COVID-19 early treatment: real-time analysis of 1,160 studies

All studies Early treatment Mortality Early treatment mortality Recent studies Adoption

Analysis of 30 COVID-19 early treatments, and database of 231 other potential treatments. 67 countries have approved early treatments. Treatments do not replace vaccines and other measures. All practical, effective, and safe means should be used. Elimination is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all variants. Denying efficacy increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage.


Random effects meta-analysis of all studies combined (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.


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.


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.


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.

Treatment

Improvement
(early)

Studies
(early)

82%

68%

67%

67%

64%

51%

Early treatments approved by >2 countries. 67 countries have officially approved treatments. Details.

Recent studies (see the individual treatment pages for all studies):


Nov 26	Early	Merck News Release (News)	death, ↓89.0%, p=0.01	Merck and Ridgeback Biotherapeutics Provide Update on Results from MOVe-OUT Study of Molnupiravir, an Investigational Oral Antiviral Medicine, in At Risk Adults With Mild-to-Moderate COVID-19
	Details News release reporting results of the MOVe-OUT trial, showing significantly lower risk of hospitalization or death. In subgroup analysis efficacy was much lower with the delta variant. NCT04575597. Discussion of concerns with this trial ..
Nov 26	Details Source PDF Early treatment study Early treatment study
	Merck News Release (News)
	Merck and Ridgeback Biotherapeutics Provide Update on Results from MOVe-OUT Study of Molnupiravir, an Investigational Oral Antiviral Medicine, in At Risk Adults With Mild-to-Moderate COVID-19
	News release reporting results of the MOVe-OUT trial, showing significantly lower risk of hospitalization or death. In subgroup analysis efficacy was much lower with the delta variant. NCT04575597. Discussion of concerns with this trial can be found at [1, 2]. See also: [3, 4]. [1] trialsitenews.com/molnupiravir-mutagenic-carcinogenic-authorized-in-the-uk/ [2] defyccc.com/wp-content/uploads/Molnupiravir-Mutagenic-Carcinogenic-TSN.pdf [3] twitter.com/Covid19Crusher/status/1464249681446420485 [4] twitter.com/Covid19Crusher/status/1464269071818661893 risk of death, 89.0% lower, RR 0.11, p = 0.01, treatment 1 of 709 (0.1%), control 9 of 699 (1.3%). risk of combined hospitalization/death, 30.4% lower, RR 0.70, p = 0.05, treatment 48 of 709 (6.8%), control 68 of 699 (9.7%). risk of combined hospitalization/death, 94.1% lower, RR 0.06, p = 0.004, treatment 0 of 37 (0.0%), control 9 of 47 (19.1%), relative risk is not 0 because of continuity correction due to zero events, gamma variant. risk of combined hospitalization/death, 49.5% lower, RR 0.50, p = 0.15, treatment 6 of 75 (8.0%), control 13 of 82 (15.9%), mu variant. risk of combined hospitalization/death, 23.7% lower, RR 0.76, p = 0.41, treatment 18 of 237 (7.6%), control 22 of 221 (10.0%), delta variant. risk of combined hospitalization/death, 42.2% lower, RR 0.58, p = 0.36, treatment 5 of 47 (10.6%), control 7 of 38 (18.4%), other variants. Merck et al., 11/26/2021, Randomized Controlled Trial, multiple countries, multiple regions, preprint, 1 author.
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Nov 24	Early	Holubar et al., medRxiv, doi:10.1101/2021.11.22.21266690 (Preprint)	hosp., ↓89.0%, p=0.06	Favipiravir for treatment of outpatients with asymptomatic or uncomplicated COVID-19: a double-blind randomized, placebo-controlled, phase 2 trial
	Details Small RCT 116 mITT patients in the USA, 59 treated with favipiravir, showing no significant differences with treatment.
Nov 24	Details Source PDF Early treatment study Early treatment study
	Holubar et al., medRxiv, doi:10.1101/2021.11.22.21266690 (Preprint)
	Favipiravir for treatment of outpatients with asymptomatic or uncomplicated COVID-19: a double-blind randomized, placebo-controlled, phase 2 trial
	Small RCT 116 mITT patients in the USA, 59 treated with favipiravir, showing no significant differences with treatment. risk of hospitalization, 89.0% lower, RR 0.11, p = 0.06, treatment 0 of 75 (0.0%), control 4 of 74 (5.4%), relative risk is not 0 because of continuity correction due to zero events. risk of ER visit, 29.5% lower, RR 0.70, p = 0.56, treatment 5 of 75 (6.7%), control 7 of 74 (9.5%). risk of no recovery, 16.0% lower, RR 0.84, p = 0.43, treatment 65, control 70, initial resolution of symptoms. viral shedding cessation, 31.6% higher, RR 1.32, p = 0.24, treatment 59, control 57. Holubar et al., 11/24/2021, Double Blind Randomized Controlled Trial, USA, North America, preprint, 26 authors.
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Nov 23	Late	Ozer et al., Journal of Medical Virology, doi:10.1002/jmv.27469 (Peer Reviewed)	death, ↓75.0%, p=0.09	Effectiveness and Safety of Ivermectin in COVID‐19 Patients: A Prospective Study at A Safety‐Net Hospital
	Details Small prospective PSM study in the USA, showing 75% lower mortality with ivermectin treatment, without reaching statistical significance, significantly shorter ventilation and ICU time, and longer hospitalization time. Authors leave the ..
Nov 23	Details Source PDF Late treatment study Late treatment study
	Ozer et al., Journal of Medical Virology, doi:10.1002/jmv.27469 (Peer Reviewed)
	Effectiveness and Safety of Ivermectin in COVID‐19 Patients: A Prospective Study at A Safety‐Net Hospital
	Small prospective PSM study in the USA, showing 75% lower mortality with ivermectin treatment, without reaching statistical significance, significantly shorter ventilation and ICU time, and longer hospitalization time. Authors leave the statistically significant improvements in ventilation and ICU time out of the abtract and conclusions, and incorrectly state that there were no differences in other outcomes (there were no statistically significant differences): [1]. Authors are ambiguous on the primary outcome, referring to the primary mortality outcome in one case, and "clinical outcomes, measured by the rate of intubation, length of hospital stay, and mechanical ventilation duration" in another case. [1] nature.com/articles/d41586-019-00857-9 risk of death, 75.0% lower, RR 0.25, p = 0.09, treatment 2 of 60 (3.3%), control 8 of 60 (13.3%), PSM. risk of mechanical ventilation, 12.6% lower, RR 0.87, p = 0.20, treatment 3 of 60 (5.0%), control 2 of 60 (3.3%), OR converted to RR, PSM, multivariable. ventilation time, 83.3% lower, relative time 0.17, p = 0.002, treatment 60, control 60. risk of ICU admission, 48.7% lower, RR 0.51, p = 0.42, treatment 6 of 60 (10.0%), control 3 of 60 (5.0%), OR converted to RR, PSM, multivariable. ICU time, 70.6% lower, relative time 0.29, p < 0.001, treatment 60, control 60. hospitalization time, 9.0% higher, relative time 1.09, p = 0.09, treatment 60, control 60, PSM, multivariable. Ozer et al., 11/23/2021, prospective, USA, North America, peer-reviewed, 12 authors, dosage 200μg/kg days 1, 3.
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Nov 19	In Vitro	Tandel et al., bioRxiv, doi:10.1101/2021.11.18.469078 (Preprint) (In Vitro)	in vitro	Metformin Suppresses SARS-CoV-2 in Cell Culture
