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c19early.org
Camostat for COVID-19
16 studies with >2,000 patients
Serious outcome risk
Camostat
Control
Significantly lower risk for mortality and recovery.
3 studies from 3 independent teams in 3 countries show significant benefit.
COVID-19 Camostat studies · October 2026
Camostat was adopted in 1 country.
Covid Analysis Camostat for COVID-19: real-time meta-analysis of 16 studies (Version 6)
Significantly lower risk is seen for mortality and recovery. 3 studies from 3 independent teams in 3 countries show significant benefit. Meta-analysis using the most serious outcome reported shows 18% [-2‑34%] lower risk, witho..
Sep 30
2025
 Milewska et al., iScience, doi:10.1016/j.isci.2025.113318 Evolution of the SARS-CoV-2 spike protein in utilizing host transmembrane serine proteases
In vitro study showing variant-dependent differences in SARS-CoV-2 spike protein activation by host transmembrane serine proteases (TTSPs). Authors find that all SARS-CoV-2 variants (Wuhan, Alpha, Beta, Gamma, Delta, and Omicron) require ..
Jun 5
2025
 Manikyam et al., Research Square, doi:10.21203/rs.3.rs-6819274/v1 INP-Guided Network Pharmacology Discloses Multi-Target Therapeutic Strategy Against Cytokine and IgE Storms in the SARS-CoV-2 NB.1.8.1 Variant
Computational modeling study presenting a multi-target therapeutic approach against the SARS-CoV-2 NB.1.8.1 variant using Intrinsic Network Pharmacology (INP) and network pharmacology tools. The researchers identified ZINC000014930714, a ..
Feb 12
2025
 Saha et al., Viruses, doi:10.3390/v17020252 Inhaled Dry Powder of Antiviral Agents: A Promising Approach to Treating Respiratory Viral Pathogens
Review of inhaled dry powder antiviral formulations for treating respiratory viral infections, focusing on COVID-19. Authors explain that traditional antiviral tablets face limitations including systemic side effects and delayed onset of ..
Mar 28
2024
 Bryce et al., NCT04470544 RECOVER: Phase 2 Randomized, Double-Blind Trial TREating Hospitalized Patients With COVID-19 With Camostat MesilatE, a TMPRSS2 Inhibitor
25% lower mortality (p=1). RCT 100 patients showing no significant difference with camostat. Results are currently unclear - different mortality numbers were provided for all-cause mortality and mortality rate (2/50 vs. 3/46 for the treatment group at 28 days, with..
Feb 14
2024
 González-Paz et al., ACS Omega, doi:10.1021/acsomega.3c06968 Biophysical Analysis of Potential Inhibitors of SARS-CoV-2 Cell Recognition and Their Effect on Viral Dynamics in Different Cell Types: A Computational Prediction from In Vitro Experimental Data
In silico study showing that nafamostat, camostat, chloroquine, hydroxychloroquine, telmisartan, and captopril may be beneficial for COVID-19 by inhibiting SARS-CoV-2 cell entry and replication in multiple cell types expressing ACE2 and T..
Nov 20
2023
 Tare et al., BJGP Open, doi:10.3399/bjgpo.2023.0109 The DAWN antivirals trial: process evaluation of a COVID-19 trial in general practice
33% improved recovery (p=0.7). Small early terminated RCT showing better recovery with camostat treatment, without statistical significance.
Jun 5
2023
 Jilg et al., Clinical Infectious Diseases, doi:10.1093/cid/ciad342 One Week of Oral Camostat Versus Placebo in Nonhospitalized Adults With Mild-to-Moderate Coronavirus Disease 2019 (COVID-19): A Randomized Controlled Phase 2 Trial
18% higher hospitalization (p=1), 10% lower progression (p=0.11), and 13% improved recovery (p=0.7). RCT 216 patients, 55% >5 days from symptom onset, showing no significant difference with camostat treatment. Longer-term mortality results are from the registry and are not shown in the paper.
Jan 24
2023
 Kim et al., Antimicrobial Agents and Chemotherapy, doi:10.1128/aac.00452-22 A Double-Blind, Randomized, Placebo-Controlled, Phase II Clinical Study To Evaluate the Efficacy and Safety of Camostat Mesylate (DWJ1248) in Adult Patients with Mild to Moderate COVID-19
8% faster recovery (p=0.54). Double-blind RCT with 342 mild to moderate COVID-19 outpatients in South Korea, showing no significant difference in time to clinical improvement with camostat mesylate. In a post-hoc subgroup analysis of high-risk patients, there were..
Sep 30
2022
 Tobback et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.06.054 Efficacy and safety of camostat mesylate in early COVID-19 disease in an ambulatory setting: a randomized placebo-controlled phase II trial
36% higher hospitalization (p=1) and 8% improved recovery (p=0.84). RCT 90 outpatients showing no significant difference in viral load or time to clinical improvement with camostat mesylate. The trial was discontinued early and did not reach the intended sample size. Authors note that combining camostat w..
