COVID-19 early treatment: real-time analysis of 873 studies

All studies Early treatment Mortality Early treatment mortality Recent studies

Analysis of the efficacy of early treatments for COVID-19. Treatments do not replace vaccines and other measures. 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.

Treatment

Improvement
(early)

Studies
(early)

82%

72%

69%

67%

64%

39%

Early treatments approved by >2 countries. 60 countries have officially approved treatments. Details.


Random effects meta-analysis of all studies combined (pooled effects, all stages). Treatments with ≤3 studies or <25 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.


Random effects meta-analysis of early treatment studies (pooled effects). Treatments with ≤3 studies or <25 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.


Random effects meta-analysis of all mortality results (all stages). Treatments with ≤3 studies or <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.


Random effects meta-analysis of early treatment mortality results. Treatments with ≤3 studies or <25 control events are shown in grey.

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


Aug 25	Meta	Varikasuvu (Preprint) (meta analysis)	meta-analysis	COVID-19 and Vitamin D (Co-VIVID Study): a systematic review and meta-analysis of randomized controlled trials
	Details Meta analysis of 6 vitamin D treatment RCTs, showing statistically significant improvements for pooled outcomes and PCR positivity, and positive but not statistically significant improvements for mortality, mechanical ventilation, ICU adm..
Aug 25	Details Source PDF Meta Meta
	Varikasuvu (Preprint) (meta analysis)
	COVID-19 and Vitamin D (Co-VIVID Study): a systematic review and meta-analysis of randomized controlled trials
	Meta analysis of 6 vitamin D treatment RCTs, showing statistically significant improvements for pooled outcomes and PCR positivity, and positive but not statistically significant improvements for mortality, mechanical ventilation, ICU admission, and severity. Varikasuvu et al., 8/25/2021, preprint, 3 authors.
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Aug 25	Early	Rodrigues et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2021.106428 (Peer Reviewed)	hosp., ↑200.0%, p=1.00	Hydroxychloroquine plus azithromycin early treatment of mild COVID-19 in outpatient setting: a randomized, double-blinded, placebo-controlled clinical trial evaluating viral clearance
	Details RCT 84 low risk patients, 42 treated with HCQ/AZ, showing no significant differences. There was only one hospitalization which was in the treatment arm. HCQ was low dose and without a loading dose, therefore may not reach therapeutic conc..
Aug 25	Details Source PDF Early treatment study Early treatment study
	Rodrigues et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2021.106428 (Peer Reviewed)
	Hydroxychloroquine plus azithromycin early treatment of mild COVID-19 in outpatient setting: a randomized, double-blinded, placebo-controlled clinical trial evaluating viral clearance
	RCT 84 low risk patients, 42 treated with HCQ/AZ, showing no significant differences. There was only one hospitalization which was in the treatment arm. HCQ was low dose and without a loading dose, therefore may not reach therapeutic concentrations before the low risk population recovers without treatment. risk of hospitalization, 200.0% higher, RR 3.00, p = 1.00, treatment 1 of 42 (2.4%), control 0 of 42 (0.0%), continuity correction due to zero event. risk of no virological cure, 14.4% lower, RR 0.86, p = 0.15, treatment 29 of 36 (80.6%), control 32 of 34 (94.1%), PP, day 3. risk of no virological cure, 13.1% lower, RR 0.87, p = 0.45, treatment 23 of 36 (63.9%), control 25 of 34 (73.5%), PP, day 6. risk of no virological cure, 23.3% lower, RR 0.77, p = 0.47, treatment 13 of 36 (36.1%), control 16 of 34 (47.1%), PP, day 9. risk of no virological cure, 3.1% lower, RR 0.97, p = 1.00, treatment 31 of 42 (73.8%), control 32 of 42 (76.2%), ITT, day 3. risk of no virological cure, no change, RR 1.00, p = 1.00, treatment 25 of 42 (59.5%), control 25 of 42 (59.5%), ITT, day 6. risk of no virological cure, 6.2% lower, RR 0.94, p = 1.00, treatment 15 of 42 (35.7%), control 16 of 42 (38.1%), ITT, day 9. time to viral-, 8.8% lower, relative time 0.91, p = 0.26, treatment 36, control 34, PP. time to viral-, 1.4% lower, relative time 0.99, p = 0.85, treatment 42, control 42, ITT. Rodrigues et al., 8/25/2021, Double Blind Randomized Controlled Trial, Brazil, South America, peer-reviewed, 8 authors.
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Aug 25	PrEP	Naggie et al., medRxiv, doi:10.1101/2021.08.19.21262275 (Preprint)	symp. case, ↓23.5%, p=0.18	Hydroxychloroquine for pre-exposure prophylaxis of COVID-19 in health care workers: a randomized, multicenter, placebo-controlled trial (HERO-HCQ)
	Details RCT 1,360 healthcare workers in the USA showing OR 0.75 [0.49-1.15] for confirmed or suspected COVID-19 clinical infection by day 30. There were no significant safety issues. Authors note that pooling the results with the COVID PREP study..
Aug 25	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Naggie et al., medRxiv, doi:10.1101/2021.08.19.21262275 (Preprint)
	Hydroxychloroquine for pre-exposure prophylaxis of COVID-19 in health care workers: a randomized, multicenter, placebo-controlled trial (HERO-HCQ)
	RCT 1,360 healthcare workers in the USA showing OR 0.75 [0.49-1.15] for confirmed or suspected COVID-19 clinical infection by day 30. There were no significant safety issues. Authors note that pooling the results with the COVID PREP study gives OR 0.74 [0.55-1.0] p = 0.046. NCT04334148. risk of symptomatic case, 23.5% lower, RR 0.76, p = 0.18, treatment 41 of 683 (6.0%), control 53 of 676 (7.8%), OR converted to RR, logistic regression. risk of symptomatic case, 29.3% lower, RR 0.71, p = 0.18, treatment 41 of 683 (6.0%), control 53 of 676 (7.8%), OR converted to RR, Mantel–Haenszel. Naggie et al., 8/25/2021, Randomized Controlled Trial, USA, North America, preprint, 22 authors.
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Aug 24	PrEP	Patil et al., Research Square, doi:10.21203/rs.3.rs-805748/v1 (Preprint)	death, ↓65.9%, p=0.10	A Prospective Longitudinal Study Evaluating The Influence of Immunosuppressives and Other Factors On COVID-19 in Autoimmune Rheumatic Diseases