	Details In Vitro study showing metformin inhibits SARS-CoV-2 in Caco2 cells. Metformin reduced viral titers by nearly 99%, and by about 90% when cells were treated prior to infection.
Nov 19	Details Source PDF In Vitro In Vitro
	Tandel et al., bioRxiv, doi:10.1101/2021.11.18.469078 (Preprint) (In Vitro)
	Metformin Suppresses SARS-CoV-2 in Cell Culture
	In Vitro study showing metformin inhibits SARS-CoV-2 in Caco2 cells. Metformin reduced viral titers by nearly 99%, and by about 90% when cells were treated prior to infection. Tandel et al., 11/19/2021, preprint, 3 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
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Nov 19	Late	Chuah et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab962 (Peer Reviewed)	death, ↑1154.0%, p=0.08	Efficacy of Early Treatment with Favipiravir on Disease Progression among High Risk COVID-19 Patients: A Randomized, Open-Label Clinical Trial
	Details RCT 500 hospitalized patients in Malaysia, showing no significant differences with favipiravir treatment.
Nov 19	Details Source PDF Late treatment study Late treatment study
	Chuah et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab962 (Peer Reviewed)
	Efficacy of Early Treatment with Favipiravir on Disease Progression among High Risk COVID-19 Patients: A Randomized, Open-Label Clinical Trial
	RCT 500 hospitalized patients in Malaysia, showing no significant differences with favipiravir treatment. risk of death, 1154.0% higher, RR 12.54, p = 0.08, treatment 5 of 250 (2.0%), control 0 of 250 (0.0%), OR converted to RR, continuity correction due to zero event. risk of mechanical ventilation, 19.5% higher, RR 1.20, p = 0.76, treatment 6 of 250 (2.4%), control 5 of 250 (2.0%), OR converted to RR. risk of ICU admission, 8.5% higher, RR 1.09, p = 0.84, treatment 13 of 250 (5.2%), control 12 of 250 (4.8%), OR converted to RR. Chuah et al., 11/19/2021, Randomized Controlled Trial, Malaysia, Europe, peer-reviewed, 18 authors.
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Nov 18	Late	RECOVERY Collaborative Group, The Lancet, doi:10.1016/S0140-6736(21)01825-0 (Peer Reviewed)	death, ↓4.0%, p=0.35	Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
	Details RCT 14,892 late stage patients, 7,351 treated with aspirin, showing slightly improved discharge and hospitalization time, and no significant difference for mortality. Results are limited due to low dose (150mg daily), late treatment (9 d..
Nov 18	Details Source PDF Late treatment study Late treatment study
	RECOVERY Collaborative Group, The Lancet, doi:10.1016/S0140-6736(21)01825-0 (Peer Reviewed)
	Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
	RCT 14,892 late stage patients, 7,351 treated with aspirin, showing slightly improved discharge and hospitalization time, and no significant difference for mortality. Results are limited due to low dose (150mg daily), late treatment (9 days post symptom onset), and 96% concurrent use of low molecular weight heparin. Greater benefits were seen for non-LMWH patients, and for very late (<= 7 days from onset) vs. extremely late (>7 days) treatment. For more discussion see [1]. [1] twitter.com/Covid19Crusher/status/1461272964675031042 risk of death, 4.0% lower, RR 0.96, p = 0.35, treatment 7,351, control 7,541. risk of death, 17.0% lower, RR 0.83, p = 0.35, treatment 7,351, control 7,541, non-LMWH. risk of mechanical ventilation, 5.0% lower, RR 0.95, p = 0.32, treatment 7,351, control 7,541. risk of no hospital discharge, 5.7% lower, RR 0.94, p = 0.006, treatment 7,351, control 7,541. risk of no hospital discharge, 16.0% lower, RR 0.84, p = 0.04, treatment 7,351, control 7,541, non-LMWH. hospitalization time, 11.1% lower, relative time 0.89, treatment 7,351, control 7,541. RECOVERY et al., 11/18/2021, Randomized Controlled Trial, multiple countries, multiple regions, peer-reviewed, 1 author.
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Nov 17	PrEP	Samajdar et al., Journal of the Association of Physicians India, 69:11 (Peer Reviewed)	cases, ↓74.5%, p<0.0001	Ivermectin and Hydroxychloroquine for Chemo-Prophylaxis of COVID-19: A Questionnaire Survey of Perception and Prescribing Practice of Physicians vis-a-vis Outcomes
	Details Physician survey in India with 164 ivermectin prophylaxis, 129 HCQ prophylaxis, and 81 control patients, showing significantly lower COVID-19 cases with treatment. Details of the treatment and control groups and the definition of cases ar..
Nov 17	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Samajdar et al., Journal of the Association of Physicians India, 69:11 (Peer Reviewed)
	Ivermectin and Hydroxychloroquine for Chemo-Prophylaxis of COVID-19: A Questionnaire Survey of Perception and Prescribing Practice of Physicians vis-a-vis Outcomes
	Physician survey in India with 164 ivermectin prophylaxis, 129 HCQ prophylaxis, and 81 control patients, showing significantly lower COVID-19 cases with treatment. Details of the treatment and control groups and the definition of cases are not provided, and the results are subject to survey bias. Authors also report on community prophylaxis but present only combined ivermectin/HCQ results. risk of case, 74.5% lower, RR 0.25, p < 0.001, treatment 12 of 129 (9.3%), control 29 of 81 (35.8%), OR converted to RR, physician survey. risk of case, 48.6% lower, RR 0.51, p = 0.03, treatment 11 of 109 (10.1%), control 39 of 200 (19.5%), OR converted to RR, combined ivermectin or HCQ in community. Excluded in after exclusion results of meta analysis: minimal details provided, unadjusted results with no group details, results may be significantly affected by survey bias. Samajdar et al., 11/17/2021, retrospective, India, South Asia, peer-reviewed, 9 authors, dosage not specified.
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Nov 16	In Vitro	Marín-Palma et al., Molecules, doi:10.3390/molecules26226900 (Peer Reviewed) (In Vitro)	in vitro	Curcumin Inhibits In Vitro SARS-CoV-2 Infection In Vero E6 Cells through Multiple Antiviral Mechanisms
	Details In Vitro study showing antiviral and anti-inflammatory effects of curcumin during SARS-CoV-2 infection. Inhibition was seen with Vero E6 cells pre-infection and post-infection, and with D614G and the delta variant. The anti-inflammatory e..
Nov 16	Details Source PDF In Vitro In Vitro
	Marín-Palma et al., Molecules, doi:10.3390/molecules26226900 (Peer Reviewed) (In Vitro)
	Curcumin Inhibits In Vitro SARS-CoV-2 Infection In Vero E6 Cells through Multiple Antiviral Mechanisms
	In Vitro study showing antiviral and anti-inflammatory effects of curcumin during SARS-CoV-2 infection. Inhibition was seen with Vero E6 cells pre-infection and post-infection, and with D614G and the delta variant. The anti-inflammatory effect was shown with peripheral blood mononuclear cells. Marín-Palma et al., 11/16/2021, peer-reviewed, 9 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
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Nov 16	PrEP	Isa et al., medRxiv, doi:10.1101/2021.11.10.21265889 (Preprint)	symp. case, ↓92.6%, p=0.002	Repeat Subcutaneous Administration of REGEN-COV® in Adults is Well-Tolerated and Prevents the Occurrence of COVID-19
