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COVID-19 early treatment: real-time analysis of 3,313 studies

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Analysis of 56 COVID early treatments, approvals in 102 countries, database of 4,988 treatments  
Recently added (more..)  Vitamin D  Vitamin C  Ivermectin  Fluvoxamine  Exercise
Sanecka
Prospective study of 171 hospitalized COVID-19 patients in Ireland, showing significantly lower mortality and ICU admission with sufficient vitamin..
Albóniga
Plasma metabolomic analysis showing significantly lower threonic acid levels for severe and mild COVID-19 cases compared with moderate cases...
Liu
In Vitro study showing that ivermectin and meclizine mitigated cardiac cell death and dysfunction caused by SARS-CoV-2 viral genes. Authors found..
Naggie
Late treatment low risk population RCT showing lower progression to hospitalization or urgent care/ER visits with fluvoxamine, without statistical..
Graydon
Analysis of 88 COVID+ patients in the USA showing that a higher frequency of natural killer (NK) cells was associated with asymptomatic infection...
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 September 2023 meta analysis results (pooled effects) 100% 50% 0% -50%
Cost per life saved from NNT in
studies to date c19early.org Sep 2023
Melatonin
9
48%
  $8
Vitamin D
66
36%
  $10
Vitamin C
38
20%
  $14
Zinc
20
29%
  $16
Ivermectin
51
49%
  $24
HCQ
244
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
49
12%
  $498,029
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 Sep 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 Sep 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%] 115 $1 184,017 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%] 42 $1 55,114 Metformin 28% [24-32%] 75 $10 262,457 Paxlovid 28% [20-36%] 37 $529 73,041 independent trials refused Ensitrelvir 26% [-14-52%] 3 $500 1,450 very limited data Hydroxychlor.. 26% [22-29%] 409 $1 523,320 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 N-acetylcys.. 21% [11-30%] 22 $1 25,933 Vitamin C 21% [14-28%] 63 $1 72,543 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% [4-17%] 58 $3,120 155,923 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 Sep 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% 115 Spironolactone 36% 11 Bebtelovimab 34% 6 intravenous Nitazoxanide 33% 13 Sleep 31% 13 Colchicine 30% 49 Budesonide 30% 12 Antiandrogens 30% 49 Zinc 29% 42 Metformin 28% 75 Paxlovid 28% 37 independent trials refused Ensitrelvir 26% 3 very limited data Hydroxychlor.. 26% 409 Sotrovimab 26% 21 variant dependent Nitric Oxide 26% 10 Probiotics 25% 23 Lactoferrin 22% 7 N-acetylcys.. 21% 22 Vitamin C 21% 63 Favipiravir 18% 66 worse w/longer followup Famotidine 16% 28 Molnupiravir 15% 34 mutagenic/teratogenic Aspirin 11% 69 Remdesivir 10% 58 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 Sep 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% 32
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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.
Vitamin D
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..
Graydon
Analysis of 88 COVID+ patients in the USA showing that a higher frequency of natural killer (NK) cells was associated with asymptomatic infection...
Ogasawara
312 patients late treatment: 78% lower progression (p=0.05) and 75% lower need for oxygen therapy (p=0.09)
Vitamin C
Albóniga
Plasma metabolomic analysis showing significantly lower threonic acid levels for severe and mild COVID-19 cases compared with moderate cases...
Graydon
Analysis of 88 COVID+ patients in the USA showing that a higher frequency of natural killer (NK) cells was associated with asymptomatic infection...
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..
Abatematteo
In Vitro and In Silico analysis supporting fluvoxamine for COVID-19. Authors investigated the mechanism of action of sigma-1 receptor (S1R) ligands..
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...
Metformin
Petrelli
Meta analysis: 31% lower mortality (p<0.0001) and 20% lower severe cases (p=0.03)
Molnupiravir
Alpizar
1,527 patient prophylaxis RCT: 24% fewer symptomatic cases (p=0.06)
Zibat
In Vitro study showing that NHC, the active compound molnupiravir, can promote rapid selection of immune escape mutants. NHC treatment enabled..
Zinc
Rolles
In Vitro study showing improved natural killer (NK) cell function with zinc. - showed that a lower frequency of natural killer cells was associated..
Graydon
Analysis of 88 COVID+ patients in the USA showing that a higher frequency of natural killer (NK) cells was associated with asymptomatic infection...
Probiotics
Finamore
RCT 98 adults, showing that probiotics improved immune function including increased natural killer (NK) cell activity. - showed that a lower..
Graydon
Analysis of 88 COVID+ patients in the USA showing that a higher frequency of natural killer (NK) cells was associated with asymptomatic infection...
Sleep
Graydon
Analysis of 88 COVID+ patients in the USA showing that a higher frequency of natural killer (NK) cells was associated with asymptomatic infection...