	Details Prospective study of 9,212 autoimmune rheumatic disease patients showing lower mortality with HCQ, without reaching statistical significance. Authors incorrectly state "HCQ use did not influence occurrence of COVID-19 (RR = 0.909, CI..
Aug 24	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Patil et al., Research Square, doi:10.21203/rs.3.rs-805748/v1 (Preprint)
	A Prospective Longitudinal Study Evaluating The Influence of Immunosuppressives and Other Factors On COVID-19 in Autoimmune Rheumatic Diseases
	Prospective study of 9,212 autoimmune rheumatic disease patients showing lower mortality with HCQ, without reaching statistical significance. Authors incorrectly state "HCQ use did not influence occurrence of COVID-19 (RR = 0.909, CI (0.715,1.154), p = 0.432) or mortality (p = 0.097)" [1]. CFR for the autoimmune rheumatic disease patients was 4.6 times higher than in the general population from the same area. [1] nature.com/articles/d41586-019-00857-9 risk of death, 65.9% lower, RR 0.34, p = 0.10, treatment 5266, control 3946. risk of COVID-19 case, 9.1% lower, RR 0.91, p = 0.43, treatment 167 of 5266 (3.2%), control 147 of 3946 (3.7%), adjusted. Patil et al., 8/24/2021, prospective, India, South Asia, preprint, 20 authors.
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Aug 24	Late	Almoosa et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.022 (Peer Reviewed)	death, ↑42.3%, p=0.10	Favipiravir versus Standard of Care in Patients with Severe COVID-19 Infections: A Retrospective Comparative Study
	Details Retrospective 226 COVID-19 pneumonia patients, 110 treated with favipiravir, showing higher mortality (p=0.1) and ICU admission (p=0.02) with treatment in multivariate analysis.
Aug 24	Details Source PDF Late treatment study Late treatment study
	Almoosa et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.022 (Peer Reviewed)
	Favipiravir versus Standard of Care in Patients with Severe COVID-19 Infections: A Retrospective Comparative Study
	Retrospective 226 COVID-19 pneumonia patients, 110 treated with favipiravir, showing higher mortality (p=0.1) and ICU admission (p=0.02) with treatment in multivariate analysis. risk of death, 42.3% higher, RR 1.42, p = 0.10, treatment 33 of 110 (30.0%), control 24 of 116 (20.7%), adjusted, OR converted to RR, overall mortality, multivariate binary logistic regression. risk of ICU admission, 90.0% higher, RR 1.90, p = 0.02, treatment 110, control 116, adjusted, multivariate binary logistic regression, RR approximated with OR. recovery time, 10.9% higher, relative time 1.11, p = 0.17, treatment 110, control 116. Almoosa et al., 8/24/2021, retrospective, Saudi Arabia, Middle East, peer-reviewed, 14 authors.
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Aug 23	Late	Reis et al., Preprint (Preprint)	death, ↓29.3%, p=0.26	Effect of early treatment with fluvoxamine on risk of emergency care and hospitalization among patients with COVID-19: The Together randomized platform clinical trial
	Details Together Trial preprint showing significantly lower hospitalization/extended ER visits with treatment, per-protocol analysis RR 0.34 [0.20-0.54]; ITT analysis RR 0.71 [0.54-0.93]. Adherence was only 73.2%. Symptom onset was unspecified or..
Aug 23	Details Source PDF Late treatment study Late treatment study
	Reis et al., Preprint (Preprint)
	Effect of early treatment with fluvoxamine on risk of emergency care and hospitalization among patients with COVID-19: The Together randomized platform clinical trial
	Together Trial preprint showing significantly lower hospitalization/extended ER visits with treatment, per-protocol analysis RR 0.34 [0.20-0.54]; ITT analysis RR 0.71 [0.54-0.93]. Adherence was only 73.2%. Symptom onset was unspecified or >= 4 days for 57% of patients. The schedule of study activities specifies treatment administration only one day after randomization, adding an additional day delay. Overall mortality is high for the patient population. Results may be impacted by late treatment, poor SOC, and may be specific to local variants [1, 2]. The total dose used is less than half of that in Lenze et al. Per protocol analysis is not provided for mortality. There is an unusual amount of missing data raising questions about the reliability of data overall - age is unknown for 6.5% of patients according to the sub-group analysis. Both age <=50 and >50 show better results on the primary outcome than the overall result, indicating that the relatively low treatment effect seen in this study is driven more by patients with unknown age. NCT04727424. Also see [3]. [1] science.sciencemag.org/content/372/6544/815 [2] thelancet.com/article/S0140-6736(21)00183-5/fulltext [3] twitter.com/Covid19Crusher/status/1430170252575395843 risk of death, 29.3% lower, RR 0.71, p = 0.26, treatment 17 of 739 (2.3%), control 24 of 733 (3.3%), OR converted to RR. risk of hospitalization, 18.9% lower, RR 0.81, p = 0.17, treatment 74 of 739 (10.0%), control 90 of 733 (12.3%), OR converted to RR. extended ER observation or hospitalization, 66.0% lower, RR 0.34, p < 0.001, treatment 541, control 609, per protocol. extended ER observation or hospitalization, 29.0% lower, RR 0.71, p = 0.01, treatment 77 of 739 (10.4%), control 108 of 733 (14.7%), ITT. extended ER observation or hospitalization, 32.0% lower, RR 0.68, p = 0.01, treatment 77 of 728 (10.6%), control 108 of 722 (15.0%), mITT. Reis et al., 8/23/2021, Double Blind Randomized Controlled Trial, Brazil, South America, preprint, 25 authors.
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Aug 20	In Silico	Song et al., Journal of Biomolecular Structure and Dynamics, doi:10.1080/07391102.2021.1964601 (Peer Reviewed)		Vitamin D3 and its hydroxyderivatives as promising drugs against COVID-19: a computational study
	Details In Silico study suggesting that vitamin D3 and its biologically active hydroxyderivatives can serve as an TMPRSS2 inhibitor, and inhibit ACE2 binding with the SARS-CoV-2 RBD.
Aug 20	Details Source PDF In Silico In Silico
	Song et al., Journal of Biomolecular Structure and Dynamics, doi:10.1080/07391102.2021.1964601 (Peer Reviewed)
	Vitamin D3 and its hydroxyderivatives as promising drugs against COVID-19: a computational study
	In Silico study suggesting that vitamin D3 and its biologically active hydroxyderivatives can serve as an TMPRSS2 inhibitor, and inhibit ACE2 binding with the SARS-CoV-2 RBD. Song et al., 8/20/2021, peer-reviewed, 7 authors.
