COVID-19 studies:  C19 studies: C19:  IvermectinIVM Vitamin DV.D PXPX FLVFLV PVP-IPI BUBU BHBH BLBL CICI HC QHC Q NZNZ COCO More..
COVID-19 early treatment: real-time analysis of 702 studies
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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.
PXProxalutamide 92% 2
FVFluvoxamine 89% 2
CCCurcumin 86% 2
BUBudesonide 82% 1
PIPovidone-Iodine 82% 4
BHBromhexine 79% 2
V.DVitamin D 78% 4
MPMolnupiravir 77% 1
IVMIvermectin 76% 25
BLBamlanivimab 75% 3
CICasirivimab/im.. 68% 3
(H)CQHydroxychloro.. 66% 29
NZNitazoxanide 49% 5
ZnZinc 42% 2
FPVFavipiravir 38% 3
V.CVitamin C 18% 1
RDRemdesivir - 0
Global early treatment adoption. Details. [0.05-0.13]31,095StudiesPatientsImprovement, RR [CI]Fluvoxamine89%0.11 [0.01-0.85]2277Curcumin86%0.14 [0.04-0.52]2181Iota-carragee..80%0.20 [0.04-0.91]1394Molnupiravir77%0.23 [0.01-5.68]1202Povidone-Iodine71%0.29 [0.14-0.61]52,048Ivermectin71%0.29 [0.23-0.38]6018,931Casirivimab/i..59%0.41 [0.18-0.95]617,274Nitazoxanide58%0.42 [0.14-1.30]61,464Bamlanivimab57%0.43 [0.23-0.81]63,121Vitamin D56%0.44 [0.34-0.57]2725,148Budesonide54%0.46 [0.11-1.96]21,806Bromhexine44%0.56 [0.40-0.78]5291Colchicine43%0.57 [0.38-0.85]917,059Zinc38%0.62 [0.54-0.70]117,172Favipiravir28%0.72 [0.57-0.92]92,169Hydroxychloro..27%0.73 [0.69-0.78]257384,791Remdesivir24%0.76 [0.62-0.92]1523,349Vitamin C21%0.79 [0.66-0.95]101,424All studies combined (pooled effects, all stages) 6/19/21Lower RiskIncreased Risk
Random effects meta-analysis of all studies combined (pooled effects, all stages). Treatments with 3 or fewer studies 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. [0.04-0.18]2505StudiesPatientsImprovement, RR [CI]Fluvoxamine89%0.11 [0.01-0.85]2277Curcumin86%0.14 [0.04-0.52]2181Budesonide82%0.18 [0.04-0.79]1146Povidone-Iodine82%0.18 [0.09-0.38]4694Bromhexine79%0.21 [0.06-0.72]296Vitamin D78%0.22 [0.12-0.39]4542Molnupiravir77%0.23 [0.01-5.68]1202Ivermectin76%0.24 [0.14-0.41]253,382Bamlanivimab75%0.25 [0.12-0.54]31,374Casirivimab/i..68%0.32 [0.20-0.52]35,575Hydroxychloro..66%0.34 [0.24-0.49]2650,997Nitazoxanide49%0.51 [0.12-2.27]51,414Zinc42%0.58 [0.16-2.11]2626Favipiravir38%0.62 [0.38-1.02]3410Vitamin C18%0.82 [0.23-2.91]198Early treatment studies (pooled effects) 6/19/21Lower RiskIncreased Risk
Random effects meta-analysis of early treatment studies (pooled effects). Treatments with 3 or fewer studies 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. [0.05-0.15]2858StudiesPatientsImprovement, RR [CI]Bromhexine91%0.09 [0.01-1.57]2178Povidone-Iodine88%0.12 [0.03-0.50]1606Curcumin82%0.18 [0.04-0.79]1140Molnupiravir77%0.23 [0.01-5.68]1202Ivermectin70%0.30 [0.19-0.47]227,690Vitamin D67%0.33 [0.22-0.50]159,263Nitazoxanide60%0.40 [0.10-1.58]3923Bamlanivimab48%0.52 [0.10-2.71]31,551Colchicine43%0.57 [0.38-0.85]917,059Zinc37%0.63 [0.55-0.73]74,850Remdesivir26%0.74 [0.59-0.93]1423,207Vitamin C26%0.74 [0.59-0.93]7882Hydroxychloro..25%0.75 [0.70-0.82]160268,648Casirivimab/i..6%0.94 [0.87-1.02]212,481Favipiravir-4%1.04 [0.66-1.66]31,456All mortality results (all stages) 6/19/21Lower RiskIncreased Risk
Random effects meta-analysis of all mortality results (all stages). Treatments with 3 or fewer studies 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. [0.00-1.43]1769StudiesPatientsImprovement, RR [CI]Bromhexine91%0.09 [0.01-1.59]178Povidone-Iodine88%0.12 [0.03-0.50]1606Curcumin82%0.18 [0.04-0.79]1140Ivermectin81%0.19 [0.07-0.54]61,193Proxalutamide80%0.20 [0.01-4.13]1268Zinc79%0.21 [0.03-1.47]1518Vitamin D78%0.22 [0.12-0.43]3500Molnupiravir77%0.23 [0.01-5.68]1202Hydroxychloro..75%0.25 [0.16-0.40]1147,344Casirivimab/i..67%0.33 [0.03-3.17]12,696Favipiravir45%0.55 [0.05-5.81]192Nitazoxanide41%0.59 [0.02-13.8]2873Early treatment mortality 6/19/21Lower RiskIncreased Risk
Random effects meta-analysis of early treatment mortality results. Treatments with 3 or fewer studies are shown in grey.
