COVID-19 early treatment: real-time analysis of 1,184 studies

All studies Early treatment Mortality Early treatment mortality Recent studies Adoption

Analysis of 30 COVID-19 early treatments, and database of 246 other potential treatments. 68 countries have approved early treatments. Treatments do not replace vaccines and other measures. All practical, effective, and safe means should be used. Elimination is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all variants. Denying efficacy increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage.


Random effects meta-analysis of all studies combined (pooled effects, all stages). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all stages and outcomes depend on the distribution of stages and outcomes tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage and outcome analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments.


Random effects meta-analysis of early treatment studies (pooled effects). Treatments with ≤3 studies with distinct authors or with <50 control events are shown in grey. Pooled results across all outcomes are affected by the distribution of outcomes tested, please see detail pages for specific outcome analysis. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments.


Random effects meta-analysis of all mortality results (all stages). Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Pooled results across all stages depend on the distribution of stages tested - for example late stage treatment may be less effective and if the majority of studies are late stage this may obscure the efficacy of early treatment. Please see the specific stage analyses. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments.


Random effects meta-analysis of early treatment mortality results. Treatments with ≤3 studies with distinct authors or with <25 control events are shown in grey. Protocols typically combine multiple treatments which may be complementary and synergistic, and the SOC in studies often includes other treatments.

Treatment

Improvement
(early)

Studies
(early)

89%

82%

68%

66%

64%

47%

Early treatments approved by >2 countries. 68 countries have officially approved treatments. Details.