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Aug 19	In Silico	González-Paz et al., Biophysical Chemistry, doi:10.1016/j.bpc.2021.106677 (Peer Reviewed)		Comparative study of the interaction of ivermectin with proteins of interest associated with SARS-CoV-2: A computational and biophysical approach
	Details In SIlico analysis of the components of ivermectin (avermectin-B1a and avermectin-B1b), suggesting different and complementary inhibitory activity of each component, with an affinity of avermectin-B1b for viral structures, and of avermect..
Aug 19	Details Source PDF In Silico In Silico
	González-Paz et al., Biophysical Chemistry, doi:10.1016/j.bpc.2021.106677 (Peer Reviewed)
	Comparative study of the interaction of ivermectin with proteins of interest associated with SARS-CoV-2: A computational and biophysical approach
	In SIlico analysis of the components of ivermectin (avermectin-B1a and avermectin-B1b), suggesting different and complementary inhibitory activity of each component, with an affinity of avermectin-B1b for viral structures, and of avermectin-B1a for host structures. González-Paz et al., 8/19/2021, peer-reviewed, 9 authors.
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Aug 19	Late	Diaz et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab698 (Peer Reviewed)	death, ↓34.7%, p=0.01	Remdesivir and Mortality in Patients with COVID-19
	Details Retrospective 1138 hospitalized patients in the USA, 286 treated with remdesivir, showing lower mortality with treatment.
Aug 19	Details Source PDF Late treatment study Late treatment study
	Diaz et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab698 (Peer Reviewed)
	Remdesivir and Mortality in Patients with COVID-19
	Retrospective 1138 hospitalized patients in the USA, 286 treated with remdesivir, showing lower mortality with treatment. risk of death, 34.7% lower, RR 0.65, p = 0.01, treatment 33 of 286 (11.5%), control 173 of 852 (20.3%), adjusted, OR converted to RR, multivariable Cox proportional-hazards. Diaz et al., 8/19/2021, retrospective, USA, North America, peer-reviewed, 45 authors.
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Aug 18	Meta	Neil et al., Research Gate, doi:10.13140/RG.2.2.19703.75680 (Preprint) (meta analysis)	meta-analysis	Bayesian hypothesis testing and hierarchical modelling of ivermectin effectiveness in treating Covid-19
	Details Updated Bayesian analysis of a subset of ivermectin trials showing that there is strong evidence to support a causal link between ivermectin and COVID-19 severity and mortality, and that the result is robust in sensitivity analysis, inclu..
Aug 18	Details Source PDF Meta Meta
	Neil et al., Research Gate, doi:10.13140/RG.2.2.19703.75680 (Preprint) (meta analysis)
	Bayesian hypothesis testing and hierarchical modelling of ivermectin effectiveness in treating Covid-19
	Updated Bayesian analysis of a subset of ivermectin trials showing that there is strong evidence to support a causal link between ivermectin and COVID-19 severity and mortality, and that the result is robust in sensitivity analysis, including exclusion of Elgazzar et al. Neil et al., 8/18/2021, preprint, 2 authors.
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Aug 17	In Silico	González-Paz et al., Journal of Molecular Liquids, doi:10.1016/j.molliq.2021.117284 (Peer Reviewed)		Structural Deformability Induced in Proteins of Potential Interest Associated with COVID-19 by binding of Homologues present in Ivermectin: Comparative Study Based in Elastic Networks Models
	Details In Silico elastic network model analysis of ivermectin components (avermectin-B1a and avermectin-B1b) providing a biophysical and computational perspective of proposed multi-target activity of ivermectin for COVID-19.
Aug 17	Details Source PDF In Silico In Silico
	González-Paz et al., Journal of Molecular Liquids, doi:10.1016/j.molliq.2021.117284 (Peer Reviewed)
	Structural Deformability Induced in Proteins of Potential Interest Associated with COVID-19 by binding of Homologues present in Ivermectin: Comparative Study Based in Elastic Networks Models
	In Silico elastic network model analysis of ivermectin components (avermectin-B1a and avermectin-B1b) providing a biophysical and computational perspective of proposed multi-target activity of ivermectin for COVID-19. González-Paz et al., 8/17/2021, peer-reviewed, 9 authors.
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Aug 17	Early	Baxter et al., medRxiv, doi:10.1101/2021.08.16.21262044 (Preprint)	hosp., ↓65.3%, p=1.00	Rapid initiation of nasal saline irrigation: hospitalizations in COVID-19 patients randomized to alkalinization or povidone-iodine compared to a national dataset
	Details Small RCT 79 PCR+ patients 55+ comparing pressure-based nasal irrigation with povidone-iodine and sodium bicarbonate, showing improved recovery with povidone-iodine, and 0/37 COVID-19 related hospitalizations for povidone-iodine compared ..
Aug 17	Details Source PDF Early treatment study Early treatment study
	Baxter et al., medRxiv, doi:10.1101/2021.08.16.21262044 (Preprint)
	Rapid initiation of nasal saline irrigation: hospitalizations in COVID-19 patients randomized to alkalinization or povidone-iodine compared to a national dataset
	Small RCT 79 PCR+ patients 55+ comparing pressure-based nasal irrigation with povidone-iodine and sodium bicarbonate, showing improved recovery with povidone-iodine, and 0/37 COVID-19 related hospitalizations for povidone-iodine compared to 1/42 for sodium bicarbonate. NCT04559035. risk of hospitalization, 65.3% lower, RR 0.35, p = 1.00, treatment 0 of 37 (0.0%), control 1 of 42 (2.4%), continuity correction due to zero event. risk of hospitalization/ER, 79.0% lower, RR 0.21, p = 0.50, treatment 0 of 37 (0.0%), control 2 of 42 (4.8%), continuity correction due to zero event. risk of no recovery, 56.0% lower, RR 0.44, p = 0.03, treatment 6 of 25 (24.0%), control 18 of 33 (54.5%). Baxter et al., 8/17/2021, Randomized Controlled Trial, USA, North America, preprint, 9 authors, this trial compares with another treatment - results may be better when compared to placebo.
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Aug 15	Early	Koshak et al., Complementary Therapies in Medicine, doi:10.1016/j.ctim.2021.102769 (Peer Reviewed)	hosp., ↓74.7%, p=0.37	Nigella sativa for the treatment of COVID-19: An open-label randomized controlled clinical trial
	Details RCT 183 mild COVID-19 outpatients in Saudi Arabia, 91 treated with Nigella Sativa, showing lower hospitalization and faster recovery with treatment. NCT04401202.
Aug 15	Details Source PDF Early treatment study Early treatment study
