showed efficacy
Azvudine Evusheld Paxlovid Regdanvimab Vitamin B12 Sunlight Phthalocyanine Montelukast Alkalinization Fluvoxamine Famotidine Aspirin Molnupiravir Quercetin Diet Bamlanivimab/e.. Hydrogen Peroxide Budesonide Probiotics Casirivimab/i.. Sleep Curcumin Povidone-Iodine Nigella Sativa Melatonin Acetaminophen ↑risk Exercise Vitamin D Antiandrogens Vitamin C 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 May 2024 Time when COVID-19 studies showed efficacy
Timeline for when studies showed efficacy - details and limitations. 0.6% of treatments show efficacy.
May 2024
c19early.org
Cost per life saved from NNT in
studies to date
Melatonin
9
48%
  $8
Vitamin D
67
36%
  $11
Alkalinization
8
46%
  $11
Zinc
20
29%
  $16
Vitamin C
42
19%
  $17
Ivermectin
51
49%
  $25
Colchicine
42
29%
  $26
HCQ
245
26%
  $27
Aspirin
63
11%
  $33
Vitamin A
5
30%
  $45
Curcumin
8
63%
  $59
Famotidine
21
18%
  $94
Probiotics
8
61%
  $99
Quercetin
5
61%
  $127
Metformin
64
34%
  $144
Antiandrogens
32
37%
  $179
Nigella Sativa
5
57%
  $187
Budesonide
12
26%
  $574
Nitazoxanide
6
42%
  $680
Azvudine
13
34%
  $1,237
Fluvoxamine
9
43%
  $1,283
Favipiravir
38
12%
  $1,717
Tixagev../c..
10
42%
  $74,506
Regdanvimab
7
63%
  $139,860
Paxlovid
29
30%
  $181,887
Casirivimab/i..
9
31%
  $203,958
Molnupiravir
19
20%
  $262,368
Bamlaniv../e..
12
56%
  $269,237
Sotrovimab
10
49%
  $352,800
Bebtelovimab
4
60%
  $737,601
Remdesivir
59
4%
  $1,558,440
Conv. Plasma
45
-1%
N/A
Acetaminophen
14
-24%
N/A
Treatment cost times median NNT - details and limitations. 0.6% of treatments show efficacy.
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All clinical results for selected treatments. 0.6% of treatments show efficacy.
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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% [22-95%] 1 $1 394 very limited data Cost Studies Patients Improvement Relative Risk Chlorhexidine 79% [66-87%] 3 $1 509 limited data Proxalutamide 78% [70-83%] 4 $500 1,953 limited data Indomethacin 74% [-20-94%] 4 $5 605 limited data Cetylpyridin.. 68% [-620-99%] 1 $1 23 very limited data Regdanvimab 63% [51-71%] 11 $2,100 7,430 Ivermectin 61% [53-68%] 103 $1 220,024 Thermotherapy 56% [9-78%] 4 $0 217 very limited data Povidone-Iod.. 51% [38-61%] 21 $1 3,249 Diet 50% [41-58%] 28 $0 693,236 Casirivimab/i.. 49% [31-63%] 28 $2,100 58,965 variant dependent Quercetin 49% [21-68%] 11 $5 1,436 Alkalinization 49% [36-59%] 14 $1 6,383 HH-120 49% [-60-84%] 2 $500 345 very limited data Bamlaniv../e.. 48% [26-63%] 20 $1,250 34,837 variant dependent Bemnifosbuvir 47% [-57-82%] 3 $500 359 very limited data Montelukast 46% [18-65%] 7 $2 2,252 limited data Ensovibep 46% [-173-89%] 2 $2,100 885 limited data Tixagev../c.. 44% [28-57%] 16 $855 29,439 variant dependent 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 Nigella Sativa 43% [24-57%] 14 $5 3,333 Curcumin 42% [30-52%] 26 $5 14,736 Exercise 39% [34-44%] 66 $0 1,936,481 Fluvoxamine 