COVID-19 early treatment: real-time analysis of 722 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%

76%

72%

66%

38%

Medications approved for early treatment by >2 countries. 55 countries have officially approved early treatment. For details see global early treatment adoption.


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.


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.


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.


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):


7/1	Late	Medeiros et al., ResearchGate (Preprint)		Proxalutamide (GT0918) Improves Lung Injury in Hospitalized COVID-19 Patients -an Analysis of the Radiological Findings of the Proxa-Rescue AndroCoV Trial
	Details Analysis of radiological findings from the Proxa-Rescue AndroCoV trial showing that proxalutamide significantly improves lung opacities compared to placebo. NCT04728802.
7/1	Details Source PDF Late treatment study Late treatment study
	Medeiros et al., ResearchGate (Preprint)
	Proxalutamide (GT0918) Improves Lung Injury in Hospitalized COVID-19 Patients -an Analysis of the Radiological Findings of the Proxa-Rescue AndroCoV Trial
	Analysis of radiological findings from the Proxa-Rescue AndroCoV trial showing that proxalutamide significantly improves lung opacities compared to placebo. NCT04728802. Medeiros et al., 7/1/2021, preprint, 23 authors.
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6/30	Review	Turkia, M., ResearchGate, doi:10.13140/RG.2.2.16973.36326 (Review) (Preprint)	review	A Continuation of a Timeline of Ivermectin-Related Events in the COVID-19 Pandemic [June 30, 2021]
	Details An extension of the ivermectin timeline covering April - June 2021, including WHO's role and funding, Gavi, COVAX, Trusted News Initiative, International Fact-Checking Network, the role of private philantrophy, Frontiers, comparison to th..
6/30	Details Source PDF Review Review
	Turkia, M., ResearchGate, doi:10.13140/RG.2.2.16973.36326 (Review) (Preprint)
	A Continuation of a Timeline of Ivermectin-Related Events in the COVID-19 Pandemic [June 30, 2021]
	An extension of the ivermectin timeline covering April - June 2021, including WHO's role and funding, Gavi, COVAX, Trusted News Initiative, International Fact-Checking Network, the role of private philantrophy, Frontiers, comparison to the H1N1 pandemic, new treatment protocols, and causal modeling. Turkia et al., 6/30/2021, preprint, 1 author.
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6/30	Late	Taieb et al., J. Clin. Med. 2021, doi:10.3390/jcm10132954 (Peer Reviewed)	no disch., ↓38.7%, p=0.02	Hydroxychloroquine and Azithromycin Treatment of Hospitalized Patients Infected with SARS-CoV-2 in Senegal from March to October 2020
	Details Retrospective 926 patients in Senegal, 674 treated with HCQ+AZ, showing significantly higher hospital discharge at day 15 with treatment.
6/30	Details Source PDF Late treatment study Late treatment study
	Taieb et al., J. Clin. Med. 2021, doi:10.3390/jcm10132954 (Peer Reviewed)
	Hydroxychloroquine and Azithromycin Treatment of Hospitalized Patients Infected with SARS-CoV-2 in Senegal from March to October 2020
	Retrospective 926 patients in Senegal, 674 treated with HCQ+AZ, showing significantly higher hospital discharge at day 15 with treatment. risk of no hospital discharge, 38.7% lower, RR 0.61, p = 0.02, treatment 674, control 252, multivariate. Taieb et al., 6/30/2021, retrospective, Senegal, Africa, peer-reviewed, 29 authors.
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6/24	Late	Sabico et al., Nutrients, doi:10.3390/nu13072170 (Peer Reviewed)		Effects of a 2-Week 5000 IU versus 1000 IU Vitamin D3 Supplementation on Recovery of Symptoms in Patients with Mild to Moderate Covid-19: A Randomized Clinical Trial
	Details Small RCT of 69 hospitalized patients comparing 1000IU and 5000IU daily cholecalciferol, showing faster recovery with the higher dose.