	Details RCT 969 patients, 729 treated with monthly subcutaneous casirivimab/imdevimab, showing significantly lower risk of COVID-19 with treatment. There were no grade 3 injection site reactions or hypersensitivity reactions. Slightly more TEAEs ..
Nov 16	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Isa et al., medRxiv, doi:10.1101/2021.11.10.21265889 (Preprint)
	Repeat Subcutaneous Administration of REGEN-COV® in Adults is Well-Tolerated and Prevents the Occurrence of COVID-19
	RCT 969 patients, 729 treated with monthly subcutaneous casirivimab/imdevimab, showing significantly lower risk of COVID-19 with treatment. There were no grade 3 injection site reactions or hypersensitivity reactions. Slightly more TEAEs were reported with treatment (54.9% vs. 48.3%), due to grade 1-2 ISRs. Serious adverse events were rare and occurred with similar percentages for treatment and control groups. There were no deaths. NCT04519437. risk of symptomatic case, 92.6% lower, RR 0.07, p = 0.002, treatment 3 of 729 (0.4%), control 13 of 240 (5.4%), OR converted to RR. risk of case, 92.7% lower, RR 0.07, p = 0.002, treatment 0 of 729 (0.0%), control 10 of 240 (4.2%), OR converted to RR, relative risk is not 0 because of continuity correction due to zero events, seroconversion. Conflicts of interest: employee of the drug patent holder. Isa et al., 11/16/2021, Double Blind Randomized Controlled Trial, USA, North America, preprint, 31 authors.
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Nov 15	PrEP	Oskotsky et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.33090 (Peer Reviewed)	death, ↑57.9%, p=0.62	Mortality Risk Among Patients With COVID-19 Prescribed Selective Serotonin Reuptake Inhibitor Antidepressants
	Details Retrospective database analysis of 83,584 patients in the USA, showing lower mortality with existing fluoxetine use in PSM analysis. There were 11 fluvoxamine patients, showing non-statistically significant higher mortality.
Nov 15	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Oskotsky et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.33090 (Peer Reviewed)
	Mortality Risk Among Patients With COVID-19 Prescribed Selective Serotonin Reuptake Inhibitor Antidepressants
	Retrospective database analysis of 83,584 patients in the USA, showing lower mortality with existing fluoxetine use in PSM analysis. There were 11 fluvoxamine patients, showing non-statistically significant higher mortality. risk of death, 57.9% higher, RR 1.58, p = 0.62, treatment 2 of 11 (18.2%), control 19 of 165 (11.5%), fluvoxamine. risk of death, 26.0% lower, RR 0.74, p = 0.04, treatment 48 of 481 (10.0%), control 956 of 7,215 (13.3%), fluoxetine. Oskotsky et al., 11/15/2021, retrospective, propensity score matching, USA, North America, peer-reviewed, 8 authors.
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Nov 14	In Vitro	Bahun et al., Food Chemistry, doi:10.1016/j.foodchem.2021.131594 (Peer Reviewed) (In Vitro)	in vitro	Inhibition of the SARS-CoV-2 3CLpro main protease by plant polyphenols
	Details In Silico and In Vitro study of plant polyphenols identifying quercetin, curcumin, ellagic acid, epigallocatechin gallate and resveratrol as SARS-CoV-2 3CL^pro inhibitors with IC₅₀ between 11.8µM and 23.4µM. Real-time binding was analyzed..
Nov 14	Details Source PDF In Vitro In Vitro
	Bahun et al., Food Chemistry, doi:10.1016/j.foodchem.2021.131594 (Peer Reviewed) (In Vitro)
	Inhibition of the SARS-CoV-2 3CLpro main protease by plant polyphenols
	In Silico and In Vitro study of plant polyphenols identifying quercetin, curcumin, ellagic acid, epigallocatechin gallate and resveratrol as SARS-CoV-2 3CL^pro inhibitors with IC₅₀ between 11.8µM and 23.4µM. Real-time binding was analyzed with surface plasmon resonance spectroscopy. Bahun et al., 11/14/2021, peer-reviewed, 10 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
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Nov 12	Levels	Sacristán et al., Transplantation Proceedings, doi:10.1016/j.transproceed.2021.08.060 (Peer Reviewed)		Risk of severe COVID-19 infection in kidney transplant recipients
	Details Retrospective 63 COVID+ kidney transplant recipients, showing significantly lower vitamin D levels before infection in patients requiring ICU admission.
Nov 12	Details Source PDF Levels Analysis of outcomes based on serum levels
	Sacristán et al., Transplantation Proceedings, doi:10.1016/j.transproceed.2021.08.060 (Peer Reviewed)
	Risk of severe COVID-19 infection in kidney transplant recipients
	Retrospective 63 COVID+ kidney transplant recipients, showing significantly lower vitamin D levels before infection in patients requiring ICU admission. Sacristán et al., 11/12/2021, peer-reviewed, 9 authors.
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Nov 12	Levels	Gönen et al., Nutrients, doi:10.3390/nu13114047 (Peer Reviewed)	death, ↓65.8%, p=0.62	Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1
	Details Retrospective 867 hospitalized COVID-19 patients in Turkey, showing worse outcomes with vitamin D deficiency (without statistical significance); followed by a prospective study of 210 patients with vitamin D supplementation for those that..
Nov 12	Details Source PDF Levels Analysis of outcomes based on serum levels
	Gönen et al., Nutrients, doi:10.3390/nu13114047 (Peer Reviewed)
	Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1
	Retrospective 867 hospitalized COVID-19 patients in Turkey, showing worse outcomes with vitamin D deficiency (without statistical significance); followed by a prospective study of 210 patients with vitamin D supplementation for those that were deficient, showing significantly lower mortality compared to the retrospective study without treatment. risk of death, 65.8% lower, RR 0.34, p = 0.62, high D levels (≥12ng/mL) 1 of 80 (1.2%), low D levels (<12ng/mL) 3 of 82 (3.7%), retrospective study. risk of ICU admission, 16.9% lower, RR 0.83, p = 1.00, high D levels (≥12ng/mL) 4 of 77 (5.2%), low D levels (<12ng/mL) 5 of 80 (6.2%), retrospective study. hospital stay >8 days, 21.1% lower, RR 0.79, p = 0.11, high D levels (≥12ng/mL) 40 of 78 (51.3%), low D levels (<12ng/mL) 52 of 80 (65.0%), retrospective study. Gönen et al., 11/12/2021, retrospective, Turkey, Europe, peer-reviewed, 20 authors, dosage varies.
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Nov 10	Levels	Asghar et al., Am. J. Trop. Med. Hyg., doi:10.4269/ajtmh.21-0577 (Peer Reviewed)	death, ↓53.1%, p=0.05	Evaluation of Vitamin-D Status and Its Association with Clinical Outcomes Among COVID-19 Patients in Pakistan
	Details Retrospective 91 hospitalized patients in Pakistan, showing vitamin D deficiency associated with mortality in multivariate Cox regression.
Nov 10	Details Source PDF Levels Analysis of outcomes based on serum levels
	Asghar et al., Am. J. Trop. Med. Hyg., doi:10.4269/ajtmh.21-0577 (Peer Reviewed)
	Evaluation of Vitamin-D Status and Its Association with Clinical Outcomes Among COVID-19 Patients in Pakistan