39% [22-53%] 21 $4 38,283 Hydrogen Per.. 38% [5-59%] 7 $1 921 very limited data Phthalocyanine 38% [20-51%] 4 $5 5,245 Xiannuoxin 38% [-46-73%] 2 $106 1,027 very limited data Sunlight 37% [22-50%] 5 $0 19,665 Propolis 37% [-23-68%] 2 $1 270 very limited data Vitamin D 37% [31-42%] 120 $1 195,508 Vitamin A 36% [4-57%] 13 $2 22,237 Selenium 34% [-40-69%] 4 $1 21,452 Bebtelovimab 34% [-24-65%] 6 $1,200 13,329 intravenous Nitazoxanide 33% [-22-63%] 13 $4 3,606 Spironolactone 31% [15-44%] 12 $5 28,019 Azvudine 31% [16-42%] 18 $25 11,834 Antiandrogens 30% [21-38%] 49 $5 120,172 Sleep 30% [22-38%] 15 $0 429,001 Vitamin B12 30% [5-48%] 4 $1 11,407 Metformin 29% [25-33%] 89 $10 274,308 Budesonide 29% [17-39%] 14 $4 27,882 Colchicine 29% [20-37%] 54 $1 32,807 Sotrovimab 29% [12-42%] 22 $2,100 43,988 variant dependent Probiotics 28% [18-37%] 26 $5 19,398 Hydroxychlor.. 28% [24-31%] 416 $1 531,648 Zinc 27% [17-36%] 44 $1 55,200 Andrographol.. 27% [-8-50%] 7 $5 1,245 Nitric Oxide 27% [-8-50%] 11 $11 2,201 Ensitrelvir 26% [-14-52%] 3 $500 1,450 very limited data N-acetylcys.. 25% [14-34%] 24 $1 26,243 Lactoferrin 24% [-24-53%] 8 $5 1,419 Vitamin C 21% [14-27%] 71 $1 88,767 UDCA 17% [5-29%] 13 $15 37,170 Paxlovid 17% [13-21%] 61 $1,390 120,358 independent trials refused Famotidine 17% [8-24%] 30 $5 114,119 Favipiravir 15% [5-24%] 68 $20 30,674 worse w/longer followup Vitamin K 14% [1-26%] 1 $1 7,766 very limited data Molnupiravir 13% [4-22%] 41 $707 137,199 mutagenic/teratogenic Aspirin 12% [6-17%] 73 $1 186,324 Deuremidevir 11% [-1-21%] 2 $112 1,432 very limited data Ambavir../r.. 11% [-154-69%] 3 $2,100 1,531 intravenous Peg.. Lambda 7% [-138-63%] 4 $500 2,143 subcutaneous Remdesivir 2% [-6-9%] 70 $3,120 187,297 worse w/longer followup Ibuprofen 0% [-9-9%] 13 $1 54,707 Conv. Plasma -1% [-5-3%] 46 $5,000 29,830 intravenous Vitamin B9 -11% [-47-15%] 11 $1 54,354 Losartan -15% [-127-42%] 5 $5 665 very limited data Cannabidiol -19% [-128-38%] 7 $25 16,883 Lufotrelvir -22% [-198-50%] 1 $2,000 58 intravenous Acetaminoph.. -28% [-41--17%] 27 $1 543,459 All studies (pooled effects, all stages) c19early.org May 2024 Favors treatment Favors control
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Iota-carragee.. 80% 1 very limited data Studies, Improvement Relative Risk Chlorhexidine 79% 3 limited data Proxalutamide 78% 4 limited data Indomethacin 74% 4 limited data Cetylpyridin.. 68% 1 very limited data Regdanvimab 63% 11 Ivermectin 61% 103 Thermotherapy 56% 4 very limited data Povidone-Iod.. 51% 21 Diet 50% 28 Casirivimab/.. 