	Koshak et al., Complementary Therapies in Medicine, doi:10.1016/j.ctim.2021.102769 (Peer Reviewed)
	Nigella sativa for the treatment of COVID-19: An open-label randomized controlled clinical trial
	RCT 183 mild COVID-19 outpatients in Saudi Arabia, 91 treated with Nigella Sativa, showing lower hospitalization and faster recovery with treatment. NCT04401202. risk of hospitalization, 74.7% lower, RR 0.25, p = 0.37, treatment 1 of 91 (1.1%), control 4 of 92 (4.3%). risk of no recovery, 42.7% lower, RR 0.57, p < 0.001, treatment 34 of 91 (37.4%), control 60 of 92 (65.2%). Koshak et al., 8/15/2021, Randomized Controlled Trial, Saudi Arabia, Middle East, peer-reviewed, 10 authors.
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Aug 13	Late	Hosseini et al., medRxiv, doi:10.1101/2021.08.13.21261992 (Preprint)		Another step toward final call on Remdesivir efficacy as a treatment for hospitalized COVID-19 patients: a multicenter open-label trial
	Details Single arm remdesivir trial with 145 hospitalized patients showing no statistically significant difference between "early" and "late" administration, however the treatment delays may be better described as late and ver..
Aug 13	Details Source PDF Late treatment study Late treatment study
	Hosseini et al., medRxiv, doi:10.1101/2021.08.13.21261992 (Preprint)
	Another step toward final call on Remdesivir efficacy as a treatment for hospitalized COVID-19 patients: a multicenter open-label trial
	Single arm remdesivir trial with 145 hospitalized patients showing no statistically significant difference between "early" and "late" administration, however the treatment delays may be better described as late and very late. The text of the paper defines early and late as less than or more than 7 days from symptom onset, however the CONSORT diagram says during or after 7 days post admission. Hosseini et al., 8/13/2021, preprint, 15 authors.
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Aug 12	Review	Hoertel et al., Molecular Psychiatry, doi:10.1038/s41380-021-01254-3 (Review) (Peer Reviewed)	review	Repurposing antidepressants inhibiting the sphingomyelinase acid/ceramide system against COVID-19: current evidence and potential mechanisms
	Details Review of the mechanisms of action and clinical studies for the treatment of COVID-19 with FIASMA antidepressants such as fluoxetine, fluvoxamine, paroxetine, escitalopram, or amitriptyline.
Aug 12	Details Source PDF Review Review
	Hoertel et al., Molecular Psychiatry, doi:10.1038/s41380-021-01254-3 (Review) (Peer Reviewed)
	Repurposing antidepressants inhibiting the sphingomyelinase acid/ceramide system against COVID-19: current evidence and potential mechanisms
	Review of the mechanisms of action and clinical studies for the treatment of COVID-19 with FIASMA antidepressants such as fluoxetine, fluvoxamine, paroxetine, escitalopram, or amitriptyline. Hoertel et al., 8/12/2021, peer-reviewed, 12 authors.
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Aug 12	Levels	di Filippo et al, The Journal of Clinical Endocrinology & Metabolism, doi:10.1210/clinem/dgab599 (Peer Reviewed)	death, ↓10.7%, p=1.00	Vitamin D levels associate with blood glucose and BMI in COVID-19 patients predicting disease severity
	Details Retrospective 88 patients in Italy, showing vitamin D deficiency associated with severe cases, blood glucose, and BMI.
Aug 12	Details Source PDF Levels Analysis of outcomes based on serum levels
	di Filippo et al, The Journal of Clinical Endocrinology & Metabolism, doi:10.1210/clinem/dgab599 (Peer Reviewed)
	Vitamin D levels associate with blood glucose and BMI in COVID-19 patients predicting disease severity
	Retrospective 88 patients in Italy, showing vitamin D deficiency associated with severe cases, blood glucose, and BMI. risk of death, 10.7% lower, RR 0.89, p = 1.00, treatment 5 of 28 (17.9%), control 12 of 60 (20.0%), >20ng/mL. risk of ICU admission, 41.6% lower, RR 0.58, p = 0.22, treatment 6 of 28 (21.4%), control 22 of 60 (36.7%), >20ng/mL. risk of COVID-19 severe case, 39.6% lower, RR 0.60, p = 0.04, treatment 11 of 28 (39.3%), control 39 of 60 (65.0%), >20ng/mL. di Filippo et al., 8/12/2021, retrospective, Italy, Europe, peer-reviewed, 8 authors.
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Aug 12	Late	Elavarasi et al., medRxiv, doi:10.1101/2021.08.10.21261855 (Preprint)	death, ↓19.6%, p=0.12	Clinical features, demography and predictors of outcomes of SARS-CoV-2 infection in a tertiary care hospital in India - a cohort study
	Details Retrospective 2017 hospitalized patients in India, showing lower mortality with ivermectin treatment in unadjusted results. No group details are provided and this result is subject to confounding by indication.
Aug 12	Details Source PDF Late treatment study Late treatment study
	Elavarasi et al., medRxiv, doi:10.1101/2021.08.10.21261855 (Preprint)
	Clinical features, demography and predictors of outcomes of SARS-CoV-2 infection in a tertiary care hospital in India - a cohort study
	Retrospective 2017 hospitalized patients in India, showing lower mortality with ivermectin treatment in unadjusted results. No group details are provided and this result is subject to confounding by indication. risk of death, 19.6% lower, RR 0.80, p = 0.12, treatment 48 of 283 (17.0%), control 311 of 1475 (21.1%), unadjusted. Elavarasi et al., 8/12/2021, retrospective, India, South Asia, preprint, 26 authors.
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Aug 12	N/A	Pedroso et al., The Brazilian Journal of Infectious Diseases, doi:10.1016/j.bjid.2021.101603 (Peer Reviewed)		Self-prescribed Ivermectin use is associated with a lower rate of seroconversion in health care workers diagnosed with COVID, in a dose-dependent response
	Details Retrospective 45 healthcare workes in Brazil, showing lower creation of antibodies with multiple doses of ivermectin, which may be expected due to the antiviral activity as demonstrated in multiple studies. Authors appear unaware of these..
Aug 12	Details Source PDF N/A N/A
	Pedroso et al., The Brazilian Journal of Infectious Diseases, doi:10.1016/j.bjid.2021.101603 (Peer Reviewed)
	Self-prescribed Ivermectin use is associated with a lower rate of seroconversion in health care workers diagnosed with COVID, in a dose-dependent response