	Retrospective 91 hospitalized patients in Pakistan, showing vitamin D deficiency associated with mortality in multivariate Cox regression. risk of death, 53.1% lower, RR 0.47, p = 0.05, high D levels (≥10ng/mL) 73, low D levels (<10ng/mL) 18, multivariate Cox regression. risk of mechanical ventilation, 19.4% lower, RR 0.81, p = 0.32, high D levels (≥10ng/mL) 5 of 73 (6.8%), low D levels (<10ng/mL) 6 of 18 (33.3%), adjusted, multivariate Cox regression. risk of ICU admission, 32.9% lower, RR 0.67, p = 0.54, high D levels (≥10ng/mL) 73, low D levels (<10ng/mL) 18, multivariate Cox regression. Asghar et al., 11/10/2021, retrospective, Pakistan, South Asia, peer-reviewed, 8 authors.
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Nov 9	Late	Shenoy et al., medRxiv, doi:10.1101/2021.11.08.21265884 (Preprint)	death, ↑29.5%, p=0.54	Favipiravir In Adults with Moderate to Severe COVID-19: A Phase 3 Multicentre, Randomized, Double-Blind, Placebo-Controlled Trial
	Details Late stage RCT with 353 hospitalized patients, showing no significant differences with favipiravir treatment overall, however a trend towards benefit was seen within patients treated relatively early, including a statistically significant..
Nov 9	Details Source PDF Late treatment study Late treatment study
	Shenoy et al., medRxiv, doi:10.1101/2021.11.08.21265884 (Preprint)
	Favipiravir In Adults with Moderate to Severe COVID-19: A Phase 3 Multicentre, Randomized, Double-Blind, Placebo-Controlled Trial
	Late stage RCT with 353 hospitalized patients, showing no significant differences with favipiravir treatment overall, however a trend towards benefit was seen within patients treated relatively early, including a statistically significant shorter time to discharge with treatment. risk of death, 29.5% higher, RR 1.29, p = 0.54, treatment 14 of 175 (8.0%), control 11 of 178 (6.2%). risk of mechanical ventilation, 33.0% higher, RR 1.33, p = 0.54, treatment 17 of 175 (9.7%), control 13 of 178 (7.3%). risk of ICU admission, 1.7% higher, RR 1.02, p = 0.54, treatment 20 of 175 (11.4%), control 20 of 178 (11.2%). time to resolution of hypoxia, 1.0% higher, RR 1.01, p = 0.94, treatment 157, control 158. time to hospital discharge, 5.7% lower, RR 0.94, p = 0.60, treatment 175, control 178. time to resolution of hypoxia, 17.4% lower, RR 0.83, p = 0.29, treatment 157, control 158, earlier treatment subgroup. time to hospital discharge, 32.0% lower, RR 0.68, p = 0.01, treatment 175, control 178, earlier treatment subgroup. Shenoy et al., 11/9/2021, Double Blind Randomized Controlled Trial, Kuwait, Middle East, preprint, 8 authors.
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Nov 9	Late	Stone et al., Research Square, doi:10.21203/rs.3.rs-1048271/v1 (Preprint)		Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours
	Details 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. For all 92 severe cases,..
Nov 9	Details Source PDF Late treatment study Late treatment study
	Stone et al., Research Square, doi:10.21203/rs.3.rs-1048271/v1 (Preprint)
	Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 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. For all 92 severe cases, there was 2 deaths and 2 additional progressions prior to recovery, significantly less than a predicted 7 deaths and 17 deteriorations based on demographics and risk factors. Stone et al., 11/9/2021, preprint, 7 authors.
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Nov 8	Late	Tehrani et al., Urology Journal, doi:10.22037/uj.v18i.6863 (Peer Reviewed)	death, ↓87.1%, p=0.13	An investigation into the Effects of Intravenous Vitamin C on Pulmonary CT Findings and Clinical Outcomes of Patients with COVID 19 Pneumonia A Randomized Clinical Trial
	Details RCT 54 late stage patients, 18 treated with IV vitamin C (2g every 6h for 5 days), showing significant relative improvements in oxygen saturation and respiratory rate.
Nov 8	Details Source PDF Late treatment study Late treatment study
	Tehrani et al., Urology Journal, doi:10.22037/uj.v18i.6863 (Peer Reviewed)
	An investigation into the Effects of Intravenous Vitamin C on Pulmonary CT Findings and Clinical Outcomes of Patients with COVID 19 Pneumonia A Randomized Clinical Trial
	RCT 54 late stage patients, 18 treated with IV vitamin C (2g every 6h for 5 days), showing significant relative improvements in oxygen saturation and respiratory rate. risk of death, 87.1% lower, RR 0.13, p = 0.13, treatment 0 of 18 (0.0%), control 4 of 26 (15.4%), relative risk is not 0 because of continuity correction due to zero events. hospitalization time, 17.6% lower, relative time 0.82, p = 0.23, treatment 18, control 26. Tehrani et al., 11/8/2021, Randomized Controlled Trial, Iran, Middle East, peer-reviewed, 10 authors.
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Nov 8	PEP	Regeneron Press Release (News)	hosp., ↓92.3%, p=0.03	New phase 3 analyses show that a single dose of REGEN-COV® (casirivimab and imdevimab) provides long-term protection against COVID-19
	Details Long-term results for PEP RCT NCT04452318, with 841 baseline seronegative casirivimab/imdevimab patients and 842 placebo patients, showing significantly lower cases with treatment.
Nov 8	Details Source PDF Post Exposure Prophylaxis study Post Exposure Prophylaxis study
	Regeneron Press Release (News)
	New phase 3 analyses show that a single dose of REGEN-COV® (casirivimab and imdevimab) provides long-term protection against COVID-19
	Long-term results for PEP RCT NCT04452318, with 841 baseline seronegative casirivimab/imdevimab patients and 842 placebo patients, showing significantly lower cases with treatment. risk of hospitalization, 92.3% lower, RR 0.08, p = 0.03, treatment 0 of 841 (0.0%), control 6 of 842 (0.7%), relative risk is not 0 because of continuity correction due to zero events, 8 months. risk of case, 81.5% lower, RR 0.19, p < 0.001, treatment 20 of 841 (2.4%), control 108 of 842 (12.8%), months 1-8. risk of case, 81.6% lower, RR 0.18, p < 0.001, treatment 7 of 841 (0.8%), control 38 of 842 (4.5%), months 2-8. risk of hospitalization/ER, 88.9% lower, RR 0.11, p = 0.06, treatment 0 of 753 (0.0%), control 4 of 752 (0.5%), relative risk is not 0 because of continuity correction due to zero events, day 29. risk of symptomatic case, 81.4% lower, RR 0.19, p < 0.001, treatment 11 of 753 (1.5%), control 59 of 752 (7.8%), day 29. recovery time, 62.5% lower, relative time 0.37, p < 0.001, treatment 753, control 752, short-term followup, relative time with symptoms. time to viral-, 69.2% lower, relative time 0.31, p < 0.001, treatment 753, control 752, short-term followup, relative time with high viral load. Regeneron et al., 11/8/2021, Double Blind Randomized Controlled Trial, multiple countries, multiple regions, preprint, 1 author.
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Nov 6	Review	Goldstein, L., TrialSite News (Review) (News)	news	Molnupiravir: mutagenic, carcinogenic, authorized in the UK
	Details Discussion of concerns with molnupiravir and the MOVe-OUT trial. Author notes that results showing bone marrow toxicity in dogs were mentioned in this preprint [1], but removed from the journal version [2]. Some additional details were pr..
Nov 6	Details Source PDF Review Review
	Goldstein, L., TrialSite News (Review) (News)
	Molnupiravir: mutagenic, carcinogenic, authorized in the UK