Tixagevimab/cilgavimab
Desai
782 patients prophylaxis: 12% lower hospitalization (p=0.81) and 35% more cases (p=0.18)
Melatonin
Tóth
Meta analysis: 38% lower mortality (p=0.03)
Budesonide
Hautefort
RCT 123 post-COVID-19 hyposmia patients, showing no significant difference in smell recovery with budesonide. 2 patients experienced improvement of..
Recent studies (see the individual treatment pages for all studies):
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 1
 Konikowska et al., Frontiers in Immunology, doi:10.3389/fimmu.2023.1231813 Association of serum vitamin D concentration with the final course of hospitalization in patients with COVID-19
Retrospective 474 hospitalized COVID-19 patients in Poland, showing lower vitamin D levels associated with mortality.
Sep 1
 Ogasawara et al., Clinical Nutrition, doi:10.1016/j.clnu.2023.08.021 The effect of 1-hydroxy-vitamin D treatment in hospitalized patients with COVID-19: A retrospective study
78% lower progression (p=0.05) and 75% lower need for oxygen therapy (p=0.09). PSM retrospective 312 hospitalized patients in Japan, showing lower progression with vitamin D (alfacalcidol) treatment, statistically significant via KM log-rank.
Aug 31
 Zibat et al., iScience, doi:10.1016/j.isci.2023.107786 N4-hydroxycytidine, the active compound of Molnupiravir, promotes SARS-CoV-2 mutagenesis and escape from a neutralizing nanobody
In Vitro study showing that NHC, the active compound molnupiravir, can promote rapid selection of immune escape mutants. NHC treatment enabled selection of nanobody-resistant mutants much faster than without NHC. While an in vitro model w..
Aug 31
 Hautefort et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2023.08.022 Local budesonide therapy in the management of persistent hyposmia in suspected non-severe COVID-19 patients: Results of a randomized controlled trial
RCT 123 post-COVID-19 hyposmia patients, showing no significant difference in smell recovery with budesonide. 2 patients experienced improvement of more than two points on the ODORATEST score compared with 0 in the control group.
Aug 30
 Srivastava et al., Stresses, doi:10.3390/stresses3030043 Paradigm of Well-Orchestrated Pharmacokinetic Properties of Curcuminoids Relative to Conventional Drugs for the Inactivation of SARS-CoV-2 Receptors: An In Silico Approach
In Silico analysis of curcuminoids showing similar drug-like properties and strong binding to the main protease and spike receptor binding domain proteins. Curcuminoid binding was comparable or better than existing drugs favipiravir, remd..
Aug 30
 Petrelli et al., Acta Biomedica Atenei Parmensis, doi:10.23750/abm.v94iS3.14405 Metformin and Covid-19: a systematic review of systematic reviews with meta-analysis
31% lower mortality (p<0.0001) and 20% lower severe cases (p=0.03). Systematic review and meta analysis of 36 studies showing significantly lower COVID-19 mortality and severity with metformin use.
Aug 28
 Zhou et al., BMJ Open Respiratory Research, doi:10.1136/bmjresp-2023-001674 Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis
Meta analysis with many errors/limitations/biases, including many missing studies, use of unadjusted results, use of non-symptomatic results, and use of all-cause instead of COVID-19 hospitalization. For HCQ, there are , including . Note ..
Aug 25
 Mbata et al., Journal of Clinical Medicine, doi:10.3390/jcm12175520 Is Serum 25-Hydroxyvitamin D Level Associated with Severity of COVID-19? A Retrospective Study
Retrospective 763 hospitalized COVID-19 patients showing no significant difference in outcomes based on serum levels. Unadjusted results show non-significantly lower risk of critical severity, death, and complications with vitamin D suffi..
Aug 24
 Guo et al., Diabetes, Metabolic Syndrome and Obesity, doi:10.2147/DMSO.S417925 Effects of Metformin on COVID-19 Patients with Type 2 Diabetes: A Retrospective Study
62% lower combined mortality/intubation (p=0.03) and 81% lower progression (p=0.003). Retrospective 571 type 2 diabetes patients with COVID-19 in China, showing lower combined mortality/mechanical ventilation with metformin.
Aug 24
 Horcajada et al., Research Square, doi:10.21203/rs.3.rs-3279701/v1 Safety and Efficacy of Favipiravir in COVID-19 Patients with Pneumonia. A randomized, double-blind, placebo-controlled study (FAVID)
383% higher mortality (p=0.49), 37% higher ventilation (p=1), no change in improvement (p=0.45), and 17% improved recovery (p=0.64). Underpowered RCT with 44 hospitalized patients in Spain, showing no significant difference with favipiravir treatment in the primary outcome of time to clinical improvement, or in the secondary efficacy outcomes. Adverse events were more ..
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 3,313 studies, 1,925 present results comparing with a control group, 1,741 are treatment studies, and 184 analyze outcomes based on serum levels. There are 40 animal studies, 82 in silico studies, 168 in vitro studies, 199 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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