	Retrospective 45 healthcare workes in Brazil, showing lower creation of antibodies with multiple doses of ivermectin, which may be expected due to the antiviral activity as demonstrated in multiple studies. Authors appear unaware of these studies, citing only earlier in vitro research, which they misinterpret to suggest that therapeutic concentrations are not reached (for details on why this is incorrect see [1]). Authors combine no dose and one dose. Clinical outcomes and timing of treatment are not provided. [1] c19ivermectin.com/caly.html Pedroso et al., 8/12/2021, peer-reviewed, 11 authors.
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Aug 10	Levels	Alpcan et al., Epidemiology & Infection, doi:10.1017/S0950268821001825 (Peer Reviewed)	cases, ↓44.6%, p=0.0004	Vitamin D levels in children with COVID-19: a report from Turkey
	Details Retrospective 75 COVID-19 hospitalized pediatric patients in Turkey and 80 healthy controls, showing significantly lower vitamin D levels in COVID-19 patients.
Aug 10	Details Source PDF Levels Analysis of outcomes based on serum levels
	Alpcan et al., Epidemiology & Infection, doi:10.1017/S0950268821001825 (Peer Reviewed)
	Vitamin D levels in children with COVID-19: a report from Turkey
	Retrospective 75 COVID-19 hospitalized pediatric patients in Turkey and 80 healthy controls, showing significantly lower vitamin D levels in COVID-19 patients. risk of COVID-19 case, 44.6% lower, RR 0.55, p < 0.001, treatment 42 of 108 (38.9%), control 33 of 47 (70.2%), >20ng/mL. Alpcan et al., 8/10/2021, retrospective, Turkey, Europe, peer-reviewed, 3 authors.
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Aug 10	News	La Pampa, Argentina (News)	death, ↓27.4%	La Pampa expondrá a la comunidad científica los resultados del Programa de Intervención Monitoreado de Ivermectina
	Details News report on the use of ivermectin in La Pampa, Argentina, showing lower mortality with treatment.
Aug 10	Details Source PDF News News
	La Pampa, Argentina (News)
	La Pampa expondrá a la comunidad científica los resultados del Programa de Intervención Monitoreado de Ivermectina
	News report on the use of ivermectin in La Pampa, Argentina, showing lower mortality with treatment. risk of death, 27.4% lower, RR 0.73, treatment 3269, control 18149. risk of combined death/ICU, 38.0% lower, RR 0.62, treatment 3269, control 18149. risk of death, 33.4% lower, RR 0.67, treatment 3269, control 18149, >40yo. risk of death, 44.0% lower, RR 0.56, treatment 3269, control 18149, >40yo including comorbidities. La Pampa et al., 8/10/2021, retrospective, Argentina, South America, preprint, 1 author.
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Aug 10	PEP	Shabani et al., Pulmonary Pharmacology & Therapeutics, doi:10.1016/j.pupt.2021.102069 (Peer Reviewed)	symp. case, ↓19.0%, p=1.00	Evaluation of the Prophylactic Effect of Hydroxychloroquine on People in Close-Contact with Patients with Covid-19
	Details Small PEP trial with 51 HCQ patients, not showing a significant difference in cases. IRCT20130917014693N10.
Aug 10	Details Source PDF Post Exposure Prophylaxis study Post Exposure Prophylaxis study
	Shabani et al., Pulmonary Pharmacology & Therapeutics, doi:10.1016/j.pupt.2021.102069 (Peer Reviewed)
	Evaluation of the Prophylactic Effect of Hydroxychloroquine on People in Close-Contact with Patients with Covid-19
	Small PEP trial with 51 HCQ patients, not showing a significant difference in cases. IRCT20130917014693N10. risk of symptomatic case, 19.0% lower, RR 0.81, p = 1.00, treatment 2 of 51 (3.9%), control 3 of 62 (4.8%), day 7. risk of COVID-19 case, 6.4% higher, RR 1.06, p = 1.00, treatment 7 of 51 (13.7%), control 8 of 62 (12.9%), day 7, PCR+ and symptomatic. risk of COVID-19 case, 21.6% higher, RR 1.22, p = 0.78, treatment 7 of 51 (13.7%), control 7 of 62 (11.3%), day 7, PCR+ only. Shabani et al., 8/10/2021, prospective, Iran, Middle East, peer-reviewed, 16 authors.
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Aug 10	News	Calderón et al., News Report (News)	news	Mantiene Hospital Mónica Pretelini bajo índice de muertes Covid de mujeres embarazadas
	Details News report on the use of nitazoxanide for pregnant COVID-19 patients in a clinic in Mexico, reporting significant improvements in hospitalization and mortality compared to locations without treatment.
Aug 10	Details Source PDF News News
	Calderón et al., News Report (News)
	Mantiene Hospital Mónica Pretelini bajo índice de muertes Covid de mujeres embarazadas
	News report on the use of nitazoxanide for pregnant COVID-19 patients in a clinic in Mexico, reporting significant improvements in hospitalization and mortality compared to locations without treatment. Calderón et al., 8/10/2021, preprint, 1 author.
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Aug 9	Late	Kuno et al., Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkab256 (Peer Reviewed)	death, ↓0.9%, p=0.96	The association of remdesivir and in-hospital outcomes for COVID-19 patients treated with steroids
	Details PSM retrospective 3,372 hospitalized patients in the USA treated with steroids, showing no significant difference in mortality with remdesivir, but a lower risk of acute kidney injury.
Aug 9	Details Source PDF Late treatment study Late treatment study
	Kuno et al., Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkab256 (Peer Reviewed)
	The association of remdesivir and in-hospital outcomes for COVID-19 patients treated with steroids
	PSM retrospective 3,372 hospitalized patients in the USA treated with steroids, showing no significant difference in mortality with remdesivir, but a lower risk of acute kidney injury. risk of death, 0.9% lower, RR 0.99, p = 0.96, treatment 214 of 999 (21.4%), control 216 of 999 (21.6%), PSM. risk of mechanical ventilation, no change, RR 1.00, p = 1.00, treatment 140 of 999 (14.0%), control 140 of 999 (14.0%), PSM. risk of ICU admission, 17.1% higher, RR 1.17, p = 0.05, treatment 260 of 999 (26.0%), control 222 of 999 (22.2%), PSM. Kuno et al., 8/9/2021, retrospective, propensity score matching, USA, North America, peer-reviewed, 6 authors.
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Aug 6	Review	Kow et al., American Journal of Therapeutics, doi:10.1097/MJT.0000000000001441 (Review) (Peer Reviewed)	review	Pitfalls in Reporting Sample Size Calculation Across Randomized Controlled Trials Involving Ivermectin for the treatment of COVID-19
	Details Review of sample size calculations in ivermectin RCTs, showing that existing RCTs are very underpowered.
Aug 6	Details Source PDF Review Review
	Kow et al., American Journal of Therapeutics, doi:10.1097/MJT.0000000000001441 (Review) (Peer Reviewed)