6/24	Details Source PDF Late treatment study Late treatment study
	Sabico et al., Nutrients, doi:10.3390/nu13072170 (Peer Reviewed)
	Effects of a 2-Week 5000 IU versus 1000 IU Vitamin D3 Supplementation on Recovery of Symptoms in Patients with Mild to Moderate Covid-19: A Randomized Clinical Trial
	Small RCT of 69 hospitalized patients comparing 1000IU and 5000IU daily cholecalciferol, showing faster recovery with the higher dose. Sabico et al., 6/24/2021, Randomized Controlled Trial, Saudi Arabia, Middle East, peer-reviewed, 12 authors.
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6/24	Meta	Pal et al., Journal of Endocrinological Investigation, doi:10.1007/s40618-021-01614-4 (Peer Reviewed) (meta analysis)	meta-analysis	Vitamin D supplementation and clinical outcomes in COVID-19: a systematic review and meta-analysis
	Details Meta analysis of 13 vitamin D treatment studies, showing significantly lower ICU admission/mortality with treatment.
6/24	Details Source PDF Meta Meta
	Pal et al., Journal of Endocrinological Investigation, doi:10.1007/s40618-021-01614-4 (Peer Reviewed) (meta analysis)
	Vitamin D supplementation and clinical outcomes in COVID-19: a systematic review and meta-analysis
	Meta analysis of 13 vitamin D treatment studies, showing significantly lower ICU admission/mortality with treatment. Pal et al., 6/24/2021, peer-reviewed, 6 authors.
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6/24	Late	Gerlovin et al., American Journal of Epidemiology, doi:10.1093/aje/kwab183 (Peer Reviewed)	death, ↑22.0%, p=0.18	Pharmacoepidemiology, Machine Learning and COVID-19: An intent-to-treat analysis of hydroxychloroquine, with or without azithromycin, and COVID-19 outcomes amongst hospitalized US Veterans
	Details Retrospective 1,769 hospitalized patients in the USA showing no significant differences for HCQ, and higher intubation for HCQ+AZ.
6/24	Details Source PDF Late treatment study Late treatment study
	Gerlovin et al., American Journal of Epidemiology, doi:10.1093/aje/kwab183 (Peer Reviewed)
	Pharmacoepidemiology, Machine Learning and COVID-19: An intent-to-treat analysis of hydroxychloroquine, with or without azithromycin, and COVID-19 outcomes amongst hospitalized US Veterans
	Retrospective 1,769 hospitalized patients in the USA showing no significant differences for HCQ, and higher intubation for HCQ+AZ. risk of death, 22.0% higher, RR 1.22, p = 0.18, treatment 90 of 429 (21.0%), control 141 of 770 (18.3%), adjusted, HCQ+AZ. risk of death, 21.0% higher, RR 1.21, p = 0.33, treatment 49 of 228 (21.5%), control 141 of 770 (18.3%), adjusted, HCQ. risk of mechanical ventilation, 55.0% higher, RR 1.55, p = 0.02, treatment 64 of 429 (14.9%), control 69 of 770 (9.0%), adjusted, HCQ+AZ. risk of mechanical ventilation, 33.0% higher, RR 1.33, p = 0.25, treatment 32 of 228 (14.0%), control 69 of 770 (9.0%), adjusted, HCQ. Gerlovin et al., 6/24/2021, retrospective, USA, North America, peer-reviewed, 21 authors.
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6/23	Early	Webb et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab331 (Peer Reviewed)	death, ↓98.3%, p=0.63	Real-World Effectiveness and Tolerability of Monoclonal Antibody Therapy for Ambulatory Patients with Early COVID-19
	Details Retrospective 115 patients treated with casirivimab/imdevimab showing lower mortality, hospital admission, and emergency department visits with treatment. Authors falsely state that "no other COVID-19 therapies for ambulatory patient..
6/23	Details Source PDF Early treatment study Early treatment study
	Webb et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab331 (Peer Reviewed)
	Real-World Effectiveness and Tolerability of Monoclonal Antibody Therapy for Ambulatory Patients with Early COVID-19
	Retrospective 115 patients treated with casirivimab/imdevimab showing lower mortality, hospital admission, and emergency department visits with treatment. Authors falsely state that "no other COVID-19 therapies for ambulatory patients have proven effective". risk of death, 98.3% lower, RR 0.02, p = 0.63, treatment 0 of 115 (0.0%), control 57 of 5536 (1.0%), continuity correction due to zero event. risk of hospitalization, 91.1% lower, RR 0.09, p < 0.001, treatment 1 of 115 (0.9%), control 538 of 5536 (9.7%). Webb et al., 6/23/2021, retrospective, USA, North America, peer-reviewed, 14 authors.