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


Dec 4	Early	Gupta et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab466.701 (Peer Reviewed)	death, ↓88.9%, p=0.12	Early COVID-19 Treatment with SARS-CoV-2 Neutralizing Antibody Sotrovimab
	Details RCT 1,057 outpatients, 529 treated with sotrovimab, showing significantly lower hospitalization and ICU admission with treatment. NCT04545060. The preprint [1] for this study appears to show different results: 10, 6, 2 for ICU, ventilati..
Dec 4	Details Source PDF Early treatment study Early treatment study
	Gupta et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab466.701 (Peer Reviewed)
	Early COVID-19 Treatment with SARS-CoV-2 Neutralizing Antibody Sotrovimab
	RCT 1,057 outpatients, 529 treated with sotrovimab, showing significantly lower hospitalization and ICU admission with treatment. NCT04545060. The preprint [1] for this study appears to show different results: 10, 6, 2 for ICU, ventilation, death, compared to 9, 4, 4 in this paper. [1] medrxiv.org/content/10.1101/2021.11.03.21265533v1 risk of death, 88.9% lower, RR 0.11, p = 0.12, treatment 0 of 528 (0.0%), control 4 of 529 (0.8%), relative risk is not 0 because of continuity correction due to zero events. risk of mechanical ventilation, 88.9% lower, RR 0.11, p = 0.12, treatment 0 of 528 (0.0%), control 4 of 529 (0.8%), relative risk is not 0 because of continuity correction due to zero events. risk of ICU admission, 94.7% lower, RR 0.05, p = 0.004, treatment 0 of 528 (0.0%), control 9 of 529 (1.7%), relative risk is not 0 because of continuity correction due to zero events. risk of hospitalization >24hrs or death, 79.0% lower, RR 0.21, p < 0.001, treatment 6 of 528 (1.1%), control 30 of 529 (5.7%), day 29, ITT. Conflicts of interest: research funding from the drug patent holder, employee of the drug patent holder. Gupta et al., 12/4/2021, Double Blind Randomized Controlled Trial, multiple countries, multiple regions, peer-reviewed, 22 authors.
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Dec 3	PrEP	Ma et al., The American Journal of Clinical Nutrition, doi:10.1093/ajcn/nqab389 (Peer Reviewed)	hosp., ↓49.0%, p=0.04	Associations between predicted vitamin D status, vitamin D intake, and risk of SARS-CoV-2 infection and Coronavirus Disease 2019 severity
	Details Analysis of 39,915 patients with 1,768 COVID+ cases based on surveys in the Nurses' Health Study II, showing higher predicted vitamin D levels associated with lower risk of COVID-19 cases. There was significantly lower risk of hospitaliza..
Dec 3	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Ma et al., The American Journal of Clinical Nutrition, doi:10.1093/ajcn/nqab389 (Peer Reviewed)
	Associations between predicted vitamin D status, vitamin D intake, and risk of SARS-CoV-2 infection and Coronavirus Disease 2019 severity
	Analysis of 39,915 patients with 1,768 COVID+ cases based on surveys in the Nurses' Health Study II, showing higher predicted vitamin D levels associated with lower risk of COVID-19 cases. There was significantly lower risk of hospitalization with vitamin D supplementation (≥400 IU/d), but no significant differences for cases based on supplementation. risk of hospitalization, 49.0% lower, RR 0.51, p = 0.04, treatment 26,605, control 12,710, adjusted, supplementation ≥400 IU/day, model 3, supplemental table 3, RR approximated with OR. risk of symptomatic case, 7.0% higher, RR 1.07, p = 0.25, treatment 7,895, control 31,420, adjusted, supplementation ≥2000 IU/day vs. <400 IU/day, multivariable, model 3, supplemental table 3, RR approximated with OR. risk of case, 17.0% lower, RR 0.83, p = 0.07, treatment 7,895, control 31,420, adjusted, supplementation ≥2000 IU/day vs. <400 IU/day, multivariable, model 3, supplemental table 3, RR approximated with OR. risk of hospitalization, 67.0% lower, RR 0.33, p = 0.15, high D levels 7,893, low D levels 7,823, adjusted, highest quintile vs. lowest quintile predicted vitamin D levels, model 3, supplemental table 3, RR approximated with OR. risk of symptomatic case, 9.0% lower, RR 0.91, p = 0.52, high D levels 7,893, low D levels 7,823, adjusted, highest quintile vs. lowest quintile predicted vitamin D levels, model 3, supplemental table 3, RR approximated with OR. risk of case, 52.0% lower, RR 0.48, p = 0.01, high D levels 7,893, low D levels 7,823, adjusted, highest quintile vs. lowest quintile predicted vitamin D levels, model 3, supplemental table 3, RR approximated with OR. Ma et al., 12/3/2021, retrospective, USA, North America, peer-reviewed, 16 authors, May 2020 - March 2021, dosage varies.