	Pitfalls in Reporting Sample Size Calculation Across Randomized Controlled Trials Involving Ivermectin for the treatment of COVID-19
	Review of sample size calculations in ivermectin RCTs, showing that existing RCTs are very underpowered. Kow et al., 8/6/2021, peer-reviewed, 2 authors.
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Aug 6	Early	Together Trial (News)	death, ↓18.0%, p=0.54	Early Treatment of COVID-19 with Repurposed Therapies: The TOGETHER Adaptive Platform Trial
	Details Preliminary report from the Together Trial showing mortality RR 0.82 [0.44-1.52]. The trial randomization chart suggests major problems and does not match the protocol. Trial week 43, the first week for 3 dose ivermectin, shows ~3x pati..
Aug 6	Details Source PDF Early treatment study Early treatment study
	Together Trial (News)
	Early Treatment of COVID-19 with Repurposed Therapies: The TOGETHER Adaptive Platform Trial
	Preliminary report from the Together Trial showing mortality RR 0.82 [0.44-1.52]. The trial randomization chart suggests major problems and does not match the protocol. Trial week 43, the first week for 3 dose ivermectin, shows ~3x patients assigned to ivermectin vs. placebo [1]. Since overall treatment improves over time, and because the distribution of variants continually changes and shows significant differences in outcomes, this invalidates the randomization of the trial. (Confounding by time is common is COVID-19 studies and has often obscured efficacy because more treatment group patients were earlier when overall treatment protocols were significantly worse). Minas Gerais statistics show a period of declining CFR shortly after the time of excess assignment to ivermectin. The total numbers for the ivermectin and placebo groups also do not appear to match the totals in the presentation - reaching the number reported for ivermectin would require including some of the patients assigned to single dose ivermectin. Reaching the placebo number requires including placebo patients from the much earlier ivermectin single dose period, and from the early two week period when zero ivermectin patients were assigned. Treatment delay is currently unknown, however the protocol allows very late inclusion and a companion trial reported mostly late treatment. Overall mortality is high for 18+ outpatients. Results may be impacted by late treatment, poor SOC, and may be specific to local variants [2, 3]. Treatment was administered on an empty stomach, greatly reducing expected tissue concentration and making the effective dose about 1/5th of current clinical practice. The trial was conducted in Minas Gerais, Brazil which had substantial community use of ivermectin [4], and prior use of ivermectin is not listed in the excluson criteria. Time from symptom onset to randomization is specified as within 7 days. However the schedule of study activities specifies treatment administration only one day after randomization, suggesting that treatment was delayed an additional day for all patients. There is an unusual inclusion criteria: "patients with expected hospital stays of <= 5 days". This is similar to "patients less likely to need treatment beyond SOC to recover", and would make it very easy to reduce the effect seen. This is not in either of the published protocols. This trial uses a soft primary outcome, easily subject to bias and event inflation in both arms (e.g., observe >6 hours independent of indication). Trial design, analysis, and presentation, along with previous public and private statements suggest investigator bias. Design: including very late treatment, additional day before administration, including low-risk patients, operation in a region with high community use, specifying administration on an empty stomach, limiting treatment to 3 days, using soft inclusion criterion and a soft primary outcome, easily subject to bias. Analysis: authors perform analysis excluding events very shortly after randomization for fluvoxamine but not ivermectin, and report viral load results for fluvoxamine but not ivermectin. Presentation: falsely describing positive but not statistically significant effects as "no effect, what so ever" [5, 6]. Prior statements: [7]. There are two published protocols, both are called "version 1", we refer to them as 1A (3/11/21 [8]) and 1B (8/5/21 [9]). 1B deletes: - subgroup analysis by treatment delay. - "Amendments to the protocol, except when necessary to eliminate an immediate danger to participants, should be made only with the prior approval of the steering committee. Each applicable regulatory authority and EC must review and approve the amendments before they are implemented." 1B adds: "we hypothesize that younger patients will benefit more than older patients" If you are a trial participant please contact us below. For other issues see: [10, 11]. [1] reddit.com/r/ivermectin/comments/p3vrrt/together_trial_was_not_randomized_possible/ [2] science.sciencemag.org/content/372/6544/815 [3] thelancet.com/article/S0140-6736(21)00183-5/fulltext [4] otempo.com.br/interessa/venda-de-ivermectina-aumenta-nove-vezes-em-minas-e-preocupa-por-risco-a-sa.. [5] odysee.com/@FrontlineCovid19CriticalCareAlliance:c/outpatients-defeating-the-delta-variant:a [6] media.nature.com/original/magazine-assets/d41586-019-00857-9/d41586-019-00857-9.pdf [7] odysee.com/@FrontlineCovid19CriticalCareAlliance:c/outpatients-defeating-the-delta-variant:a [8] drive.google.com/file/d/1RewIbMErzo0ALy3au9NbTy6DHBeRd7D2/view [9] gatesopenresearch.org/articles/5-117 [10] twitter.com/Covid19Crusher/status/1426612910579757059 [11] twitter.com/Covid19Crusher/status/1427255119800848386 risk of death, 18.0% lower, RR 0.82, p = 0.54, treatment 18 of 677 (2.7%), control 22 of 678 (3.2%). extended ER observation or hospitalization, 9.0% lower, RR 0.91, p = 0.51, treatment 86 of 677 (12.7%), control 95 of 678 (14.0%). Together Trial et al., 8/6/2021, Double Blind Randomized Controlled Trial, Brazil, South America, preprint, 1 author.
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Aug 5	Levels	Nimavat et al., Annals of Medicine and Surgery, doi:10.1016/j.amsu.2021.102661 (Peer Reviewed)	death, ↓50.4%, p=0.17	Vitamin D deficiency and COVID-19: A case-control study at a tertiary care hospital in India
	Details Case control study with 156 PCR+ cases in India and 204 controls, showing more frequent vitamin D deficiency in COVID-19 patients, and an association between lower vitamin D levels and COVID-19 severity.