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6/22	News	Misiones Ministry of Public Health (News)	news	Results from ivermectin use from the Misiones Ministry of Public Health
	Details News report on ivermectin use in Misiones, Argentina, showing significantly lower hospitalization and mortality, and a dose-dependent effect with improved results for those taking 0.6mg/kg.
6/22	Details Source PDF News News
	Misiones Ministry of Public Health (News)
	Results from ivermectin use from the Misiones Ministry of Public Health
	News report on ivermectin use in Misiones, Argentina, showing significantly lower hospitalization and mortality, and a dose-dependent effect with improved results for those taking 0.6mg/kg. Misiones Ministry of Public Health et al., 6/22/2021, preprint, 1 author.
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6/21	Late	Arch et al., medRxiv, doi:10.1101/2021.06.18.21259072 (Preprint)	death, ↓19.9%, p=0.03	Evaluation of the effectiveness of remdesivir in treating severe COVID-19 using data from the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, national cohort study
	Details Prospective PSM analysis of remdesivir use in the UK showing statistically significantly lower mortality at 28 days. For unspecified reasons, the study prioritized short-term outcomes. Mortality at 14 days was also lower but not statistic..
6/21	Details Source PDF Late treatment study Late treatment study
	Arch et al., medRxiv, doi:10.1101/2021.06.18.21259072 (Preprint)
	Evaluation of the effectiveness of remdesivir in treating severe COVID-19 using data from the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, national cohort study
	Prospective PSM analysis of remdesivir use in the UK showing statistically significantly lower mortality at 28 days. For unspecified reasons, the study prioritized short-term outcomes. Mortality at 14 days was also lower but not statistically significant. Confounding by indication is likely and may only be partially addressed by the variables included in the PSM. risk of death, 19.9% lower, RR 0.80, p = 0.03, treatment 203 of 1491 (13.6%), control 777 of 4676 (16.6%), OR converted to RR, 28 days. risk of death, 18.0% lower, RR 0.82, p = 0.12, treatment 140 of 1502 (9.3%), control 565 of 4728 (12.0%), OR converted to RR, 28 days. risk of mechanical ventilation, 68.0% higher, RR 1.68, p = 0.003, treatment 106 of 1498 (7.1%), control 153 of 4602 (3.3%), OR converted to RR, 28 days. Arch et al., 6/21/2021, prospective, United Kingdom, Europe, preprint, 10 authors.
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6/21	In Silico	Yadav et al., Research Square, doi:10.21203/rs.3.rs-628277/v1 (Preprint)		Repurposing the Combination Drug of Favipiravir, Hydroxychloroquine and Oseltamivir as a Potential Inhibitor Against SARS-CoV-2: A Computational Study
	Details In Silico study showing stronger inhibition of SAR-CoV-2 for HCQ+favipiravir+oseltamivir compared to any of these alone or combinations of two of these drugs.
6/21	Details Source PDF In Silico In Silico
	Yadav et al., Research Square, doi:10.21203/rs.3.rs-628277/v1 (Preprint)
	Repurposing the Combination Drug of Favipiravir, Hydroxychloroquine and Oseltamivir as a Potential Inhibitor Against SARS-CoV-2: A Computational Study
	In Silico study showing stronger inhibition of SAR-CoV-2 for HCQ+favipiravir+oseltamivir compared to any of these alone or combinations of two of these drugs. Yadav et al., 6/21/2021, preprint, 2 authors.
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6/19	Early	Ahmadi et al., Food Science and Nutrition, doi:10.1002/fsn3.2226 (Peer Reviewed)	hosp., ↓85.7%, p=0.24	Oral nano-curcumin formulation efficacy in the management of mild to moderate outpatient COVID-19: A randomized triple-blind placebo-controlled clinical trial
	Details RCT 60 outpatients in Iran, 30 treated with nano-curcumin showing lower hospitalization and faster recovery with treatment.