Sep 27
2022
 Kinoshita et al., BMC Medicine, doi:10.1186/s12916-022-02518-7 A multicenter, double-blind, randomized, parallel-group, placebo-controlled study to evaluate the efficacy and safety of camostat mesilate in patients with COVID-19 (CANDLE study)
67% lower progression (p=1), 50% lower need for oxygen therapy (p=0.37), 1% worse recovery (p=1), and 1% worse viral clearance (p=0.97). RCT 155 hospitalized patients showing no significant differences with camostat.
Jul 22
2022
 Karolyi et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.870493 Camostat Mesylate Versus Lopinavir/Ritonavir in Hospitalized Patients With COVID-19—Results From a Randomized, Controlled, Open Label, Platform Trial (ACOVACT)
72% lower mortality (p=0.1), 70% lower ventilation (p=0.02), 60% lower combined mortality/intubation (p=0.04), and 18% faster recovery (p=0.005). RCT 201 hospitalized COVID-19 patients showing faster clinical improvement, less progression to mechanical ventilation or death, and shorter hospital stay with camostat mesylate compared to lopinavir/ritonavir. There was also a trend towa..
Jun 30
2022
 Umar et al., Jurnal Teknologi Laboratorium, doi:10.29238/teknolabjournal.v11i1.344 Inhibitory potentials of ivermectin, nafamostat, and camostat on spike protein and some nonstructural proteins of SARS-CoV-2: Virtual screening approach
In silico study of ivermectin, camostat, and nafamostat, showing that ivermectin had the best inhibitory action on the SARS-CoV-2 spike protein and Nsp10, while nafamostat had the best results for the other non-structural proteins. Author..
Jun 3
2022
 Terada et al., eClinicalMedicine, doi:10.1016/j.eclinm.2022.101484 Favipiravir, camostat, and ciclesonide combination therapy in patients with moderate COVID-19 pneumonia with/without oxygen therapy: An open-label, single-center phase 3 randomized clinical trial
8% lower progression (p=1) and 40% higher hospital discharge (p=0.04). RCT 117 hospitalized patients with moderate COVID-19 pneumonia in Japan, showing a shorter time to discharge with favipiravir, camostat, and ciclesonide combination therapy compared to favipiravir monotherapy. Subgroup analysis showed gre..
Mar 3
2022
 Dhaliwal et al., NCT04455815 A Randomised Phase II Trial in Early COVID-19, Assessing Use of Camostat by Blocking SARS-CoV-2 Spike Protein-initiated Membrane Fusion
14% lower hospitalization (p=1). Early terminated RCT with 34 patients showing no significant differences with camostat treatment.
Feb 7
2022
 Schultz et al., Nature, doi:10.1038/s41586-022-04482-x Pyrimidine inhibitors synergize with nucleoside analogues to block SARS-CoV-2
In vitro and mouse study showing synergistic antiviral effects when combining pyrimidine biosynthesis inhibitors with antiviral nucleoside analogues against SARS-CoV-2. Authors screened 18 thousand drugs and validated 122 with antiviral a..
Jan 31
2022
 Chupp et al., medRxiv, doi:10.1101/2022.01.28.22270035 A Phase 2 Randomized, Double-Blind, Placebo-controlled Trial of Oral Camostat Mesylate for Early Treatment of COVID-19 Outpatients Showed Shorter Illness Course and Attenuation of Loss of Smell and Taste
37% improved recovery (p=0.15). RCT 70 outpatients showing significantly lower symptom scores at day 6, faster recovery, and improved taste/smell, and fatigue with camostat treatment. There was no significant difference for viral load. The recovery result is from..
Jan 12
2022
 Unal et al., bioRxiv, doi:10.1101/2022.01.11.475889 Favipiravir, umifenovir and camostat mesylate: a comparative study against SARS-CoV-2
In vitro and in silico study showing that the combination of favipiravir and umifenovir or camostat mesylate has greater antiviral efficacy than single drug treatment.
Dec 31
2021
 Hempel et al., Chemical Science, doi:10.1039/D1SC01494C Synergistic inhibition of SARS-CoV-2 cell entry by otamixaban and covalent protease inhibitors: pre-clinical assessment of pharmacological and molecular properties
In vitro study showing that otamixaban inhibits SARS-CoV-2 cell entry through TMPRSS2 inhibition. Authors found otamixaban to be a weak TMPRSS2 inhibitor in cell culture (IC50 of 18.7 μM) compared to camostat (IC50 of 151.1 nM) and nafamo..
Dec 9
2022
 Jeon et al., NCT04713176 A Double-blind, Randomized, Placebo-controlled, Multi-center, Phase III Study to Evaluate the Efficacy and Safety of DW1248 With Remdesivir in Severe COVID-19 Patients
240 patient camostat late treatment RCT with results not reported over 3 years after completion.