49% 28 variant dependent Quercetin 49% 11 Alkalinization 49% 14 HH-120 49% 2 very limited data Bamlaniv../e.. 48% 20 variant dependent Bemnifosbuvir 47% 3 very limited data Montelukast 46% 7 limited data Ensovibep 46% 2 limited data Tixagev../c.. 44% 16 variant dependent Adintrevimab 43% 2 intramuscular Melatonin 43% 18 Bromhexine 43% 7 very limited data Nigella Sativa 43% 14 Curcumin 42% 26 Exercise 39% 66 Fluvoxamine 39% 21 Hydrogen Per.. 38% 7 very limited data Phthalocyanine 38% 4 Xiannuoxin 38% 2 very limited data Sunlight 37% 5 Propolis 37% 2 very limited data Vitamin D 37% 120 Vitamin A 36% 13 Selenium 34% 4 Bebtelovimab 34% 6 intravenous Nitazoxanide 33% 13 Spironolactone 31% 12 Azvudine 31% 18 Antiandrogens 30% 49 Sleep 30% 15 Vitamin B12 30% 4 Metformin 29% 89 Budesonide 29% 14 Colchicine 29% 54 Sotrovimab 29% 22 variant dependent Probiotics 28% 26 Hydroxychlor.. 28% 416 Zinc 27% 44 Andrographol.. 27% 7 Nitric Oxide 27% 11 Ensitrelvir 26% 3 very limited data N-acetylcys.. 25% 24 Lactoferrin 24% 8 Vitamin C 21% 71 UDCA 17% 13 Paxlovid 17% 61 independent trials refused Famotidine 17% 30 Favipiravir 15% 68 worse w/longer followup Vitamin K 14% 1 very limited data Molnupiravir 13% 41 mutagenic/teratogenic Aspirin 12% 73 Deuremidevir 11% 2 very limited data Ambavir../r.. 11% 3 intravenous Peg.. Lambda 7% 4 subcutaneous Remdesivir 2% 70 worse w/longer followup Ibuprofen 0% 13 Conv. Plasma -1% 46 intravenous Vitamin B9 -11% 11 Losartan -15% 5 very limited data Cannabidiol -19% 7 Lufotrelvir -22% 1 intravenous Acetaminoph.. -28% 27 All studies (pooled effects, all stages) c19early.org May 2024 Rotate device for details Favors treatment Favors control
Random effects meta-analysis of all studies (pooled effects, all stages). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all stages and outcomes depend on the distribution of stages and outcomes tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage and outcome analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of early treatment studies (pooled effects). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all outcomes are affected by the distribution of outcomes tested, please see detail pages for specific outcome analysis. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of all mortality results (all stages). Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Pooled results across all stages depend on the distribution of stages tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of early treatment mortality results. Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of prophylaxis studies (pooled effects). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all outcomes are affected by the distribution of outcomes tested, please see detail pages for specific outcome analysis. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
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Random effects meta-analysis of prophylaxis mortality results. Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments. 0.6% of proposed treatments show efficacy in clinical studies.
LATE TREATMENT
Physician / TeamLocationPatients HospitalizationHosp. MortalityDeath
Dr. David Uip (*) Brazil 2,200 38.6% (850) Ref. 2.5% (54) Ref.
EARLY TREATMENT - 40 physicians/teams
Physician / TeamLocationPatients HospitalizationHosp. ImprovementImp. MortalityDeath ImprovementImp.