6/19	Details Source PDF Early treatment study Early treatment study
	Ahmadi et al., Food Science and Nutrition, doi:10.1002/fsn3.2226 (Peer Reviewed)
	Oral nano-curcumin formulation efficacy in the management of mild to moderate outpatient COVID-19: A randomized triple-blind placebo-controlled clinical trial
	RCT 60 outpatients in Iran, 30 treated with nano-curcumin showing lower hospitalization and faster recovery with treatment. risk of hospitalization, 85.7% lower, RR 0.14, p = 0.24, treatment 0 of 30 (0.0%), control 3 of 30 (10.0%), continuity correction due to zero event. recovery time, 20.6% lower, relative time 0.79, p = 0.37, treatment 30, control 30. Ahmadi et al., 6/19/2021, Double Blind Randomized Controlled Trial, Iran, Middle East, peer-reviewed, 11 authors.
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6/18	Review	Lind et al., Journal of General Internal Medicine, doi:10.1007/s11606-021-06948-6 (Review) (Peer Reviewed)	review	Increase in Outpatient Ivermectin Dispensing in the US During the COVID-19 Pandemic: A Cross-Sectional Analysis
	Details CDC analysis of ivermectin prescriptions in the US suggesting that, while national health authority recognition is delayed in that country, many physicians are aware of the efficacy demonstrated in clinical trials.
6/18	Details Source PDF Review Review
	Lind et al., Journal of General Internal Medicine, doi:10.1007/s11606-021-06948-6 (Review) (Peer Reviewed)
	Increase in Outpatient Ivermectin Dispensing in the US During the COVID-19 Pandemic: A Cross-Sectional Analysis
	CDC analysis of ivermectin prescriptions in the US suggesting that, while national health authority recognition is delayed in that country, many physicians are aware of the efficacy demonstrated in clinical trials. Lind et al., 6/18/2021, peer-reviewed, 6 authors.
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6/18	Late	Schwartz et al., CMAJ Open, doi:10.9778/cmajo.20210069 (Peer Reviewed)	ICU, ↑133.3%, p=1.00	Assessing the efficacy and safety of hydroxychloroquine as outpatient treatment of COVID-19: a randomized controlled trial
	Details Small early terminated late treatment RCT not showing significant differences. The HCQ group was a median of 7 days from symptom onset at baseline, which may not include the delay delivering the medication. From the 4 HCQ hospitalizations..
6/18	Details Source PDF Late treatment study Late treatment study
	Schwartz et al., CMAJ Open, doi:10.9778/cmajo.20210069 (Peer Reviewed)
	Assessing the efficacy and safety of hydroxychloroquine as outpatient treatment of COVID-19: a randomized controlled trial
	Small early terminated late treatment RCT not showing significant differences. The HCQ group was a median of 7 days from symptom onset at baseline, which may not include the delay delivering the medication. From the 4 HCQ hospitalizations, only one is in the per-protocol analysis, and that patient was hospitalized one day after randomization (authors do not specify if the patient received and took any HCQ before the hospitalization). The trial was terminated early due to the fraudulent Lancet article (wording here is notably different between the submitted and published versions). Per-protocol analysis, the submitted version, and the peer-review comments (two reviewers, only one with substantial feedback) are in the supplementary material. risk of ICU admission, 133.3% higher, RR 2.33, p = 1.00, treatment 1 of 111 (0.9%), control 0 of 37 (0.0%), continuity correction due to zero event. risk of hospitalization, 533.3% higher, RR 6.33, p = 0.57, treatment 4 of 111 (3.6%), control 0 of 37 (0.0%), continuity correction due to zero event. risk of ICU admission, 141.9% higher, RR 2.42, p = 1.00, treatment 1 of 74 (1.4%), control 0 of 31 (0.0%), continuity correction due to zero event, per-protocol. risk of hospitalization, 141.9% higher, RR 2.42, p = 1.00, treatment 1 of 74 (1.4%), control 0 of 31 (0.0%), continuity correction due to zero event, per-protocol. Schwartz et al., 6/18/2021, Double Blind Randomized Controlled Trial, Canada, North America, peer-reviewed, 20 authors.