Recent studies (see the individual treatment pages for all studies):

Early Fischer et al., medRxiv, doi:10.1101/2021.06.17.21258639 (Preprint) death, ↓76.5%, p=0.31 Molnupiravir, an Oral Antiviral Treatment for COVID-19
Details   RCT 202 outpatients in the USA showing significantly faster viral clearance, but no significant differences in symptom duration or severity. NCT04405570.
Early Krolewiecki et al., EClinicalMedicine, doi:10.1016/j.eclinm.2021.100959 (Peer Reviewed) ventilation, ↑151.9%, p=1.00 Antiviral effect of high-dose ivermectin in adults with COVID-19: A proof-of-concept randomized trial
Details   Proof of concept RCT with 30 ivermectin patients and 15 control patients, showing a concentration dependent antiviral activity, but no significant difference in clinical outcomes. There was no significant difference in viral load reductio..
Levels Jude et al., Journal of Clinical Endocrinology & Metabolism, doi:10.1210/clinem/dgab439 (Peer Reviewed) hosp., ↓71.6%, p<0.0001 Vitamin D deficiency is associated with higher hospitalisation risk from COVID-19: a retrospective case-control study
Details   Retrospective 80,670 people in the UK with vitamin D levels measured within the last 12 months, showing higher risk of hospitalization with low vitamin D levels.
Late Horby et al., medRxiv, doi:10.1101/2021.06.15.21258542 (Peer Reviewed) death, ↓6.0%, p=0.17 Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Details   RCT 9,785 hospitalized patients in the UK showing lower mortality with casirivimab/imdevimab, with statistical significance reached for baseline seronegative patients.
Review Zaidi et al., The Journal of Antibiotics, doi:10.1038/s41429-021-00430-5 (Review) (Peer Reviewed) review The mechanisms of action of Ivermectin against SARS-CoV-2: An evidence-based clinical review article
Details   Extensive review of 20 mechanisms of action of ivermectin for SARS-CoV-2.
In Vitro Panchariya et al., bioRxiv, doi:10.1101/2021.06.15.448551 (Preprint) (In Vitro) in vitro Zinc2+ ion inhibits SARS-CoV-2 main protease and viral replication in vitro
Details   In Silico and In Vitro study showing that ionic zinc inhibits SARS-CoV-2 main protease (Mpro) and inhibits viral replication. Zinc acetate inhibited viral replication in Vero E6 cells, while zinc glycinate and zinc gluconate did not at n..
Early Aref et al., International Journal of Nanomedicine, doi:10.2147/IJN.S313093 (Peer Reviewed) recov. time, ↓63.2%, p=0.0001 Clinical, Biochemical and Molecular Evaluations of Ivermectin Mucoadhesive Nanosuspension Nasal Spray in Reducing Upper Respiratory Symptoms of Mild COVID-19
Details   RCT 114 patients in Egypt, 57 treated with ivermectin mucoadhesive nanosuspension intranasal spray, showing faster recovery and viral clearance with treatment. NCT04716569.
Levels Campi et al., BMC Infectious Diseases, doi:10.1186/s12879-021-06281-7 (Peer Reviewed) death, ↓24.3%, p=0.53 Vitamin D and COVID-19 severity and related mortality: a prospective study in Italy
Details   Prospective study of 103 hospitalized patients in Italy, showing very high prevalence of vitamin D deficiency, and increased severity for lower vitamin D levels.