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Dec 3	N/A	Anonymous, Authorea, doi:10.22541/au.163854323.34557301/v1 (Review) (Preprint)	review	Treating a Pandemic Respiratory Disease with a Mutagen is a Doomsday Scenario
	Details Review of molnupiravir's mutagenic mechanism of action, and analysis of the increased probability of creating dangerous variants.
Dec 3	Details Source PDF N/A N/A
	Anonymous, Authorea, doi:10.22541/au.163854323.34557301/v1 (Review) (Preprint)
	Treating a Pandemic Respiratory Disease with a Mutagen is a Doomsday Scenario
	Review of molnupiravir's mutagenic mechanism of action, and analysis of the increased probability of creating dangerous variants. Anonymous et al., 12/3/2021, preprint, 1 author.
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Dec 2	Late	Shohan et al., European Journal of Pharmacology, doi:10.1016/j.ejphar.2021.1746158 (Peer Reviewed)	death, ↓85.7%, p=0.24	The therapeutic efficacy of quercetin in combination with antiviral drugs in hospitalized COVID-19 patients: A randomized controlled trial
	Details Small RCT with 60 severe hospitalized patients in Iran, 30 treated with quercetin, showing shorter time until discharge. All patients received remdesivir or favipiravir, and vitamin C, vitamin D, famotidine, zinc, dexamethasone, and magne..
Dec 2	Details Source PDF Late treatment study Late treatment study
	Shohan et al., European Journal of Pharmacology, doi:10.1016/j.ejphar.2021.1746158 (Peer Reviewed)
	The therapeutic efficacy of quercetin in combination with antiviral drugs in hospitalized COVID-19 patients: A randomized controlled trial
	Small RCT with 60 severe hospitalized patients in Iran, 30 treated with quercetin, showing shorter time until discharge. All patients received remdesivir or favipiravir, and vitamin C, vitamin D, famotidine, zinc, dexamethasone, and magnesium (depending on serum levels). Quercetin 1000mg daily for 7 days. IRCT20200419047128N2. risk of death, 85.7% lower, RR 0.14, p = 0.24, treatment 0 of 30 (0.0%), control 3 of 30 (10.0%), relative risk is not 0 because of continuity correction due to zero events. risk of ICU admission, 40.0% lower, RR 0.60, p = 0.71, treatment 3 of 30 (10.0%), control 5 of 30 (16.7%). days from end of intervention to discharge, 32.4% lower, relative time 0.68, p = 0.04, treatment 30, control 30. Shohan et al., 12/2/2021, Randomized Controlled Trial, Iran, Middle East, peer-reviewed, mean age 50.9 (treatment) 52.7 (control), 8 authors.
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Dec 1	Review	Behl et al., Science of The Total Environment, doi:10.1016/j.scitotenv.2021.152072 (Review) (Peer Reviewed)	review	CD147-spike protein interaction in COVID-19: Get the ball rolling with a novel receptor and therapeutic target
	Details Review of the cluster of differentiation 147 (CD147) transmembrane protein as an entry route for SARS-CoV-2, correlation with observed characteristics of COVID-19, and relevant potential therapeutics including azithromycin, melatonin, sta..
Dec 1	Details Source PDF Review Review
	Behl et al., Science of The Total Environment, doi:10.1016/j.scitotenv.2021.152072 (Review) (Peer Reviewed)
	CD147-spike protein interaction in COVID-19: Get the ball rolling with a novel receptor and therapeutic target
	Review of the cluster of differentiation 147 (CD147) transmembrane protein as an entry route for SARS-CoV-2, correlation with observed characteristics of COVID-19, and relevant potential therapeutics including azithromycin, melatonin, statins, beta adrenergic blockers, ivermectin, and meplazumab. Behl et al., 12/1/2021, peer-reviewed, 9 authors.
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Dec 1	Late	McCreary et al., medRxiv, doi:10.1101/2021.11.30.21266756 (Preprint)	death, ↓93.0%, p=0.009	Association of subcutaneous or intravenous route of administration of casirivimab and imdevimab monoclonal antibodies with clinical outcomes in COVID-19
	Details Prospective study comparing subcutaneous and intravenous casirivimab/imdevimab, and comparing to a PSM matched control set, showing significantly lower mortality and hospitalization with treatment. Controls were matched with EUA-eligible ..
Dec 1	Details Source PDF Late treatment study Late treatment study
	McCreary et al., medRxiv, doi:10.1101/2021.11.30.21266756 (Preprint)
	Association of subcutaneous or intravenous route of administration of casirivimab and imdevimab monoclonal antibodies with clinical outcomes in COVID-19