Dr. Roberto Alfonso Accinelli
0/360 deaths for treatment within 3 days
Peru 1,265 0.6% (7) 77.5%
Dr. Mohammed Tarek Alam
patients up to 84 years old
Bangladesh 100 0.0% (0) 100.0%
Dr. Oluwagbenga Alonge Nigeria 310 0.0% (0) 100.0%
Dr. Raja Bhattacharya
up to 88yo, 81% comorbidities
India 148 1.4% (2) 44.9%
Dr. Flavio Cadegiani Brazil 3,450 0.1% (4) 99.7% 0.0% (0) 100.0%
Dr. Alessandro Capucci Italy 350 4.6% (16) 88.2%
Dr. Shankara Chetty South Africa 8,000 0.0% (0) 100.0%
Dr. Deborah Chisholm USA 100 0.0% (0) 100.0%
Dr. Ryan Cole USA 400 0.0% (0) 100.0% 0.0% (0) 100.0%
Dr. Marco Cosentino
vs. 3-3.8% mortality during period; earlier treatment better
Italy 392 6.4% (25) 83.5% 0.3% (1) 89.6%
Dr. Jeff Davis USA 6,000 0.0% (0) 100.0%
Dr. Dhanajay India 500 0.0% (0) 100.0%
Dr. Bryan Tyson & Dr. George Fareed USA 20,000 0.0% (6) 99.9% 0.0% (4) 99.2%
Dr. Raphael Furtado Brazil 170 0.6% (1) 98.5% 0.0% (0) 100.0%
Rabbi Yehoshua Gerzi Israel 860 0.1% (1) 99.7% 0.0% (0) 100.0%
Dr. Heather Gessling USA 1,500 0.1% (1) 97.3%
Dr. Ellen Guimarães Brazil 500 1.6% (8) 95.9% 0.4% (2) 83.7%
Dr. Syed Haider USA 4,000 0.1% (5) 99.7% 0.0% (0) 100.0%
Dr. Mark Hancock USA 24 0.0% (0) 100.0%
Dr. Sabine Hazan USA 1,000 0.0% (0) 100.0%
Dr. Mollie James USA 3,500 1.1% (40) 97.0% 0.0% (1) 98.8%
Dr. Roberta Lacerda Brazil 550 1.5% (8) 96.2% 0.4% (2) 85.2%
Dr. Katarina Lindley USA 100 5.0% (5) 87.1% 0.0% (0) 100.0%
Dr. Ben Marble USA 150,000 0.0% (4) 99.9%
Dr. Edimilson Migowski Brazil 2,000 0.3% (7) 99.1% 0.1% (2) 95.9%
Dr. Abdulrahman Mohana Saudi Arabia 2,733 0.0% (0) 100.0%
Dr. Carlos Nigro Brazil 5,000 0.9% (45) 97.7% 0.5% (23) 81.3%
Dr. Benoit Ochs Luxembourg 800 0.0% (0) 100.0%
Dr. Ortore Italy 240 1.2% (3) 96.8% 0.0% (0) 100.0%
Dr. Valerio Pascua
one death for a patient presenting on the 5th day in need of supplemental oxygen
Honduras 415 6.3% (26) 83.8% 0.2% (1) 90.2%
Dr. Sebastian Pop Romania 300 0.0% (0) 100.0%
Dr. Brian Proctor USA 869 2.3% (20) 94.0% 0.2% (2) 90.6%
Dr. Anastacio Queiroz Brazil 700 0.0% (0) 100.0%
Dr. Didier Raoult France 8,315 2.6% (214) 93.3% 0.1% (5) 97.6%
Dr. Karin Ried
up to 99yo, 73% comorbidities, av. age 63
Turkey 237 0.4% (1) 82.8%
Dr. Roman Rozencwaig
patients up to 86 years old
Canada 80 0.0% (0) 100.0%
Dr. Vipul Shah India 8,000 0.1% (5) 97.5%
Dr. Silvestre Sobrinho Brazil 116 8.6% (10) 77.7% 0.0% (0) 100.0%
Dr. Unknown Brazil 957 1.7% (16) 95.7% 0.2% (2) 91.5%
Dr. Vladimir Zelenko USA 2,200 0.5% (12) 98.6% 0.1% (2) 96.3%
Mean improvement with early treatment protocols 238,381 HospitalizationHosp. 94.4% MortalityDeath 94.9%
Physician results with early treatment protocols compared to no early treatment. These results are subject to selection and ascertainment bias and more accurate analysis requires details of the patient populations and followup, however results are consistently better across many teams, and consistent with the extensive controlled trial evidence that shows a significant reduction in risk with many early treatments, and improved results with the use of multiple treatments in combination.
Yang
Meta analysis of 19 RCTs with 2,435 total participants showing significantly lower ICU admission and mechanical ventilation with vitamin D treatment..
Bessi
In Vitro study showing that NHC, the active form of molnupiravir, can base pair with both G and A in two different tautomeric forms. This ambiguous..
Horby
923 patient late treatment RCT: 11% higher mortality (p=0.55), 43% higher ventilation (p=0.59), 9% lower hospital discharge (p=0.46), and 12% improved viral clearance (p<0.0001)
Zhang
Retrospective 440 counties/districts across 7 countries in the Americas, showing solar radiation exhibited an overall negative association with..