Aug 5	Details Source PDF Levels Analysis of outcomes based on serum levels
	Nimavat et al., Annals of Medicine and Surgery, doi:10.1016/j.amsu.2021.102661 (Peer Reviewed)
	Vitamin D deficiency and COVID-19: A case-control study at a tertiary care hospital in India
	Case control study with 156 PCR+ cases in India and 204 controls, showing more frequent vitamin D deficiency in COVID-19 patients, and an association between lower vitamin D levels and COVID-19 severity. risk of death, 50.4% lower, RR 0.50, p = 0.17, treatment 13 of 131 (9.9%), control 5 of 25 (20.0%), >10ng/mL, within cases. risk of COVID-19 severe case, 67.6% lower, RR 0.32, p = 0.003, treatment 17 of 131 (13.0%), control 10 of 25 (40.0%), >10ng/mL, within cases. Nimavat et al., 8/5/2021, retrospective, India, South Asia, peer-reviewed, 5 authors.
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Aug 5	Meta	Anseems et al., Cochrane Database of Systematic Reviews, doi:10.1002/14651858.CD014962 (Preprint) (meta analysis)	meta-analysis	Remdesivir for the treatment of COVID‐19
	Details Review of 5 RCTs prior to April 17, 2021 showing mortality RR 0.93 [0.81-1.06] for hospitalized patients.
Aug 5	Details Source PDF Meta Meta
	Anseems et al., Cochrane Database of Systematic Reviews, doi:10.1002/14651858.CD014962 (Preprint) (meta analysis)
	Remdesivir for the treatment of COVID‐19
	Review of 5 RCTs prior to April 17, 2021 showing mortality RR 0.93 [0.81-1.06] for hospitalized patients. Anseems et al., 8/5/2021, preprint, 10 authors.
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Aug 5	Meta	Stricker et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.001 (Peer Reviewed) (meta analysis)	death, ↓75.0%, p<0.0001	Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis
	Details Meta analysis of 11 HCQ PrEP studies in India covering 7,616 healthcare workers, showing significantly lower cases with treatment.
Aug 5	Details Source PDF Meta Meta
	Stricker et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.001 (Peer Reviewed) (meta analysis)
	Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis
	Meta analysis of 11 HCQ PrEP studies in India covering 7,616 healthcare workers, showing significantly lower cases with treatment. risk of death, 75.0% lower, RR 0.25, p < 0.001, treatment 1273, control 4127, >=6 doses. risk of death, 44.0% lower, RR 0.56, p = 0.004, treatment 3489, control 4127, any number of doses. Stricker et al., 8/5/2021, peer-reviewed, 2 authors.
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Aug 5	In Silico	Rana et al., Research Square, doi:10.21203/rs.3.rs-755838/v1 (Preprint)		A Computational Study of Ivermectin and Doxycycline Combination Drug Against SARS-CoV-2 Infection
	Details 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.
Aug 5	Details Source PDF In Silico In Silico
	Rana et al., Research Square, doi:10.21203/rs.3.rs-755838/v1 (Preprint)
	A Computational Study of Ivermectin and Doxycycline Combination Drug Against SARS-CoV-2 Infection
	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. Rana et al., 8/5/2021, preprint, 3 authors.
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Aug 4	Late	Zhang et al., Therapeutic Advances in Gastroenterology, doi:10.1177/17562848211035670 (Peer Reviewed)	hosp. time, ↓13.6%, p=0.009	Probiotics use is associated with improved clinical outcomes among hospitalized patients with COVID-19
	Details Retrospective 375 patients in China, 179 treated with probiotics (Bifidobacterium, Lactobacillus, and Enterococcus), showing improved clinical outcomes with treatment.
Aug 4	Details Source PDF Late treatment study Late treatment study
	Zhang et al., Therapeutic Advances in Gastroenterology, doi:10.1177/17562848211035670 (Peer Reviewed)
	Probiotics use is associated with improved clinical outcomes among hospitalized patients with COVID-19
	Retrospective 375 patients in China, 179 treated with probiotics (Bifidobacterium, Lactobacillus, and Enterococcus), showing improved clinical outcomes with treatment. hospitalization time, 13.6% lower, relative time 0.86, p = 0.009, treatment 150, control 150, PSM. time to clinical improvement, 14.3% lower, relative time 0.86, p = 0.02, treatment 150, control 150, PSM. time to viral-, 16.7% lower, relative time 0.83, p < 0.001, treatment 150, control 150, PSM. Zhang et al., 8/4/2021, retrospective, China, Asia, peer-reviewed, 14 authors.
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Aug 4	Late	Özuygur Ermiş et al., Turkish Journal of Medical Sciences, doi:10.3906/sag-2009-64 (Peer Reviewed)		The Efficacy of Hydroxychloroquine and Azithromycin Combination Therapy on Hospital Mortality in COVID 19 Pneumonia Patients
	Details Retrospective 370 hospitalized patients, 222 receiving HCQ+AZ and 148 receiving HCQ, showing mortality OR 0.61 [0.23-1.59], p = 0.31 for the addition of AZ.
Aug 4	Details Source PDF Late treatment study Late treatment study
	Özuygur Ermiş et al., Turkish Journal of Medical Sciences, doi:10.3906/sag-2009-64 (Peer Reviewed)
	The Efficacy of Hydroxychloroquine and Azithromycin Combination Therapy on Hospital Mortality in COVID 19 Pneumonia Patients
	Retrospective 370 hospitalized patients, 222 receiving HCQ+AZ and 148 receiving HCQ, showing mortality OR 0.61 [0.23-1.59], p = 0.31 for the addition of AZ. Özuygur Ermiş et al., 8/4/2021, peer-reviewed, 13 authors.
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Aug 4	PrEP	Bhatt et al., medRxiv, doi:10.1101/2021.08.02.21260750 (Preprint)	cases, ↑49.3%, p=0.02	Hydroxychloroquine Prophylaxis against Coronavirus Disease-19: Practice Outcomes among Health-Care Workers
	Details Observational study of 927 low-risk healthcare workers in India, 731 volunteering for weekly HCQ prophylaxis, showing higher cases with treatment in unadjusted results. Clinical outcome was in the protocol, however no information on which..
Aug 4	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Bhatt et al., medRxiv, doi:10.1101/2021.08.02.21260750 (Preprint)
	Hydroxychloroquine Prophylaxis against Coronavirus Disease-19: Practice Outcomes among Health-Care Workers
	Observational study of 927 low-risk healthcare workers in India, 731 volunteering for weekly HCQ prophylaxis, showing higher cases with treatment in unadjusted results. Clinical outcome was in the protocol, however no information on which patients were symptomatic is provided. There were no adverse events and no hospitalizations or deaths. Adherence was very low, decreasing weekly, with almost all participants discontinuing by week 11. The majority of infections occurred in later weeks when adherence was very low, and there was no per protocol analysis. #ECR/206/Inst/GJ/2013/RR-20. risk of COVID-19 case, 49.3% higher, RR 1.49, p = 0.02, treatment 167 of 731 (22.8%), control 30 of 196 (15.3%). Bhatt et al., 8/4/2021, prospective, India, South Asia, preprint, 4 authors.