	Prospective study comparing subcutaneous and intravenous casirivimab/imdevimab, and comparing to a PSM matched control set, showing significantly lower mortality and hospitalization with treatment. Controls were matched with EUA-eligible risk factors only, authors were unable to determine symptom severity. risk of death, 93.0% lower, RR 0.07, p = 0.009, treatment 1 of 652 (0.2%), control 29 of 1,304 (2.2%), propensity score matching. risk of death/hospitalization, 56.0% lower, RR 0.44, p < 0.001, treatment 22 of 652 (3.4%), control 101 of 1,304 (7.7%), propensity score matching. risk of hospitalization, 48.0% lower, RR 0.52, p = 0.005, treatment 22 of 652 (3.4%), control 85 of 1,304 (6.5%), propensity score matching. risk of hospitalization/ER, 40.0% lower, RR 0.60, p = 0.003, treatment 40 of 652 (6.1%), control 133 of 1,304 (10.2%), propensity score matching. SQ vs. IV death, 53.0% lower, RR 0.47, p = 0.52, treatment 1 of 969 (0.1%), control 3 of 1,216 (0.2%), adjusted. SQ vs. IV death/hosp., 71.0% higher, RR 1.71, p = 0.06, treatment 27 of 969 (2.8%), control 21 of 1,216 (1.7%), adjusted. SQ vs. IV hospitalization, 79.0% higher, RR 1.79, p = 0.05, treatment 27 of 969 (2.8%), control 20 of 1,216 (1.6%), adjusted. SQ vs. IV ER/hosp., 15.0% lower, RR 0.85, p = 0.38, treatment 47 of 969 (4.9%), control 71 of 1,216 (5.8%), adjusted. McCreary et al., 12/1/2021, prospective, USA, North America, preprint, 27 authors, 14 July, 2021 - 26 October, 2021.
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Nov 30	Levels	Fatemi et al., Acute and Critical Care, doi:10.4266/acc.2021.00605 (Peer Reviewed)	death, ↓42.0%, p=0.07	Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study
	Details Prospective study of 248 hospitalized COVID+ patients in Iran with vitamin D levels measured in the previous year and again at admission, showing vitamin D status associated with severity and mortality.
Nov 30	Details Source PDF Levels Analysis of outcomes based on serum levels
	Fatemi et al., Acute and Critical Care, doi:10.4266/acc.2021.00605 (Peer Reviewed)
	Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study
	Prospective study of 248 hospitalized COVID+ patients in Iran with vitamin D levels measured in the previous year and again at admission, showing vitamin D status associated with severity and mortality. risk of death, 42.0% lower, RR 0.58, p = 0.07, high D levels 18 of 139 (12.9%), low D levels 25 of 109 (22.9%), OR converted to RR, vitamin D measured prior to COVID-19, multivariate. risk of death, 51.1% lower, RR 0.49, p = 0.02, high D levels 13 of 115 (11.3%), low D levels 30 of 133 (22.6%), OR converted to RR, vitamin D measured on admission, multivariate. risk of severe case, 37.9% lower, RR 0.62, p = 0.007, high D levels 38 of 139 (27.3%), low D levels 48 of 109 (44.0%), vitamin D measured prior to COVID-19. risk of severe case, 34.8% lower, RR 0.65, p = 0.02, high D levels 31 of 115 (27.0%), low D levels 55 of 133 (41.4%), vitamin D measured on admission. Fatemi et al., 11/30/2021, prospective, Iran, Middle East, peer-reviewed, 5 authors, 1 October, 2020 - 31 May, 2021.
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Nov 30	Levels	Kaur et al., Indian Journal of Clinical Practice, 32:6 (Peer Reviewed)	death, ↓89.8%, p<0.0001	Correlation of Vitamin D Levels with COVID-19 Severity and Outcome
	Details Prospective study of 81 hospitalized COVID+ patients in India, showing low vitamin D levels associated with COVID-19 severity and mortality.
Nov 30	Details Source PDF Levels Analysis of outcomes based on serum levels
	Kaur et al., Indian Journal of Clinical Practice, 32:6 (Peer Reviewed)
	Correlation of Vitamin D Levels with COVID-19 Severity and Outcome
	Prospective study of 81 hospitalized COVID+ patients in India, showing low vitamin D levels associated with COVID-19 severity and mortality. risk of death, 89.8% lower, RR 0.10, p < 0.001, high D levels (≥10ng/mL) 5 of 64 (7.8%), low D levels (<10ng/mL) 13 of 17 (76.5%). risk of mechanical ventilation, 90.3% lower, RR 0.10, p < 0.001, high D levels (≥10ng/mL) 4 of 64 (6.2%), low D levels (<10ng/mL) 11 of 17 (64.7%). Excluded in after exclusion results of meta analysis: unadjusted results with no group details. Kaur et al., 11/30/2021, prospective, India, South Asia, peer-reviewed, 5 authors.
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Nov 30	Early	Alattar et al., medRxiv, doi:10.1101/2021.11.29.21267042 (Preprint)	death, ↓33.3%, p=0.50	Favipiravir for the Treatment of Coronavirus Disease 2019; a propensity score-matched cohort study
	Details PSM retrospective with 1,493 patients, showing significantly improved viral clearance with favipiravir. There were no signficant differences in clinical improvement or mortality. Mortality was lower (2.1% vs 3.1%), without statistical sig..