Late Saib et al., PLOS ONE, doi:10.1371/journal.pone.0252388 (Peer Reviewed) int./death, ↑125.0%, p=0.23 Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A retrospective study
Details   203 hospitalized patients in France, not showing significant differences with treatment. Confounding by indication is likely. Authors do not discuss confounding.
Late Singh et al., medRxiv, doi:0.1101/2021.06.06.21258091 (Preprint) death, ↓47.5%, p=0.45 Safety and efficacy of antiviral therapy alone or in combination in COVID-19 - a randomized controlled trial (SEV COVID Trial)
Details   Very small early terminated RCT in India, showing lower mortality but without statistical significance with the very small sample size. Time since symptom onset is not provided. The recovery percentage for non-severe group B (86.7%) does ..
Late Al Sulaiman et al., Research Square, doi:10.21203/ (Preprint) death, ↓35.0%, p=0.05 Evaluation of Zinc Sulfate as an Adjunctive Therapy in COVID-19 Critically Ill Patients: a Two Center Propensity-score Matched Study
Details   Retrospective 266 ICU patients showing lower mortality with zinc treatment (very close to statistical significance), and higher odds of acute kidney injury.
PrEP Dinesh et al., Journal of the Association of Physicians of India (Peer Reviewed) cases, ↓60.1%, p<0.0001 Hydroxychloroquine for SARS CoV2 Prophylaxis in Healthcare Workers – A Multicentric Cohort Study Assessing Effectiveness and Safety
Details   Prophylaxis study with 2,727 Indian healthcare workers, showing lower risk of COVID-19 cases with treatment, and increasingly lower risk for longer durations of HCQ prophylaxis. The appendices are not currently available.
Levels Dror et al., medRxiv, doi:10.1101/2021.06.04.21258358 (Preprint) severe case, ↓85.1%, p<0.0001 Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness
Details   Retrospective 253 hospitalized patients in Israel showing higher mortality and higher risk of severe cases with vitamin D deficiency. Vitamin D levels were measured 14 to 730 days before the COVID-19 test. Adjusted results are only provid..
Levels Diaz-Curiel, Journal of Steroid Biochemistry and Molecular Biology, doi:10.1016/j.jsbmb.2021.105928 (Peer Reviewed) ICU, ↓73.2%, p=0.02 The relationship between 25(OH) vitamin D levels and COVID-19 onset and disease course in Spanish patients
Details   Retrospective 1,549 patients in Spain showing that the frequency of vitamin D deficiency was higher in admitted patients compared to the overall Spanish population, and that vitamin D deficiency was associated with increased risk of ICU a..
N/A Hariyanto et al., Reviews In Medical Virology, doi:10.1002/rmv.2265 (Peer Reviewed) death, ↓69.0%, p=0.001 Ivermectin and outcomes from Covid-19 pneumonia: A systematic review and meta-analysis of randomized clinical trial studies
Details   Systematic review and meta analysis of 19 RCTs showing mortality RR 0.31 [0.15-0.62].
Levels Kotur et al., Frontiers in Nutrition, doi:10.3389/fnut.2021.689419 (Peer Reviewed) Association of Vitamin D, Zinc and Selenium Related Genetic Variants With COVID-19 Disease Severity
Details   Analysis of variants in genes significant for the status of vitamin D in 120 Serbian COVID-19 patients, showing that vitamin D related genetic variants DHCR7/NADSYN rs12785878 and CYP2R1 rs10741657 were associated with severe COVID-19 in ..
Late Lagier et al., Preprint (Preprint) death, ↓32.0%, p=0.004 Outcomes of 2,111 COVID-19 hospitalised patients treated with 2 hydroxychloroquine/azithromycin and other regimens in Marseille, France: a 3 monocentric retrospective analysis
Details   Retrospective 2,011 hospitalized patients in France, median age 67, showing lower mortality with HCQ+AZ, and further benefit with the addition of zinc.
Late Byakika-Kibwika et al., Research Square, doi:10.21203/ (Preprint) recov. time, 0.0%, p=0.91 Safety and Efficacy of Hydroxychloroquine for Treatment of Non-Severe COVID-19 in Adults in Uganda: A Randomized Open Label Phase II Clinical Trial
Details   Small 105 patient RCT in Uganda showing no significant differences. No mortality was reported. The patients were very young (median age 32), recovering in a median time of 3 days with standard of care, so there is little room for a treatm..