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6/18	In Vitro	Purwati et al., PLOS One, doi:10.1371/journal.pone.0252302 (Peer Reviewed) (In Vitro)	in vitro	An in vitro study of dual drug combinations of anti-viral agents, antibiotics, and/or hydroxychloroquine against the SARS-CoV-2 virus isolated from hospitalized patients in Surabaya, Indonesia
	Details In Vitro study of combinations of drugs showing antiviral efficacy of HCQ alone and in combination with AZ, favipiravir, and doxycycline. No high levels of cytotoxicity were observed, and authors conclude that using a combination of drugs..
6/18	Details Source PDF In Vitro In Vitro
	Purwati et al., PLOS One, doi:10.1371/journal.pone.0252302 (Peer Reviewed) (In Vitro)
	An in vitro study of dual drug combinations of anti-viral agents, antibiotics, and/or hydroxychloroquine against the SARS-CoV-2 virus isolated from hospitalized patients in Surabaya, Indonesia
	In Vitro study of combinations of drugs showing antiviral efficacy of HCQ alone and in combination with AZ, favipiravir, and doxycycline. No high levels of cytotoxicity were observed, and authors conclude that using a combination of drugs can reduce the degree of cytotoxicity, increase antiviral activity, reduce the effect on pro-inflammatory markers, and increase anti-inflammatory response. Purwati et al., 6/18/2021, peer-reviewed, 16 authors.
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6/18	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.
6/18	Details Source PDF Early treatment study Early treatment study
	Fischer et al., medRxiv, doi:10.1101/2021.06.17.21258639 (Preprint)
	Molnupiravir, an Oral Antiviral Treatment for COVID-19
	RCT 202 outpatients in the USA showing significantly faster viral clearance, but no significant differences in symptom duration or severity. NCT04405570. risk of death, 76.5% lower, RR 0.23, p = 0.31, treatment 0 of 140 (0.0%), control 1 of 62 (1.6%), continuity correction due to zero event, all. risk of death, 65.4% lower, RR 0.35, p = 1.00, treatment 0 of 55 (0.0%), control 1 of 62 (1.6%), continuity correction due to zero event, 800mg. risk of death, 66.7% lower, RR 0.33, p = 1.00, treatment 0 of 62 (0.0%), control 1 of 62 (1.6%), continuity correction due to zero event, 400mg. risk of death, 57.8% lower, RR 0.42, p = 1.00, treatment 0 of 23 (0.0%), control 1 of 62 (1.6%), continuity correction due to zero event, 200mg. risk of hospitalization, 32.9% higher, RR 1.33, p = 1.00, treatment 3 of 140 (2.1%), control 1 of 62 (1.6%), all. risk of hospitalization, 12.7% higher, RR 1.13, p = 1.00, treatment 1 of 55 (1.8%), control 1 of 62 (1.6%), 800mg. risk of hospitalization, 100% higher, RR 2.00, p = 1.00, treatment 2 of 62 (3.2%), control 1 of 62 (1.6%), 400mg. risk of hospitalization, 57.8% lower, RR 0.42, p = 1.00, treatment 0 of 23 (0.0%), control 1 of 62 (1.6%), continuity correction due to zero event, 200mg. risk of no virological cure, 49.2% lower, RR 0.51, p = 0.12, treatment 10 of 118 (8.5%), control 9 of 54 (16.7%), infectious, day 3, all. risk of no virological cure, 88.7% lower, RR 0.11, p = 0.02, treatment 1 of 53 (1.9%), control 9 of 54 (16.7%), infectious, day 3, 800mg. risk of no virological cure, 30.2% lower, RR 0.70, p = 0.57, treatment 5 of 43 (11.6%), control 9 of 54 (16.7%), infectious, day 3, 400mg. risk of no virological cure, 9.1% higher, RR 1.09, p = 1.00, treatment 4 of 22 (18.2%), control 9 of 54 (16.7%), infectious, day 3, 200mg. risk of no virological cure, 92.3% lower, RR 0.08, p = 0.004, treatment 1 of 117 (0.9%), control 6 of 54 (11.1%), infectious, day 5, all. risk of no virological cure, 92.2% lower, RR 0.08, p = 0.03, treatment 0 of 53 (0.0%), control 6 of 54 (11.1%), continuity correction due to zero event, infectious, day 5, 800mg. risk of no virological cure, 91.4% lower, RR 0.09, p = 0.03, treatment 0 of 42 (0.0%), control 6 of 54 (11.1%), continuity correction due to zero event, infectious, day 5, 400mg. risk of no virological cure, 59.1% lower, RR 0.41, p = 0.67, treatment 1 of 22 (4.5%), control 6 of 54 (11.1%), infectious, day 5, 200mg. risk of no virological cure, 29.5% lower, RR 0.70, p = 0.30, treatment 19 of 137 (13.9%), control 12 of 61 (19.7%), all. risk of no virological cure, 61.6% lower, RR 0.38, p = 0.10, treatment 4 of 53 (7.5%), control 12 of 61 (19.7%), 800mg. risk of no virological cure, 8.3% higher, RR 1.08, p = 1.00, treatment 13 of 61 (21.3%), control 12 of 61 (19.7%), 400mg. risk of no virological cure, 55.8% lower, RR 0.44, p = 0.33, treatment 2 of 23 (8.7%), control 12 of 61 (19.7%), 200mg. Fischer et al., 6/18/2021, USA, North America, preprint, 18 authors.
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6/18	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..
6/18	Details Source PDF Early treatment study Early treatment study
	Krolewiecki et al., EClinicalMedicine, doi:10.1016/j.eclinm.2021.100959 (Peer Reviewed)
	Antiviral effect of high-dose ivermectin in adults with COVID-19: A proof-of-concept randomized trial
	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 reduction between groups overall, but a significant difference was found in patients with higher median plasma ivermectin levels (72% vs. 42%, p=0.004). Mean ivermectin plasma concentration levels correlated with viral decay rate (r=0.47, p=0.02). NCT004381884. risk of mechanical ventilation, 151.9% higher, RR 2.52, p = 1.00, treatment 1 of 27 (3.7%), control 0 of 14 (0.0%), continuity correction due to zero event. risk of disease progression, 3.7% higher, RR 1.04, p = 1.00, treatment 2 of 27 (7.4%), control 1 of 14 (7.1%). Krolewiecki et al., 6/18/2021, Randomized Controlled Trial, Argentina, South America, peer-reviewed, 23 authors.
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6/17	Meta	Bryant et al., American Journal of Therapeutics, doi:10.1097/MJT.0000000000001402 (preprint 3/11/21) (Peer Reviewed) (meta analysis)	death, ↓62.0%, p=0.005	Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines
	Details Systematic review, meta analysis, and trial sequential analysis of 24 RCTs finding mortality RR 0.38 [0.19-0.73].
6/17	Details Source PDF Meta Meta
	Bryant et al., American Journal of Therapeutics, doi:10.1097/MJT.0000000000001402 (preprint 3/11/21) (Peer Reviewed) (meta analysis)
	Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines
	Systematic review, meta analysis, and trial sequential analysis of 24 RCTs finding mortality RR 0.38 [0.19-0.73]. risk of death, 62.0% lower, RR 0.38, p = 0.005. Bryant et al., 6/17/2021, peer-reviewed, 7 authors.
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6/17	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.
6/17	Details Source PDF Levels Analysis of outcomes based on serum levels
	Jude et al., Journal of Clinical Endocrinology & Metabolism, doi:10.1210/clinem/dgab439 (Peer Reviewed)
	Vitamin D deficiency is associated with higher hospitalisation risk from COVID-19: a retrospective case-control study
	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. risk of hospitalization, 71.6% lower, RR 0.28, p < 0.001, adjusted, OR converted to RR, >25 nmol/L, control prevalence approximated with overall prevalence. risk of hospitalization, 57.9% lower, RR 0.42, p < 0.001, adjusted, OR converted to RR, >50 nmol/L, control prevalence approximated with overall prevalence. Jude et al., 6/17/2021, retrospective, United Kingdom, Europe, peer-reviewed, 5 authors.