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Aug 4	Late	Alghamdi et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2021.08.008 (Peer Reviewed)	death, ↑39.2%, p=0.52	Clinical characteristics and treatment outcomes of severe (ICU) COVID-19 patients in Saudi Arabia: A single centre study
	Details Retrospective 171 ICU patients in Saudi Arabia showing no significant difference for HCQ treatment in unadjusted results.
Aug 4	Details Source PDF Late treatment study Late treatment study
	Alghamdi et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2021.08.008 (Peer Reviewed)
	Clinical characteristics and treatment outcomes of severe (ICU) COVID-19 patients in Saudi Arabia: A single centre study
	Retrospective 171 ICU patients in Saudi Arabia showing no significant difference for HCQ treatment in unadjusted results. risk of death, 39.2% higher, RR 1.39, p = 0.52, treatment 29 of 128 (22.7%), control 7 of 43 (16.3%). Alghamdi et al., 8/4/2021, retrospective, Saudi Arabia, Middle East, peer-reviewed, 1 author.
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Aug 3	Review	Santin et al., New Microbes and New Infections, doi:10.1016/j.nmni.2021.100924 (Review) (Peer Reviewed)	review	Ivermectin: a multifaceted drug of Nobel prize-honored distinction with indicated efficacy against a new global scourge, COVID-19
	Details Review concluding that the evidence supports worldwide use of ivermectin for COVID-19, complementary to immunization. Authors note that it is likely non-epitope specific, possibly retaining efficacy with new viral strains. They note that ..
Aug 3	Details Source PDF Review Review
	Santin et al., New Microbes and New Infections, doi:10.1016/j.nmni.2021.100924 (Review) (Peer Reviewed)
	Ivermectin: a multifaceted drug of Nobel prize-honored distinction with indicated efficacy against a new global scourge, COVID-19
	Review concluding that the evidence supports worldwide use of ivermectin for COVID-19, complementary to immunization. Authors note that it is likely non-epitope specific, possibly retaining efficacy with new viral strains. They note that ivermectin has been safely used with 3.7 billion doses since 1987, is well tolerated even at much greater than standard doses, and has been used without serious AEs in high-dose COVID-19 treatment studies. Santin et al., 8/3/2021, peer-reviewed, 5 authors.
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Jul 31	Late	Barra et al., medRxiv, doi:10.1101/2021.07.30.21261220 (Preprint)	death, ↓10.8%, p=1.00	COVID-19 in hospitalized patients in 4 hospitals in San Isidro, Buenos Aires, Argentina
	Details Retrospective 668 hospitalized patients in Argentina, 18 treated with HCQ, not showing a significant difference in unadjusted results.
Jul 31	Details Source PDF Late treatment study Late treatment study
	Barra et al., medRxiv, doi:10.1101/2021.07.30.21261220 (Preprint)
	COVID-19 in hospitalized patients in 4 hospitals in San Isidro, Buenos Aires, Argentina
	Retrospective 668 hospitalized patients in Argentina, 18 treated with HCQ, not showing a significant difference in unadjusted results. risk of death, 10.8% lower, RR 0.89, p = 1.00, treatment 2 of 18 (11.1%), control 81 of 650 (12.5%), unadjusted. Barra et al., 7/31/2021, retrospective, Argentina, South America, preprint, 12 authors.
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Jul 30	Levels	Matin et al., Archives of Microbiology, doi:10.1007/s00203-021-02482-5 (Peer Reviewed)	cases, ↓66.1%, p<0.0001	The sufficient vitamin D and albumin level have a protective effect on COVID-19 infection
	Details Case control study with 191 COVID-19 patients and 203 healthy controls in Iran, showing an association between vitamin D deficiency and COVID-19 infection and severity. 84.4% of COVID-19 patients had vitamin D deficiency.
Jul 30	Details Source PDF Levels Analysis of outcomes based on serum levels
	Matin et al., Archives of Microbiology, doi:10.1007/s00203-021-02482-5 (Peer Reviewed)
	The sufficient vitamin D and albumin level have a protective effect on COVID-19 infection
	Case control study with 191 COVID-19 patients and 203 healthy controls in Iran, showing an association between vitamin D deficiency and COVID-19 infection and severity. 84.4% of COVID-19 patients had vitamin D deficiency. risk of COVID-19 case, 66.1% lower, RR 0.34, p < 0.001, >20ng/mL, RR approximated with OR. Matin et al., 7/30/2021, retrospective, case control, Iran, Middle East, peer-reviewed, 8 authors.
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Jul 30	Late	Abdelwahab et al., Clinical Drug Investigation, doi:10.1007/s40261-021-01061-2 (Peer Reviewed)	ventilation, ↑7.8%, p=0.93	Acetylsalicylic Acid Compared with Enoxaparin for the Prevention of Thrombosis and Mechanical Ventilation in COVID-19 Patients: A Retrospective Cohort Study
	Details Retrospective 225 hospitalized patients in Egypt, showing significantly lower thromboembolic events with aspirin treatment, but no significant difference in the need for mechanical ventilation.
Jul 30	Details Source PDF Late treatment study Late treatment study
	Abdelwahab et al., Clinical Drug Investigation, doi:10.1007/s40261-021-01061-2 (Peer Reviewed)
	Acetylsalicylic Acid Compared with Enoxaparin for the Prevention of Thrombosis and Mechanical Ventilation in COVID-19 Patients: A Retrospective Cohort Study
	Retrospective 225 hospitalized patients in Egypt, showing significantly lower thromboembolic events with aspirin treatment, but no significant difference in the need for mechanical ventilation. risk of mechanical ventilation, 7.8% higher, RR 1.08, p = 0.93, treatment 11 of 31 (35.5%), control 6 of 36 (16.7%), adjusted, OR converted to RR. Abdelwahab et al., 7/30/2021, retrospective, Egypt, Africa, peer-reviewed, 17 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 873 studies, 597 present results comparing with a control group, 530 are treatment studies, and 67 analyze outcomes based on serum levels. There are 12 animal studies, 25 in silico studies, 46 in vitro studies, and 55 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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