Guan
2,621 patients prophylaxis: 31% fewer symptomatic cases (p=0.007)
Hemilä
Reanalysis of the REMAP-CAP and LOVIT-COVID vitamin C RCTs- showing that the poor results may be explained by a rebound effect due to the abrupt..
Horby
137 patient early treatment RCT: 1% higher mortality (p=1), 35% lower hospital discharge (p=0.33), and 19% improved viral clearance (p<0.0001)
Naggie
Partial correction to ACTIV-6 600 confirming that 16% of patients were missing in the analysis. It's not clear how the trial could have such a large..
Rothman
1,250 patient late treatment RCT: 1% fewer combined hospitalization/ER visits (p=1), 32% lower progression (p=0.29), and 2% improved recovery (p=0.71)
Gaweł
Analysis of 69 lactating mothers showing higher colostrum lactoferrin concentrations in mothers with a history of COVID-19 infection during..
Recent studies (see the individual treatment pages for all studies):

May 31
Zhang et al., Heliyon, doi:10.1016/j.heliyon.2024.e31160 Non-linear effects of meteorological factors on COVID-19: An analysis of 440 counties in the americas
Retrospective 440 counties/districts across 7 countries in the Americas, showing solar radiation exhibited an overall negative association with daily new COVID-19 cases. The study used generalized additive models (GAM) and distributed lag..
May 24
Horby et al., medRxiv, doi:10.1101/2024.05.23.24307731 Molnupiravir or nirmatrelvir-ritonavir versus usual care in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
11% higher mortality (p=0.55), 43% higher ventilation (p=0.59), 9% lower hospital discharge (p=0.46), and 12% improved viral clearance (p<0.0001). RECOVERY RCT showing no significant differences in mortality, ventilation, or discharge with either molnupiravir (923 patients) or paxlovid (137 patients). Viral load was improved with treatment but did not translate into clinical benefit..
May 23
Lee et al., Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfae069.1573 Effectiveness of regdanvimab on clinical outcomes in COVID-19 infected patients on hemodialysis
59% lower mortality (p=0.002). Retrospective 230 hemodialysis patients with COVID-19, showing lower mortality with regdanvimab. Details of the adjusted results are not provided.
May 22
Guan et al., The American Journal of the Medical Sciences, doi:10.1016/j.amjms.2024.05.005 High-dose Vitamin C Intake and COVID-19 Related Symptoms During the SARS-CoV-2 Pandemic
31% fewer symptomatic cases (p=0.007). Retrospective 2,746 individuals in China showing significantly lower incidence of COVID-19 symptoms and fever with higher vitamin C intake, with a dose response relationship.
May 21
Hemilä et al., Frontiers in Medicine, doi:10.3389/fmed.2024.1391346 Rebound effect explains the divergence in survival after 5 days in a controlled trial on vitamin C for COVID-19 patients
Reanalysis of the REMAP-CAP and LOVIT-COVID vitamin C RCTs [Adhikari] showing that the poor results may be explained by a rebound effect due to the abrupt termination of vitamin C treatment after 4 days. Authors describe a rebound effect ..
May 18
Rothman et al., medRxiv, doi:10.1101/2024.05.16.24307115 Effect of Montelukast vs Placebo on Time to Sustained Recovery in Outpatients with COVID-19: The ACTIV-6 Randomized Clinical Trial
1% fewer combined hospitalization/ER visits (p=1), 32% lower progression (p=0.29), and 2% improved recovery (p=0.71). RCT 1,250 outpatients with mild to moderate COVID-19 showing no significant difference in time to sustained recovery with montelukast treatment. There were no deaths and only 2 hospitalizations in each group. Notably, results were better ..
May 17
Xu et al., Molecular Biomedicine, doi:10.1186/s43556-024-00183-1 Effects of different treatments for type 2 diabetes mellitus on mortality of coronavirus disease from 2019 to 2021 in China: a multi-institutional retrospective study
52% lower mortality (p=0.01), 54% lower ventilation (p=0.007), and 72% lower ARDS (p=0.04). Retrospective 4,922 COVID-19 patients with type 2 diabetes in China, showing lower mortality with metformin and alpha-glucosidase inhibitor treatment and higher mortality with insulin treatment.
