0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Mahmud (DB RCT) 86% 0.14 [0.01-2.75] death 0/183 3/183 CT​1 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.2 Early treatment 86% 0.14 [0.01-2.75] 0/183 3/183 86% lower risk Hashim (SB RCT) 92% 0.08 [0.01-0.80] death 0/59 6/70 CT​1 Improvement, RR [CI] Treatment Control Spoorthi 21% 0.79 [0.64-0.98] recov. time 50 (n) 50 (n) CT​1 Ahsan 50% 0.50 [0.28-0.90] death 17/110 17/55 CT​1 Tau​2 = 0.11, I​2 = 53.5%, p = 0.079 Late treatment 38% 0.62 [0.36-1.06] 17/219 23/175 38% lower risk Stambouli (DB RCT) 49% 0.51 [0.13-1.94] symp. case 3/56 6/57 Improvement, RR [CI] Treatment Control Tau​2 = 0.00, I​2 = 0.0%, p = 0.33 Prophylaxis 49% 0.51 [0.13-1.94] 3/56 6/57 49% lower risk All studies 39% 0.61 [0.40-0.94] 20/458 32/415 39% lower risk 5 doxycycline COVID-19 studies c19early.org June 2026 Tau​2 = 0.07, I​2 = 30.6%, p = 0.023 Effect extraction pre-specified(most serious outcome) 1 CT: study uses combined treatment Favors doxycycline Favors control
Feb 16
McLindon et al., American Journal of Therapeutics, doi:10.1097/MJT.0000000000002118 Safety and Tolerability of Multimodal Therapy (Ivermectin, Doxycycline, Vitamin C, Vitamin D, and Zinc) With or Without Famotidine in Australian Patients With COVID-19 Infection: A Pilot Cohort Trial
RCT 275 outpatients showing very low hospitalization with combination therapy including ivermectin, doxycycline, vitamin C, vitamin D3, and zinc, with or without famotidine. There was no control group. Only 4 patients were hospitalized wi..
Jul 31
2025
Hazan et al., Preprint, 2025 Rapid recovery of peripheral oxygen saturation in hypoxic COVID-19 patients with ivermectin/doxycycline/zinc multidrug therapy
Retrospective 26 consecutive severe COVID-19 outpatients with hypoxia (25 with SpO2 ≤90%) showing rapid oxygen saturation recovery and survival with ivermectin/doxycycline/zinc/vitamin C/vitamin D combination therapy. All 24 patients comp..
Mar 25
2025
Gkioulekas et al., The Japanese Journal of Antibiotics, doi:10.11553/antibiotics.78.1_35 Critical appraisal of multidrug therapy in the ambulatory management of patients with COVID-19 and hypoxemia Part II: Causal inference using the Bradford Hill criteria
Critical appraisal of three case series totaling 119 COVID-19 patients with hypoxemia treated with ivermectin-based multidrug protocols in the United States, Zimbabwe, and Nigeria, showing reduced hospitalization and mortality. Authors ap..
Mar 25
2025
Gkioulekas, Ph.D. et al., The Japanese Journal of Antibiotics, doi:10.11553/antibiotics.78.1_2 Critical appraisal of multidrug therapy in the ambulatory management of patients with COVID-19 and hypoxemia Part I. Evidence supporting the strength of association
Critical appraisal of 119 COVID-19 hypoxemic patients treated with ivermectin-based multidrug protocols in the United States, Zimbabwe, and Nigeria, showing significant hospitalization rate reduction and mortality rate reduction compared ..
Jan 14
2024
Zhang et al., Pathogens, doi:10.3390/pathogens13010075 SARS-CoV-2 ORF3a Protein as a Therapeutic Target against COVID-19 and Long-Term Post-Infection Effects
Review of the ORF3a protein of SARS-CoV-2 as a therapeutic target for COVID-19 due to its role in viral pathogenesis, triggering cytokine storms, tissue damage, and disease severity. Existing drugs doxycycline, metformin, and ibrutinib ar..
Jun 17
2022
Stambouli et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.06.016 COVID-19 prophylaxis with Doxycycline and Zinc in Health Care Workers: A prospective randomized double-blind clinical tria
64% fewer cases (p=0.04) and 15% improved viral load (p<0.0001). Prophylaxis RCT with 59 zinc + doxycycline, 56 doxycycline, and 57 placebo healthcare workers, showing lower symptomatic cases and significantly improved Ct values with the addition of zinc to doxycycline treatment. Doxycycline 100mg/day ..
Nov 9
2021
Stone et al., Biologics, doi:10.3390/biologics2030015 (date from preprint) Changes in SpO2 on Room Air for 34 Severe COVID-19 Patients after Ivermectin-Based Combination Treatment: 62% Normalization within 24 Hours
Retrospective severe COVID-19 patients in Zimbabwe treated with ivermectin, doxycycline, and zinc. For 34 with SpO2 tracking, there was rapid improvement in SpO2, with 55% recovery towards SpO2 97 within 12 hours. The preprint shows furth..
Oct 19
2021
Borody et al., TrialSite News Combination Therapy For COVID-19 Based on Ivermectin in an Australian Population
92% lower mortality (p=0.03) and 93% lower hospitalization (p<0.0001). Retrospective 600 PCR+ outpatients in Australia treated with ivermectin, zinc, and doxycycline, showing significantly lower mortality and hospitalization with treatment. This trial uses a synthetic control group, and the preliminary repor..