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6/16	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.
6/16	Details Source PDF Late treatment study Late treatment study
	Horby et al., medRxiv, doi:10.1101/2021.06.15.21258542 (Peer Reviewed)
	Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
	RCT 9,785 hospitalized patients in the UK showing lower mortality with casirivimab/imdevimab, with statistical significance reached for baseline seronegative patients. risk of death, 6.0% lower, RR 0.94, p = 0.17, treatment 944 of 4839 (19.5%), control 1026 of 4946 (20.7%), all patients. risk of mechanical ventilation, no change, RR 1.00, p = 1.00, treatment 479 of 4556 (10.5%), control 487 of 4642 (10.5%), all patients. risk of death, 20.0% lower, RR 0.80, p = 0.001, treatment 396 of 1633 (24.2%), control 451 of 1520 (29.7%), seronegative patients. risk of mechanical ventilation, 12.0% lower, RR 0.88, p = 0.18, treatment 189 of 1599 (11.8%), control 200 of 1484 (13.5%), seronegative patients. Horby et al., 6/16/2021, Randomized Controlled Trial, United Kingdom, Europe, peer-reviewed, 34 authors.
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6/15	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.
6/15	Details Source PDF Review Review
	Zaidi et al., The Journal of Antibiotics, doi:10.1038/s41429-021-00430-5 (Review) (Peer Reviewed)
	The mechanisms of action of Ivermectin against SARS-CoV-2: An evidence-based clinical review article
	Extensive review of 20 mechanisms of action of ivermectin for SARS-CoV-2. Zaidi et al., 6/15/2021, peer-reviewed, 2 authors.
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6/15	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..
6/15	Details Source PDF In Vitro In Vitro
	Panchariya et al., bioRxiv, doi:10.1101/2021.06.15.448551 (Preprint) (In Vitro)
	Zinc2+ ion inhibits SARS-CoV-2 main protease and viral replication in vitro
	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 non-toxic concentrations. The combination of zinc acetate with zinc ionophore quercetin signficantly improved inhibition at low concentrations. Panchariya et al., 6/15/2021, preprint, 14 authors.
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6/15	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.
6/15	Details Source PDF Early treatment study Early treatment study
	Aref et al., International Journal of Nanomedicine, doi:10.2147/IJN.S313093 (Peer Reviewed)
	Clinical, Biochemical and Molecular Evaluations of Ivermectin Mucoadhesive Nanosuspension Nasal Spray in Reducing Upper Respiratory Symptoms of Mild COVID-19
	RCT 114 patients in Egypt, 57 treated with ivermectin mucoadhesive nanosuspension intranasal spray, showing faster recovery and viral clearance with treatment. NCT04716569. relative duration of fever, 63.2% lower, relative time 0.37, p < 0.001, treatment 57, control 57. risk of no virological cure, 78.6% lower, RR 0.21, p = 0.004, treatment 3 of 57 (5.3%), control 14 of 57 (24.6%). Aref et al., 6/15/2021, Randomized Controlled Trial, Egypt, Middle East, peer-reviewed, 7 authors.
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6/14	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.
6/14	Details Source PDF Levels Analysis of outcomes based on serum levels
	Campi et al., BMC Infectious Diseases, doi:10.1186/s12879-021-06281-7 (Peer Reviewed)
	Vitamin D and COVID-19 severity and related mortality: a prospective study in Italy
	Prospective study of 103 hospitalized patients in Italy, showing very high prevalence of vitamin D deficiency, and increased severity for lower vitamin D levels. risk of death for severe patients, 24.3% lower, RR 0.76, p = 0.53, treatment 6 of 39 (15.4%), control 13 of 64 (20.3%), >20ng/mL. risk of ICU for severe patients, 53.1% lower, RR 0.47, p < 0.001, treatment 12 of 39 (30.8%), control 42 of 64 (65.6%), >20ng/mL. Campi et al., 6/14/2021, prospective, Italy, Europe, peer-reviewed, 21 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 722 studies, 506 present results comparing with a control group, 447 are treatment studies, 59 analyze outcomes based on serum levels, and 46 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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