May 17
Gaweł et al., Biomedicines, doi:10.3390/biomedicines12051120 Colostrum Lactoferrin Following Active and Recovered SARS-CoV-2 Infections during Pregnancy
Analysis of 69 lactating mothers showing higher colostrum lactoferrin concentrations in mothers with a history of COVID-19 infection during pregnancy or delivery compared to pre-pandemic controls. The highest lactoferrin concentrations we..
May 16
Huang et al., Journal of Dentistry, doi:10.1016/j.jdent.2024.105082 Satisfaction with Government Recommended Pre-Procedural Mouth Rinses in the Mitigation of Covid-19 in Hong Kong SAR: A Triple Blind Randomized Controlled Clinical Trial
RCT 228 dental patients showing high satisfaction and acceptability of three pre-procedural mouthrinses (povidone-iodine, hydrogen peroxide, and chlorhexidine digluconate) recommended by the Hong Kong government for mitigating COVID-19 tr..
May 16
Zhou et al., PLOS ONE, doi:10.1371/journal.pone.0300512 The efficacy and safety of fluvoxamine in patients with COVID-19: A systematic review and meta-analysis from randomized controlled trials
Meta analysis of 6 RCTs with 4,711 total participants showing significantly lower clinical deterioration and hospitalization with fluvoxamine treatment for COVID-19. Fluvoxamine doses ≥200mg daily were more effective than lower doses. The..
May 16
Naggie, S., JAMA, doi:10.1001/jama.2024.8723 Error in the Exclusion of Participants From Analysis in the ACTIV-6 Platform Randomized Clinical Trial
Partial correction to ACTIV-6 600 confirming that 16% of patients were missing in the analysis. It's not clear how the trial could have such a large error for the number of patients randomized, why the correction took over a year, or why ..
May 15
Irfan et al., BMC Infectious Diseases, doi:10.1186/s12879-024-09387-w Phytoconstituents of Artemisia Annua as potential inhibitors of SARS CoV2 main protease: an in silico study
In Silico study showing that quercetin binds strongly to the SARS-CoV-2 main protease (Mpro) and may be a potential inhibitor of viral replication. Authors screened 25 compounds from Artemisia annua and found that quercetin had one of the..
May 15
Wang et al., Cell Biochemistry and Function, doi:10.1002/cbf.4039 1,25‐Dihydroxyvitamin D3 attenuates platelet aggregation potentiated by SARS‐CoV‐2 spike protein via inhibiting integrin αIIbβ3 outside‐in signaling
In Vitro study showing that calcitriol minimizes platelet aggregation mediated by SARS-CoV-2 spike protein via inhibiting integrin αIIbβ3 outside-in signaling. Authors find that calcitriol reduces platelet aggregation and Src-mediated sig..
May 15
Gertner et al., Cureus, doi:10.7759/cureus.60364 Colchicine and/or Naltrexone for Hospitalized COVID-19 Patients Not Requiring High Levels of Ventilatory Support (COLTREXONE): A Prospective, Randomized, Open-Label Trial
65% lower ICU admission (p=0.11), 43% improved recovery (p=0.14), 34% lower need for oxygen therapy (p=0.34), and 20% shorter hospitalization (p=0.13). Open-label RCT 137 hospitalized COVID-19 patients, showing lower progression to ICU/step-down ICU and improved recovery with colchicine, both without statistical significance. The primary outcome was changed mid-trial due to the low numbe..
May 13
Pakotiprapha et al., ASPET 2024 Annual Meeting Abstract - Toxicology, doi:10.1124/jpet.212.937140 Molnupiravir Active Metabolite–N4 hydroxycytidine causes Cytotoxicity to Mammalian Cells In Vitro
In Vitro study showing cytotoxicity of N4-hydroxycytidine (NHC), the active metabolite of molnupiravir, at concentrations relevant to therapeutic doses of molnupiravir in COR-L23 and HepG2 cancer cell lines, and compared with cytotoxicity..