Sep 30
2021
Butler et al., The Lancet Respiratory Medicine, doi:10.1016/S2213-2600(21)00310-6 Doxycycline for community treatment of suspected COVID-19 in people at high risk of adverse outcomes in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial
12% higher combined mortality/hospitalization (p=0.59), 51% lower ventilation (p=0.48), 45% lower ICU admission (p=0.36), and 2% lower need for oxygen therapy (p=0.95). RCT 2,508 high-risk patients (aged ≥65 or ≥50 with comorbidities) showing no significant benefit with doxycycline.
Aug 5
2021
Rana et al., In Silico Pharmacology, doi:10.1007/s40203-026-00576-w (date from preprint) Ivermectin and Doxycycline combination as a promising anti-viral drug candidate: an in-silico and DFT study
In silico study showing strong binding affinity of ivermectin and doxycycline for SARS-CoV-2 main protease 3CLpro, and increased binding affinity for the combination of both.
Jul 7
2021
Hazan et al., medRxiv, doi:10.1101/2021.07.06.21259924 Effectiveness of ivermectin-based multidrug therapy in severely hypoxic, ambulatory COVID-19 patients
100% lower mortality (p=0.04) and 100% lower hospitalization (p=0.001). Small study of 24 consecutive patients in serious condition (9 days post symptoms, mean SpO2 87.4) using combined treatment with ivermectin, doxycycline, zinc, vitamin D, and vitamin C, showing no mortality or hospitalization with treatme..
Jun 18
2021
Purwati et al., PLOS One, doi:10.1371/journal.pone.0252302 An in vitro study of dual drug combinations of anti-viral agents, antibiotics, and/or hydroxychloroquine against the SARS-CoV-2 virus isolated from hospitalized patients in Surabaya, Indonesia
In vitro study of combinations of drugs showing antiviral efficacy of HCQ alone and in combination with AZ, favipiravir, and doxycycline. No high levels of cytotoxicity were observed, and authors conclude that using a combination of drugs..
Apr 29
2021
Ahsan et al., Cureus, doi:10.7759/cureus.14761 Clinical Variants, Characteristics, and Outcomes Among COVID-19 Patients: A Case Series Analysis at a Tertiary Care Hospital in Karachi, Pakistan
50% lower mortality (p=0.03). Retrospective 165 hospitalized patients in Pakistan showing unadjusted lower mortality with combined ivermectin and doxycycline treatment. Details of the ivermectin group compared to other patients are not provided, however ivermectin was..
Dec 11
2020
Hussain et al., International Journal of Molecular and Immuno Oncology, doi:10.25259/IJMIO_30_2020 Outcome of ivermectin and doxycycline in cancer patients with COVID-19: A positive experience in Bangladesh
Small case study of ivermectin + doxycycline with 8 cancer patients, with all patients becoming PCR- by day 6 when tested again.
Nov 14
2020
Spoorthi et al., IAIM, 2020, 7:10, 177-182 Utility of Ivermectin and Doxycycline combination for the treatment of SARSCoV-2
21% faster recovery (p=0.03) and 16% shorter hospitalization (p=0.01). 100 patient prospective trial of ivermectin + doxycycline showing reduced time to symptom resolution and shorter hospital stay with treatment.
Oct 26
2020
Hashim et al., Iraqi Journal of Medical Science, 19:1 Controlled randomized clinical trial on using Ivermectin with doxycycline for treating COVID-19 patients in Baghdad, Iraq
92% lower mortality (p=0.03), 83% lower progression (p=0.07), and 41% faster recovery (p=0.0001). RCT 70 ivermectin+doxycycline patients and 70 control patients showing reduced time to recovery and reduced mortality with treatment. Earlier treatment was more successful. For ethical reasons, critical patients were all in the treatment ..
Oct 9
2020
Mahmud et al., Journal of International Medical Research, doi:10.5061/dryad.qjq2bvqf6 (date from preprint) Ivermectin in combination with doxycycline for treating COVID-19 symptoms: a randomized trial
86% lower mortality (p=0.25), 57% lower progression (p=0.001), 94% improved recovery (p<0.0001), and 39% improved viral clearance (p=0.002). RCT for ivermectin+doxycycline showing improvements in mortality, recovery, progression, and virological cure. 183 treatment and 183 control patients with no deaths in the treatment arm vs. 3 in the control arm (the 3 control deaths are n..
Jul 31
2020
Alam et al., Journal of Bangladesh College of Physicians and Surgeons, doi:10.3329/jbcps.v38i0.47512 A Case Series of 100 COVID-19 Positive Patients Treated with Combination of Ivermectin and Doxycycline
Case study of 100 patients treated with ivermectin and doxycycline, with no ICU admission, deaths, or serious side effects reported.
Jul 31
2020
Rahman et al., J. Bangladesh Coll. Phys. Surg. 38, 5-9, doi:10.3329/jbcps.v38i0 Comparison of Viral Clearance between Ivermectin with Doxycycline and Hydroxychloroquine with Azithromycin in COVID-19 Patients
Comparison of 200 patients treated with ivermectin + doxycycline and 200 treated with HCQ + AZ. The HCQ + AZ group had more severe cases at baseline. Viral clearance was faster with ivermectin + doxycycline, however ivermectin clearance r..
Jul 9
2020
Maurya, D., American Chemical Society (ACS), doi:10.26434/chemrxiv.12630539.v1 A Combination of Ivermectin and Doxycycline Possibly Blocks the Viral Entry and Modulate the Innate Immune Response in COVID-19 Patients
In silico study showing that a combination of ivermectin and doxycycline may inhibit SARS-CoV-2 infection through binding to multiple viral proteins as well as the host ACE2 receptor. Authors suggest that ivermectin may block viral entry ..