Nov 30	Details Source PDF Early treatment study Early treatment study
	Alattar et al., medRxiv, doi:10.1101/2021.11.29.21267042 (Preprint)
	Favipiravir for the Treatment of Coronavirus Disease 2019; a propensity score-matched cohort study
	PSM retrospective with 1,493 patients, showing significantly improved viral clearance with favipiravir. There were no signficant differences in clinical improvement or mortality. Mortality was lower (2.1% vs 3.1%), without statistical significance with the small number of events. risk of death, 33.3% lower, RR 0.67, p = 0.50, treatment 8 of 387 (2.1%), control 12 of 387 (3.1%), propensity score matching. risk of no clinical improvement, 2.2% higher, RR 1.02, p = 0.73, treatment 26 of 387 (6.7%), control 28 of 387 (7.2%), adjusted, day 28, Cox proportional hazards, propensity score matching. days to clinical improvement, 6.2% higher, relative time 1.06, p = 0.07, treatment 387, control 387, propensity score matching. risk of no virological cure, 43.9% lower, RR 0.56, p < 0.001, treatment 78 of 387 (20.2%), control 139 of 387 (35.9%), propensity score matching. Alattar et al., 11/30/2021, retrospective, Qatar, Middle East, preprint, 25 authors, 23 May, 2020 - 18 July, 2020.
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Nov 30	In Vitro	Jitobaom et al., Research Square, doi:10.21203/rs.3.rs-1069947/v1 (Preprint) (In Vitro)	in vitro	Synergistic Anti-SARS-CoV-2 Activity of Repurposed Anti-Parasitic Drug Combinations
	Details In Vitro study showing a strong synergistic effect of combinations of ivermectin, niclosamide, and chloroquine, with >10x reduction in IC₅₀ compared to individual drugs.
Nov 30	Details Source PDF In Vitro In Vitro
	Jitobaom et al., Research Square, doi:10.21203/rs.3.rs-1069947/v1 (Preprint) (In Vitro)
	Synergistic Anti-SARS-CoV-2 Activity of Repurposed Anti-Parasitic Drug Combinations
	In Vitro study showing a strong synergistic effect of combinations of ivermectin, niclosamide, and chloroquine, with >10x reduction in IC₅₀ compared to individual drugs. Jitobaom et al., 11/30/2021, preprint, 8 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
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Nov 26	Late	Ferreira et al., Revista da Associação Médica Brasileira, doi:10.1590/1806-9282.20210661 (Peer Reviewed)	death, ↑151.5%, p=0.03	Outcomes associated with Hydroxychloroquine and Ivermectin in hospitalized patients with COVID-19: a single-center experience
	Details Retrospective 230 hospitalized patients in Brazil showing higher mortality with HCQ treatment. Authors note that the treatments were more likely to be offered to sicker patients. Authors indicate that they do not know when medication was ..
Nov 26	Details Source PDF Late treatment study Late treatment study
	Ferreira et al., Revista da Associação Médica Brasileira, doi:10.1590/1806-9282.20210661 (Peer Reviewed)
	Outcomes associated with Hydroxychloroquine and Ivermectin in hospitalized patients with COVID-19: a single-center experience
	Retrospective 230 hospitalized patients in Brazil showing higher mortality with HCQ treatment. Authors note that the treatments were more likely to be offered to sicker patients. Authors indicate that they do not know when medication was started, which in some cases could have been after ICU admission or intubation. Dosage is unknown. risk of death, 151.5% higher, RR 2.51, p = 0.03, treatment 17 of 111 (15.3%), control 11 of 81 (13.6%), OR converted to RR, multivariate. risk of death/intubation, 45.9% higher, RR 1.46, p = 0.23, treatment 30 of 111 (27.0%), control 15 of 81 (18.5%). risk of death/intubation/ICU, 61.3% higher, RR 1.61, p = 0.04, treatment 42 of 111 (37.8%), control 19 of 81 (23.5%). Ferreira et al., 11/26/2021, retrospective, Brazil, South America, peer-reviewed, 5 authors, 12 March, 2020 - 8 July, 2020, dosage not specified.
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Nov 26	Early	Merck News Release (News)	death, ↓89.0%, p=0.01	Merck and Ridgeback Biotherapeutics Provide Update on Results from MOVe-OUT Study of Molnupiravir, an Investigational Oral Antiviral Medicine, in At Risk Adults With Mild-to-Moderate COVID-19
	Details News release reporting results of the MOVe-OUT trial, showing significantly lower risk of hospitalization or death. In subgroup analysis efficacy was much lower with the delta variant. NCT04575597. Discussion of concerns with this trial ..
Nov 26	Details Source PDF Early treatment study Early treatment study
	Merck News Release (News)
	Merck and Ridgeback Biotherapeutics Provide Update on Results from MOVe-OUT Study of Molnupiravir, an Investigational Oral Antiviral Medicine, in At Risk Adults With Mild-to-Moderate COVID-19