May 10
Nicoliche et al., Scientific Reports, doi:10.1038/s41598-024-61662-7 Antiviral, anti-inflammatory and antioxidant effects of curcumin and curcuminoids in SH-SY5Y cells infected by SARS-CoV-2
In Vitro study showing antiviral, anti-inflammatory, and antioxidant effects of curcumin and curcuminoids in SARS-CoV-2 infected SH-SY5Y human neuroblastoma cells. Authors found that the curcuminoid Me23 significantly decreased expression..
May 10
Plowman et al., International Journal of Molecular Sciences, doi:10.3390/ijms25105190 Anti-Inflammatory Potential of the Anti-Diabetic Drug Metformin in the Prevention of Inflammatory Complications and Infectious Diseases Including COVID-19: A Narrative Review
Review of the potential of metformin for preventing inflammatory complications and infectious diseases including COVID-19. Authors discuss evidence from preclinical and clinical studies suggesting metformin may help prevent symptoms of CO..
May 9
Dong et al., Frontiers in Pharmacology, doi:10.3389/fphar.2024.1388348 Vitamin D level in COVID-19 patients has positive correlations with autophagy and negative correlations with disease severity
Retrospective 52 COVID-19 patients showing that patients with severe/critical disease had lower levels of vitamin D and autophagy markers ATG7 and BECN1 compared to those with mild or moderate disease. Vitamin D levels had a significant n..
May 7
Sobczak et al., Nutrients, doi:10.3390/nu16101402 Effect of Vitamin D3 Supplementation on Severe COVID-19: A Meta-Analysis of Randomized Clinical Trials
44% lower mortality (p=0.02), 27% lower ICU admission (p=0.02), and 21% lower need for oxygen therapy (p=0.07). Meta analysis of 13 RCTs for severe COVID-19 showing lower ICU admission and lower COVID-19 mortality with vitamin D treatment. Other outcomes show lower risk with treatment but without statistical significance. Authors conclude that it i..
May 6
Gruber et al., Journal of Medical Virology, doi:10.1002/jmv.29642 Molnupiravir increases SARS‐CoV‐2 genome diversity and complexity: A case‐control cohort study
Analysis of 38 COVID-19 outpatients treated with molnupiravir showing significantly increased SARS-CoV-2 genetic diversity and complexity compared to 17 patients treated with tixagevimab/cilgavimab. Molnupiravir increased the mutation rat..
May 4
Kali et al., Global Journal of Medical, Pharmaceutical, and Biomedical Update, doi:10.25259/GJMPBU_78_2023 Curcumin as a Promising Therapy for COVID-19: A Review
Review of curcumin for COVID-19. Authors discuss the molecular mechanisms of COVID-19 pathogenesis and the properties and mechanisms of action of curcumin. Curcumin exhibits antiviral activity against SARS-CoV-2 by interfering with viral ..
May 3
Kingsley et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofae233 The DARPin antiviral ensovibep for non-hospitalized patients with COVID-19: Results from EMPATHY, a randomized, placebo-controlled Phase 2 study
89% lower mortality (p=0.06), 78% fewer combined hospitalization/ER visits (p=0.02), 87% lower hospitalization (p=0.01), and 87% improvement (p=0.01). RCT 407 mild to moderate COVID-19 outpatients showing faster viral clearance, lower risk of hospitalization/ER visits, and shorter time to sustained recovery with ensovibep treatment (75/225/600mg single infusion). There were 2 COVID-19 r..
May 3
Mohammadifard et al., Scientific Reports, doi:10.1038/s41598-024-57424-0 Comparing vitamin D receptor gene polymorphisms in rs11568820, rs7970314, rs4334089 between COVID-19 patients with mild and severe symptoms: a case control study
Case control study of 176 COVID-19 patients showing the TT genotype of the rs11568820 vitamin D receptor (VDR) polymorphism was associated with a lower risk of severe COVID-19 requiring hospitalization. No significant differences were fou..
Apr 30
Brechot et al., Medical Research Archives, doi:10.18103/mra.v12i4.5252 Nitazoxanide in the Treatment of COVID-19: A paradigm for Antiviral Drugs Targeting Host-Infected Cells
Review of nitazoxanide as a potential treatment for COVID-19. Authors highlight nitazoxanide's unique mechanism of action, which involves inhibiting mitochondrial oxidative phosphorylation in host cells, thereby lowering cellular ATP cont..