	Discussion of concerns with molnupiravir and the MOVe-OUT trial. Author notes that results showing bone marrow toxicity in dogs were mentioned in this preprint [1], but removed from the journal version [2]. Some additional details were provided by the UK regulator: “Reversible, dose-related bone marrow toxicity affecting all haematopoietic cell lines was observed in dogs at ≥17 mg/kg/day (0.4 times the human NHC exposure at the recommended human dose (RHD)).” [3] For those without TrialSite News access, this article can also be found at [4]. [1] medrxiv.org/content/10.1101/2020.12.10.20235747v1 [2] journals.asm.org/doi/full/10.1128/AAC.02428-20 [3] gov.uk/government/publications/regulatory-approval-of-lagevrio-molnupiravir/summary-of-product-cha.. [4] defyccc.com/wp-content/uploads/Molnupiravir-Mutagenic-Carcinogenic-TSN.pdf Goldstein et al., 11/6/2021, preprint, 1 author.
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Nov 5	Early	Chechter et al., medRxiv, doi:10.1101/2021.11.05.21265569 (Preprint)	hosp., ↓94.7%, p=0.004	Evaluation of patients treated by telemedicine in the COVID-19 pandemic by a private clinic in Sao Paulo, Brazil: A non-randomized clinical trial preliminary study
	Details Prospective study of 187 telemedicine patients in Brazil. 74 presenting with moderate symptoms were offered treatment with HCQ+AZ, 12 did not accept HCQ (taking AZ only), forming a control group. There was lower hospitalization and improv..
Nov 5	Details Source PDF Early treatment study Early treatment study
	Chechter et al., medRxiv, doi:10.1101/2021.11.05.21265569 (Preprint)
	Evaluation of patients treated by telemedicine in the COVID-19 pandemic by a private clinic in Sao Paulo, Brazil: A non-randomized clinical trial preliminary study
	Prospective study of 187 telemedicine patients in Brazil. 74 presenting with moderate symptoms were offered treatment with HCQ+AZ, 12 did not accept HCQ (taking AZ only), forming a control group. There was lower hospitalization and improved recovery with treatment. There appears to be different group sizes in the text and tables without explanation (maybe a typo). RBR-658khm. risk of hospitalization, 94.7% lower, RR 0.05, p = 0.004, treatment 0 of 60 (0.0%), control 3 of 12 (25.0%), relative risk is not 0 because of continuity correction due to zero events. Excluded in after exclusion results of meta analysis: unadjusted results with no group details. Chechter et al., 11/5/2021, prospective, Brazil, South America, preprint, 13 authors, dosage 800mg day 1, 400mg days 2-5.
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Nov 5	Animal	Abdelnabi et al., bioRxiv, doi:10.1101/2021.11.04.467077 (Preprint)	animal study	The oral protease inhibitor (PF-07321332) protects Syrian hamsters against infection with SARS-CoV-2 variants of concern
	Details In Vitro and hamster study showing paxlovid component PF-07321332 effective against four variants of concern, inibits replication of the alpha variant in primary human airway epithelial cells, protected Syrian hamsters against intranasal ..
Nov 5	Details Source PDF Animal study Animal study
	Abdelnabi et al., bioRxiv, doi:10.1101/2021.11.04.467077 (Preprint)
	The oral protease inhibitor (PF-07321332) protects Syrian hamsters against infection with SARS-CoV-2 variants of concern
	In Vitro and hamster study showing paxlovid component PF-07321332 effective against four variants of concern, inibits replication of the alpha variant in primary human airway epithelial cells, protected Syrian hamsters against intranasal infection with B.1.351 and B.1.617.2, and prevented transmission from B.1.617.2 infected animals. Abdelnabi et al., 11/5/2021, preprint, 17 authors.
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Nov 5	Early	Pfizer Press Release (News)	death, ↓95.2%, p=0.002	Pfizer's novel COVID-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of phase 2/3 EPIC-HR study
	Details Interim analysis of EPIC-HR, 607 higher risk patients treated with paxlovid (PF-07321332 + ritonavir) and 612 control patients, showing significantly lower mortality and hospitalization with treatment.
Nov 5	Details Source PDF Early treatment study Early treatment study
	Pfizer Press Release (News)
	Pfizer's novel COVID-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of phase 2/3 EPIC-HR study
	Interim analysis of EPIC-HR, 607 higher risk patients treated with paxlovid (PF-07321332 + ritonavir) and 612 control patients, showing significantly lower mortality and hospitalization with treatment. risk of death, 95.2% lower, RR 0.05, p = 0.002, treatment 0 of 607 (0.0%), control 10 of 612 (1.6%), relative risk is not 0 because of continuity correction due to zero events, within 5 days. risk of death, 93.4% lower, RR 0.07, p = 0.007, treatment 0 of 389 (0.0%), control 7 of 385 (1.8%), relative risk is not 0 because of continuity correction due to zero events, within 3 days. risk of hospitalization, 85.2% lower, RR 0.15, p < 0.001, treatment 6 of 607 (1.0%), control 41 of 612 (6.7%), within 5 days. risk of hospitalization, 89.0% lower, RR 0.11, p < 0.001, treatment 3 of 389 (0.8%), control 27 of 385 (7.0%), within 3 days. Pfizer et al., 11/5/2021, Double Blind Randomized Controlled Trial, multiple countries, multiple regions, preprint, 1 author.
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Nov 3	Early	Rubin et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab546 (Peer Reviewed)	death, ↓97.0%, p<0.01	Bamlanivimab efficacy in older and high BMI outpatients with Covid-19 selected for treatment in a lottery-based allocation process
	Details Retrospective database analysis of 1257 PCR+ outpatients with age ≥65, BMI≥35, 191 receiving bamlanivimab via lottery. Authors note that the alpha variant was most common during the study period, and that efficacy against other variants c..
Nov 3	Details Source PDF Early treatment study Early treatment study
	Rubin et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab546 (Peer Reviewed)
	Bamlanivimab efficacy in older and high BMI outpatients with Covid-19 selected for treatment in a lottery-based allocation process
	Retrospective database analysis of 1257 PCR+ outpatients with age ≥65, BMI≥35, 191 receiving bamlanivimab via lottery. Authors note that the alpha variant was most common during the study period, and that efficacy against other variants can be much lower. Authors note confounding due to prioritization in the lottery and differential reporting in the database. The adjusted mortality result is in the abstract, with no details or mention in the paper, and we note that the change after adjustments is large: RR 0.56 -> OR 0.03. risk of death, 97.0% lower, RR 0.03, p < 0.01, treatment 1 of 191 (0.5%), control 10 of 1,066 (0.9%), OR converted to RR. risk of hospitalization, 65.3% lower, RR 0.35, p = 0.04, treatment 16 of 191 (8.4%), control 121 of 1,065 (11.4%), OR converted to RR, IPTW weighted logistic regression. Excluded in after exclusion results of meta analysis: significant unadjusted confounding possible. Conflicts of interest: research funding from the drug patent holder, consulting for the pharmaceutical industry. Rubin et al., 11/3/2021, retrospective, USA, North America, peer-reviewed, 7 authors.
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Nov 3	Levels	Gallelli et al., Nutrients, doi:10.3390/nu13113932 (Peer Reviewed)		Vitamin D Serum Levels in Subjects Tested for SARS-CoV-2: What Are the Differences among Acute, Healed, and Negative COVID-19 Patients? A Multicenter Real-Practice Study