Late Sivapalan et al., European Respiratory Journal, doi:10.1183/13993003.00752-2021 (Peer Reviewed) death, ↓92.0%, p=0.32 Azithromycin and hydroxychloroquine in hospitalised patients with confirmed COVID-19–a randomised double-blinded placebo-controlled trial
Details   Early terminated late stage (8 days from onset, 59% on oxygen) RCT not showing statistically significant differences. NCT04322396. NNF20SA0062834.
PrEP Fasano et al., Movement Disorders, doi:10.1002/mds.28176 (Peer Reviewed) cases, ↓42.0%, p=0.05 COVID-19 in Parkinson’s Disease Patients Living in Lombardy, Italy
Details   Retrospective phone survey of 1,486 Parkinson's disease patients in Italy, showing lower risk of COVID-19 cases with vitamin D supplementation. This paper also presents a case control study of PD patients and family member control patients.
Late Abd-Elsalam et al., Journal of Medical Virology, doi:10.1002/jmv.27122 (Peer Reviewed) death, ↓25.0%, p=0.70 Clinical Study Evaluating the Efficacy of Ivermectin in COVID-19 Treatment: A Randomized Controlled Study
Details   RCT 164 hospitalized patients in Egypt showing lower mortality and shorter hospitalization, but without statistical significance. There were no serious adverse effects. Authors suggest the low dosage may have resulted in lower efficacy th..
PrEP Korkmaz et al., Authorea, doi:10.22541/au.162257516.68665404/v1 (Preprint) death, ↓82.1%, p=0.19 The effect of Hydroxychloroquine use due to rheumatic disease on the risk of Covid-19 infection and its course
Details   Retrospective 683 patients in a rheumatology department, 384 chronic HCQ users and 299 control patients, showing no mortality for HCQ users vs. 2 deaths in the control group, and significantly fewer cases for HCQ users.
Levels Butler-Laporte et al., PLOS Medicine, doi:10.1371/journal.pmed.1003605 (Peer Reviewed) Vitamin D and COVID-19 susceptibility and severity in the COVID-19 Host Genetics Initiative: A Mendelian randomization study
Details   Mendelian randomization study not finding significant differences in COVID-19 outcomes based on vitamin D level. This study does not compare patients with deficiency/insuffiency/sufficiency, only providing ORs for increase in D levels. Au..
PrEP Kamstrup et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.05.076 (Peer Reviewed) hosp., ↑44.0%, p=0.25 Hydroxychloroquine as a primary prophylactic agent against sars-cov-2 infection: a cohort study
Details   Retrospective HCQ users in Denmark, not showing a significant difference, however authors do not adjust for the very different baseline risk for systemic autoimmune disease patients. Authors appear unaware of research in the area, for ex..
Late Smith et al., medRxiv, doi:10.1101/2021.05.28.21258012 (Peer Reviewed) death, ↓27.2%, p<0.0001 Observational Study on 255 Mechanically Ventilated Covid Patients at the Beginning of the USA Pandemic
Details   Retrospective 255 mechanical ventilation patients in USA, showing that weight-adjusted HCQ+AZ improved survival by over 100%. QTc prolongation did not correlate with cumulative HCQ dose or HCQ serum level. Although authors mention immort..
Levels Sooriyaarachchi et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2021.05.011 (Peer Reviewed) Impact of vitamin D deficiency on COVID-19
Details   Analysis of vitamin D deficiency and COVID-19 cases and deaths in 47 countries, showing vitamin D deficiency significantly associated with mortality.
Early Pawar et al., Frontiers in Pharmacology, doi:10.3389/fphar.2021.669362 (Peer Reviewed) death, ↓81.8%, p=0.02 Oral Curcumin With Piperine as Adjuvant Therapy for the Treatment of COVID-19: A Randomized Clinical Trial
Details   RCT 140 patients, 70 treated with curcumin and piperine (for absorption), showing faster recovery, lower progression, and lower mortality with treatment. Control group partients also received probiotics. CTRI/2020/05/025482.
Early Sánchez-Zuno, J. Clinical Medicine, doi:10.3390/jcm10112378 (Peer Reviewed) severe case, ↓89.4%, p=0.04 Vitamin D Levels in COVID-19 Outpatients from Western Mexico: Clinical Correlation and Effect of Its Supplementation
Details   Very small 42 PCR+ outpatient RCT in Mexico, 22 treated with vitamin D. Most patients had insufficient vitamin D levels, there were more symptoms in those with insufficient levels, and there were less cases with fever or with >3 symptoms ..
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 702 studies, 496 present results comparing with a control group, 437 are treatment studies, 59 analyze outcomes based on serum levels, and 45 are 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.
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