Dec 2
2021
 Boutboul et al., NCT04608266 A Multicenter Randomized Trial to Evaluate the Efficacy and Safety of Camostat Mesylate for the Treatment of SARS-CoV-2 Infection - COVID-19 in Ambulatory Adult Patients (CAMOVID)
70 patient camostat early treatment RCT with results not reported over 4 years after completion.
Oct 29
2021
 Keitel-Anselmino et al., NCT04681430 Reconvalescent Plasma / Camostat Mesylate Early in Sars-CoV-2 Q-PCR (COVID-19) Positive High-risk Individuals
22 patient camostat early treatment RCT with results not reported over 4 years after completion.
Jun 10
2021
 Palazuelos et al., NCT04530617 Randomized, Double-blind, Placebo-controlled, Multicenter, Multi-arm, Phase II Trial of Novel Agents for the Treatment of Mild to Moderate COVID-19 Positive Outpatients
246 patient camostat early treatment RCT with results not reported over 5 years after completion.
May 31
2021
 Gunst et al., eClinicalMedicine, doi:10.1016/j.eclinm.2021.100849 Efficacy of the TMPRSS2 inhibitor camostat mesilate in patients hospitalized with Covid-19-a double-blind randomized controlled trial
18% lower mortality (p=0.75), 31% lower ventilation (p=0.65), 20% lower ICU admission (p=0.61), and 15% improved recovery (p=0.28). RCT 205 hospitalized patients showing no significant benefit with camostat. There was a trend towards lower risk of ICU admission or death in the camostat group (10% vs. 18% for placebo), but the study was not powered for this endpoint. V..
May 15
2021
 Parsonnet et al., NCT04524663 A Phase 2 Randomized, Double Blinded, Placebo Controlled Study of Oral Camostat Mesilate Compared to Standard of Care in Subjects With Mild-Moderate COVID-19
35% improved recovery (p=0.24), 86% improvement (p=0.11), and 41% improved viral clearance (p=0.24). RCT 49 outpatients in the USA, showing no significant differences with camostat treatment.
Apr 30
2021
 Sgrignani et al., Frontiers in Molecular Biosciences, doi:10.3389/fmolb.2021.666626 Computational Identification of a Putative Allosteric Binding Pocket in TMPRSS2
In silico study of TMPRSS2 inhibition by camostat, nafamostat, and bromhexine, suggesting allosteric binding for bromhexine, compared to camostat and nafamostat which bind to the active site of TMPRSS2 forming covalent adducts.
Apr 12
2021
 Sakr et al., Intensive Care Medicine, doi:10.1007/s00134-021-06395-1 Camostat mesylate therapy in critically ill patients with COVID-19 pneumonia
69% lower mortality (p=0.001), 10% lower ventilation (p=1), and 17% longer hospitalization (p=0.35). Retrospective 371 critically ill COVID-19 patients showing lower mortality with camostat mesylate treatment.
Mar 31
2021
 Sagent Pharmaceuticals, NCT04583592 A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of the Efficacy of Camostat Mesilate for Treatment of COVID-19 in Outpatients
152% higher mortality (p=1), 13% lower progression (p=0.79), and 16% improved viral clearance (p=0.36). RCT 295 outpatients in the USA, showing no significant differences with camostat.
Dec 19
2020
 Huh et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.12.041 Association of prescribed medications with the risk of COVID-19 infection and severity among adults in South Korea
14% more cases (p=0.84). Retrospective database analysis showing no significant differences with camostat use.
Dec 11
2020
 Levi et al., NCT04355052 Open Label Study to Compare Efficacy, Safety and Tolerability of Hydroxychloroquine Combined With Azithromycin Compared to Hydroxychloroquine Combined With Camostat Mesylate and to "no Treatment" in SARS CoV 2 Virus (COSTA)
Estimated 250 patient camostat late treatment RCT with results not reported over 5 years after estimated completion.
Nov 16
2020
 Hofmann-Winkler et al., Critical Care Explorations, doi:10.1097/CCE.0000000000000284 Camostat Mesylate May Reduce Severity of Coronavirus Disease 2019 Sepsis: A First Observation
58% lower mortality (p=0.55), 61% shorter ICU admission, and 56% improved recovery. Retrospective 11 critically ill COVID-19 ICU patients with organ failure treated with camostat mesylate (6 patients) or HCQ (5 patients). Over an 8 day period, the severity of COVID-19 decreased in the camostat group as measured by a decl..
Mar 5
2020
 Hoffman et al., Cell, doi:10.1016/j.cell.2020.02.052 SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor
In vitro study showing that SARS-CoV-2 uses ACE2 for entry and TMPRSS2 for S protein priming, and that TMPRSS2 inhibitor camostat blocked entry and may be an effective treaetment.