	Details Analysis of 117 patients in Italy, showing COVID-19 patients had significantly lower vitamin D levels than control patients.
Nov 3	Details Source PDF Levels Analysis of outcomes based on serum levels
	Gallelli et al., Nutrients, doi:10.3390/nu13113932 (Peer Reviewed)
	Vitamin D Serum Levels in Subjects Tested for SARS-CoV-2: What Are the Differences among Acute, Healed, and Negative COVID-19 Patients? A Multicenter Real-Practice Study
	Analysis of 117 patients in Italy, showing COVID-19 patients had significantly lower vitamin D levels than control patients. Gallelli et al., 11/3/2021, prospective, Italy, Europe, peer-reviewed, 17 authors.
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Nov 3	Late	Malaysia Ministry of Health (News)	death, ↓69.1%, p=0.09	Kenyataan Akhbar KPK 3 November 2021 – Hasil Dapatan Kajian Keberkesanan Rawatan Ivermectin Untuk Pesakit COVID-19 Berisiko Tinggi (I-TECH Study)
	Details RCT 490 hospitalized patients in Malaysia, showing no significant differences. There was only 13 deaths - 3 for ivermectin and 10 for control. Minimal details are available currently. Group sizes are not provided (241/249 are the closest ..
Nov 3	Details Source PDF Late treatment study Late treatment study
	Malaysia Ministry of Health (News)
	Kenyataan Akhbar KPK 3 November 2021 – Hasil Dapatan Kajian Keberkesanan Rawatan Ivermectin Untuk Pesakit COVID-19 Berisiko Tinggi (I-TECH Study)
	RCT 490 hospitalized patients in Malaysia, showing no significant differences. There was only 13 deaths - 3 for ivermectin and 10 for control. Minimal details are available currently. Group sizes are not provided (241/249 are the closest counts that can produce the progression percentages provided). If the same event rates continue, the trial would need to add only ~13% more patients to find a statistically significant reduction in mortality. We note a stark contrast between the objective mortality results and the subjective progression results, and that the trial is open label. Some people involved in this trial may be subject to potential liability related to treatment decisions that could be partially mitigated by conflicting results. NCT04920942. risk of death, 69.1% lower, RR 0.31, p = 0.09, treatment 3 of 241 (1.2%), control 10 of 249 (4.0%), OR converted to RR. risk of disease progression, 22.8% higher, RR 1.23, p = 0.30, treatment 51 of 241 (21.2%), control 43 of 249 (17.3%), OR converted to RR. Excluded in after exclusion results of meta analysis: preliminary report with minimal details. Malaysia Ministry of Health et al., 11/3/2021, Randomized Controlled Trial, Malaysia, Europe, preprint, 1 author, dosage 400μg/kg days 1-5.
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Nov 2	Levels	Atanasovska et al., Redox Report, doi:10.1080/13510002.2021.1999126 (Peer Reviewed)	death, ↓40.7%, p=0.68	Vitamin D levels and oxidative stress markers in patients hospitalized with COVID-19
	Details Retrospective 33 COVID-19 hospitalized patients in North Macedonia, showing significantly lower vitamin D levels for severe vs. moderate cases. Oxidative stress was also higher for vitamin D insufficient patients.
Nov 2	Details Source PDF Levels Analysis of outcomes based on serum levels
	Atanasovska et al., Redox Report, doi:10.1080/13510002.2021.1999126 (Peer Reviewed)
	Vitamin D levels and oxidative stress markers in patients hospitalized with COVID-19
	Retrospective 33 COVID-19 hospitalized patients in North Macedonia, showing significantly lower vitamin D levels for severe vs. moderate cases. Oxidative stress was also higher for vitamin D insufficient patients. risk of death, 40.7% lower, RR 0.59, p = 0.68, high D levels (≥30ng/mL) 2 of 9 (22.2%), low D levels (<30ng/mL) 9 of 24 (37.5%). risk of severe case, 59.0% lower, RR 0.41, p = 0.13, high D levels (≥30ng/mL) 2 of 9 (22.2%), low D levels (<30ng/mL) 13 of 24 (54.2%). Atanasovska et al., 11/2/2021, retrospective, North Macedonia, Europe, peer-reviewed, 8 authors.
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Nov 2	Late	Sarhan et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.10.024 (Peer Reviewed)	death, ↓25.7%, p=0.39	Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients
	Details Small 108 patient RCT comparing HCQ vs. remdesivir in very late stage treatment. All patients received tocilizumab. There were significant unadjusted baseline differences in ventilation and ICU admission. NCT04779047. REC-H-PhBSU-21011.
Nov 2	Details Source PDF Late treatment study Late treatment study
	Sarhan et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.10.024 (Peer Reviewed)
	Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients
	Small 108 patient RCT comparing HCQ vs. remdesivir in very late stage treatment. All patients received tocilizumab. There were significant unadjusted baseline differences in ventilation and ICU admission. NCT04779047. REC-H-PhBSU-21011. risk of death, 25.7% lower, RR 0.74, p = 0.39, treatment 12 of 56 (21.4%), control 15 of 52 (28.8%). risk of no hospital discharge, 25.7% lower, RR 0.74, p = 0.39, treatment 12 of 56 (21.4%), control 15 of 52 (28.8%). hospitalization time, 25.0% higher, relative time 1.25, p = 0.06, treatment 56, control 52. Excluded in after exclusion results of meta analysis: very late stage, >50% on oxygen/ventilation at baseline, significant unadjusted differences between groups. Sarhan et al., 11/2/2021, Randomized Controlled Trial, Egypt, Africa, peer-reviewed, 8 authors, this trial compares with another treatment - results may be better when compared to placebo.
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Nov 2	N/A	Kaleta et al., Research Square, doi:10.21203/rs.3.rs-995033/v1 (Preprint)		Antibody escape and global spread of SARS-CoV-2 lineage A.27
	Details Anaysis of antibody escape showing variant A.27 completely escaped neutralization with LY-COV555 and partially with REGN10987. B.1.617.2 escaped these antibodies in a similar manner, suggesting that L452R facilitates the escape. Authors n..
Nov 2	Details Source PDF N/A N/A
	Kaleta et al., Research Square, doi:10.21203/rs.3.rs-995033/v1 (Preprint)
	Antibody escape and global spread of SARS-CoV-2 lineage A.27
	Anaysis of antibody escape showing variant A.27 completely escaped neutralization with LY-COV555 and partially with REGN10987. B.1.617.2 escaped these antibodies in a similar manner, suggesting that L452R facilitates the escape. Authors note that B.1.351 and P.1 escaped LY-COV555 and REGN10933, likely facilitated by the E484K mutation, suggesting that L452R and E484K lead to escape from LY-COV555 and to partial resistance to either REGN10987 or REGN10933, respectively. Kaleta et al., 11/2/2021, preprint, 33 authors.
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Nov 1	Late	Calusic et al., British Journal of Clinical Pharmacology, doi:10.1111/bcp.15126 (Peer Reviewed)	death, ↓42.0%, p=0.03	Safety and efficacy of fluvoxamine in COVID-19 ICU patients: an open label, prospective cohort trial with matched controls
	Details Prospective PSM study of 51 COVID-19 ICU patients in Croatia and 51 matched controls, showing significantly lower mortality with treatment.
Nov 1	Details Source PDF Late treatment study Late treatment study
	Calusic et al., British Journal of Clinical Pharmacology, doi:10.1111/bcp.15126 (Peer Reviewed)