Apr 30
Ho et al., Heliyon, doi:10.1016/j.heliyon.2024.e30080 Therapeutic Implications of Quercetin and its Derived-products in COVID-19 Protection and Prophylactic
Review of quercetin and its derivatives for prevention and treatment of COVID-19. Authors discuss molecular docking evidence showing quercetin and its derivatives can bind to multiple SARS-CoV-2 proteins including the main protease, spike..
Apr 30
Varnaseri et al., Jundishapur Journal of Health Sciences, doi:10.5812/jjhs-146703 Ivermectin as a Potential Addition to the Limited Anti-COVID-19 Arsenal: A Double-Blinded Clinical Trial
82% lower ventilation (p=0.02), 83% lower ICU admission (p=0.0004), 33% shorter hospitalization (p=0.001), and 28% faster recovery (p<0.0001). Double-blind RCT 110 hospitalized moderate to severe COVID-19 patients showing significantly reduced ICU admission, shorter hospitalization, faster resolution of symptoms, and improved CRP and LDH levels with ivermectin treatment compared..
Apr 29
Song et al., Therapeutic Innovation & Regulatory Science, doi:10.1007/s43441-024-00633-6 The Effect of Antihyperglycemic Medications on COVID-19: A Meta-analysis and Systematic Review from Observational Studies
34% lower mortality (p<0.0001), 35% lower severe cases (p=0.002), and 23% lower hospitalization (p=0.02). Meta analysis of 56 studies showing lower mortality and hospitalization with metformin, GLP-1 receptor agonists, and SGLT-2 inhibitors in COVID-19 patients with type 2 diabetes, while insulin was associated with increased risks.
Apr 29
Thomas et al., Scientific Reports, doi:10.1038/s41598-024-58532-7 Cheminformatics approach to identify andrographolide derivatives as dual inhibitors of methyltransferases (nsp14 and nsp16) of SARS-CoV-2
In Silico study showing that andrographolide derivatives (PubChem CID 2734589 and 138968421) are potential dual inhibitors of SARS-CoV-2 methyltransferases nsp14 and nsp16, which are crucial for viral replication and evading host immune r..
Apr 28
de Oliveira Só et al., MDPI AG, doi:10.20944/preprints202404.1825.v1 In Silico Comparative Analysis of Ivermectin and Nirmatrelvir Inhibitors Interacting with the SARS-CoV-2 Main Protease
In Silico study showing that ivermectin and nirmatrelvir interact with the SARS-CoV-2 main protease (Mpro). Authors used molecular docking and 100ns molecular dynamics simulations to investigate the binding interactions. Nirmatrelvir form..
Apr 28
Ochoa-Ramírez et al., International Journal of Immunogenetics, doi:10.1111/iji.12674 Vitamin D receptor gene polymorphisms role in COVID‐19 severity: Results of a Mexican patients’ cohort
Retrospective 292 COVID-19 patients finding that haplotype TC of the FokI and TaqI vitamin D receptor (VDR) gene polymorphisms was associated with an increased risk of critical COVID-19.
Apr 27
Autier et al., medRxiv, doi:10.1101/2024.04.26.24306354 Vitamin D, acute respiratory infections, and Covid-19: the curse of small-size randomised trials. A critical review with meta-analysis of randomised trials
Unregistered meta analysis cherry-picking the ICU outcome and including 9 late treatment RCTs with ICU outcomes for vitamin D. It's unclear why ICU risk would be used when there are more studies reporting mortality which is also less subj..
We aim to cover the most promising early treatments for COVID-19. We use pre-specified effect extraction criteria that prioritizes more serious outcomes, for details see methods. For specific outcomes and different treatment stages see the individual pages. Not all treatments are covered here, effectiveness has been reported for many other treatments in studies. Of the 4,216 studies, 2,190 present results comparing with a control group, 1,994 are treatment studies, and 196 analyze outcomes based on serum levels. There are 67 animal studies, 145 in silico studies, 241 in vitro studies, 263 reviews, and 189 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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