	Safety and efficacy of fluvoxamine in COVID-19 ICU patients: an open label, prospective cohort trial with matched controls
	Prospective PSM study of 51 COVID-19 ICU patients in Croatia and 51 matched controls, showing significantly lower mortality with treatment. risk of death, 42.0% lower, RR 0.58, p = 0.03, treatment 30 of 51 (58.8%), control 39 of 51 (76.5%), adjusted, propensity score matching. Calusic et al., 11/1/2021, prospective, propensity score matching, Croatia, Europe, peer-reviewed, 7 authors.
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Nov 1	Late	Zarabanda et al., Laryngoscope, doi:10.1002/lary.29935 (Peer Reviewed)	no recov., ↑26.9%, p=1.00	The Effect of Povidone-Iodine Nasal Spray on COVID-19 Nasopharyngeal Viral Load in Patients: A Randomized Control Trial
	Details Very late treatment (7 days from onset) RCT comparing 11 & 13 PVP-I (0.5% and 2%), and 11 saline spray patients in the USA, showing no significant differences. There was no control group (saline is likely not a placebo, showing efficacy i..
Nov 1	Details Source PDF Late treatment study Late treatment study
	Zarabanda et al., Laryngoscope, doi:10.1002/lary.29935 (Peer Reviewed)
	The Effect of Povidone-Iodine Nasal Spray on COVID-19 Nasopharyngeal Viral Load in Patients: A Randomized Control Trial
	Very late treatment (7 days from onset) RCT comparing 11 & 13 PVP-I (0.5% and 2%), and 11 saline spray patients in the USA, showing no significant differences. There was no control group (saline is likely not a placebo, showing efficacy in other trials). There are large unadjusted differences between groups, e.g. 7.1 days from onset for PVP-I versus 4.8 for saline. Baseline Ct was higher for PVP-I, providing less room for improvement. Authors note that they cannot determine if earlier use is more beneficial. risk of no recovery, 26.9% higher, RR 1.27, p = 1.00, treatment 3 of 13 (23.1%), control 2 of 11 (18.2%), 2%. risk of no recovery, 50.0% higher, RR 1.50, p = 1.00, treatment 3 of 11 (27.3%), control 2 of 11 (18.2%), 0.5%. risk of no virological cure, no change, RR 1.00, p = 1.00, treatment 2 of 7 (28.6%), control 2 of 7 (28.6%), day 5, minus strand PCR. Zarabanda et al., 11/1/2021, Randomized Controlled Trial, USA, North America, peer-reviewed, 13 authors, this trial compares with another treatment - results may be better when compared to placebo.
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Nov 1	Late	Damayanti et al., Kesmas: National Public Health Journal, doi:10.21109/kesmas.v16i4.5433 (Peer Reviewed)	no recov., ↓54.5%, p=0.03	The Effectiveness and Safety of Favipiravir in COVID-19 Hospitalized Patients in Bali, Indonesia
	Details Retrospective 192 hospitalized patients in Indonesia, 96 patients treated with favipiravir, showing improved recovery with treatment. Only the abstract is currently available.
Nov 1	Details Source PDF Late treatment study Late treatment study
	Damayanti et al., Kesmas: National Public Health Journal, doi:10.21109/kesmas.v16i4.5433 (Peer Reviewed)
	The Effectiveness and Safety of Favipiravir in COVID-19 Hospitalized Patients in Bali, Indonesia
	Retrospective 192 hospitalized patients in Indonesia, 96 patients treated with favipiravir, showing improved recovery with treatment. Only the abstract is currently available. risk of no recovery, 54.5% lower, RR 0.46, p = 0.03, treatment 96, control 96, adjusted. Excluded in after exclusion results of meta analysis: minimal details provided. Damayanti et al., 11/1/2021, retrospective, Indonesia, South Asia, peer-reviewed, 3 authors.
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Oct 29	Early	Schiaroli et al., Mediterranean Journal of Hematology and Infectious Diseases, doi:10.4084/MJHID.2021.061 (Peer Reviewed)		Early Treatment with BamlanivimabAlone does not Prevent COVID-19 Hospitalization and Its Post-Acute Sequelae. A Real Experience in Umbria, Italy
	Details Retrospective 39 patients treated with bamlanivimab in Italy, showing results far below expectations based on the BLAZE1 trial. Authors note that most patients had the alpha variant which does not have the E484K and L452R mutations known ..
Oct 29	Details Source PDF Early treatment study Early treatment study
	Schiaroli et al., Mediterranean Journal of Hematology and Infectious Diseases, doi:10.4084/MJHID.2021.061 (Peer Reviewed)
	Early Treatment with BamlanivimabAlone does not Prevent COVID-19 Hospitalization and Its Post-Acute Sequelae. A Real Experience in Umbria, Italy
	Retrospective 39 patients treated with bamlanivimab in Italy, showing results far below expectations based on the BLAZE1 trial. Authors note that most patients had the alpha variant which does not have the E484K and L452R mutations known to lead to resistance. Schiaroli et al., 10/29/2021, retrospective, Italy, Europe, peer-reviewed, 7 authors.
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Oct 28	PEP	Verma et al., Indian Journal of Community Health, 33:3 (Peer Reviewed)		Assessing Knowledge, Attitude, and Practices towards Ivermectin Pre-exposure Prophylaxis for COVID-19 among Health Care Workers
	Details Survey of 306 healthcare workers involved in the medication of COVID-19 patients in India. 71% indicated that ivermectin had a protective effect for COVID-19.
Oct 28	Details Source PDF Post Exposure Prophylaxis study Post Exposure Prophylaxis study
	Verma et al., Indian Journal of Community Health, 33:3 (Peer Reviewed)
	Assessing Knowledge, Attitude, and Practices towards Ivermectin Pre-exposure Prophylaxis for COVID-19 among Health Care Workers
	Survey of 306 healthcare workers involved in the medication of COVID-19 patients in India. 71% indicated that ivermectin had a protective effect for COVID-19. Verma et al., 10/28/2021, peer-reviewed, 6 authors.
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Oct 27	Early	Baker et al., medRxiv, doi:10.1101/2021.10.26.21265512 (Preprint)		Dampening of the respiratory cytokine storm is promoted by inhaled budesonide in patients with early COVID-19
	Details Analysis of inflammatory mediators in the nasal mucosa of patients in the STOIC1 trial and a cohort of SARS-CoV-2 negative controls, showing that budesonide treatment decreased IL-33 and IFN-γ, implying a reduction in epithelial damage an..
Oct 27	Details Source PDF Early treatment study Early treatment study
	Baker et al., medRxiv, doi:10.1101/2021.10.26.21265512 (Preprint)
	Dampening of the respiratory cytokine storm is promoted by inhaled budesonide in patients with early COVID-19
	Analysis of inflammatory mediators in the nasal mucosa of patients in the STOIC1 trial and a cohort of SARS-CoV-2 negative controls, showing that budesonide treatment decreased IL-33 and IFN-γ, implying a reduction in epithelial damage and dampening of the interferon response. Treatment also increased CCL17 concentrations, suggesting improved T-cell response. Baker et al., 10/27/2021, preprint, 10 authors.
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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 1,160 studies, 772 present results comparing with a control group, 683 are treatment studies, and 89 analyze outcomes based on serum levels. There are 17 animal studies, 40 in silico studies, 57 in vitro studies, and 58 meta analyses.

Please send us corrections, updates, or comments. Vaccines and treatments are both extremely valuable and complementary. All practical, effective, and safe means should be used. Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage. 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. Treatment protocols for physicians are available from the FLCCC.

Thanks for your feedback! Please search before submitting papers and note that studies are listed under the date they were first available, which may be the date of an earlier preprint.

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Antiandrogens	(meta)	Metformin	(meta)
Aspirin	(meta)	Molnupiravir	(meta)
Bamlanivimab	(meta)	Nigella Sativa	(meta)
Bromhexine	(meta)	Nitazoxanide	(meta)
Budesonide	(meta)	Paxlovid	(meta)
Casirivimab/i..	(meta)	Povidone-Iod..	(meta)
Colchicine	(meta)	Probiotics	(meta)
Conv. Plasma	(meta)	Proxalutamide	(meta)
Curcumin	(meta)	Quercetin	(meta)
Favipiravir	(meta)	Remdesivir	(meta)
Fluvoxamine	(meta)	Sotrovimab	(meta)
Hydroxychloro..	(meta)	Vitamin A	(meta)
Iota-carragee..	(meta)	Vitamin C	(meta)
Ivermectin	(meta)	Vitamin D	(meta)
Melatonin	(meta)	Zinc	(meta)

Other Treatments		Global Adoption