	News release reporting results of the MOVe-OUT trial, showing significantly lower risk of hospitalization or death. In subgroup analysis efficacy was much lower with the delta variant. NCT04575597. Discussion of concerns with this trial can be found at [1, 2]. See also: [3, 4]. [1] trialsitenews.com/molnupiravir-mutagenic-carcinogenic-authorized-in-the-uk/ [2] defyccc.com/wp-content/uploads/Molnupiravir-Mutagenic-Carcinogenic-TSN.pdf [3] twitter.com/Covid19Crusher/status/1464249681446420485 [4] twitter.com/Covid19Crusher/status/1464269071818661893 risk of death, 89.0% lower, RR 0.11, p = 0.01, treatment 1 of 709 (0.1%), control 9 of 699 (1.3%). risk of death/hospitalization, 30.4% lower, RR 0.70, p = 0.05, treatment 48 of 709 (6.8%), control 68 of 699 (9.7%). risk of death/hospitalization, 94.1% lower, RR 0.06, p = 0.004, treatment 0 of 37 (0.0%), control 9 of 47 (19.1%), relative risk is not 0 because of continuity correction due to zero events, gamma variant. risk of death/hospitalization, 49.5% lower, RR 0.50, p = 0.15, treatment 6 of 75 (8.0%), control 13 of 82 (15.9%), mu variant. risk of death/hospitalization, 23.7% lower, RR 0.76, p = 0.41, treatment 18 of 237 (7.6%), control 22 of 221 (10.0%), delta variant. risk of death/hospitalization, 42.2% lower, RR 0.58, p = 0.36, treatment 5 of 47 (10.6%), control 7 of 38 (18.4%), other variants. Merck et al., 11/26/2021, Randomized Controlled Trial, multiple countries, multiple regions, preprint, 1 author.
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Nov 25	Early	Ried et al., Cureus, doi:10.7759/cureus.19902 (Peer Reviewed)	no recov., ↓30.6%, p=0.008	Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial
	Details RCT 237 patients in Turkey, 162 treated with IV vitamin C in addition to HCQ/AZ/zinc/vitamin D used for all patients, showing significantly faster recovery with the addition of IV vitamin C. 97% of patients were vitamin D deficient, and ..
Nov 25	Details Source PDF Early treatment study Early treatment study
	Ried et al., Cureus, doi:10.7759/cureus.19902 (Peer Reviewed)
	Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial
	RCT 237 patients in Turkey, 162 treated with IV vitamin C in addition to HCQ/AZ/zinc/vitamin D used for all patients, showing significantly faster recovery with the addition of IV vitamin C. 97% of patients were vitamin D deficient, and lower vitamin D levels were associated with ICU admission and longer hospital stay. Only 1 of 237 hospitalized patients died (average age 63, range 22-99) - a 70-year-old patient with heart and lung disease and severely deficient vitamin D levels (6 nmol/L). ACTRN12620000557932. risk of no recovery, 30.6% lower, RR 0.69, p = 0.008, treatment 69 of 162 (42.6%), control 46 of 75 (61.3%), day 15 mid-recovery. Ried et al., 11/25/2021, Randomized Controlled Trial, Turkey, Europe, peer-reviewed, 3 authors.
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Nov 24	Levels	Jenei et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2021.11.025 (Peer Reviewed)		COVID-19 mortality is associated with low Vitamin D levels in patients with risk factors and/or advanced age
	Details Retrospective 257 hospitalized patients in Hungary, showing mortality associated with lower vitamin D levels for all patients, for patients >60, and for age-matched patients with risk factors or age >60. The non-age-matched analyses are c..
Nov 24	Details Source PDF Levels Analysis of outcomes based on serum levels
	Jenei et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2021.11.025 (Peer Reviewed)
	COVID-19 mortality is associated with low Vitamin D levels in patients with risk factors and/or advanced age
	Retrospective 257 hospitalized patients in Hungary, showing mortality associated with lower vitamin D levels for all patients, for patients >60, and for age-matched patients with risk factors or age >60. The non-age-matched analyses are confounded by age, with elderly patients more likely to have lower vitamin D levels. Jenei et al., 11/24/2021, peer-reviewed, 10 authors.
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Nov 24	Early	Holubar et al., medRxiv, doi:10.1101/2021.11.22.21266690 (Preprint)	hosp., ↓89.0%, p=0.06	Favipiravir for treatment of outpatients with asymptomatic or uncomplicated COVID-19: a double-blind randomized, placebo-controlled, phase 2 trial
	Details Small RCT 116 mITT patients in the USA, 59 treated with favipiravir, showing no significant differences with treatment.
Nov 24	Details Source PDF Early treatment study Early treatment study
	Holubar et al., medRxiv, doi:10.1101/2021.11.22.21266690 (Preprint)
	Favipiravir for treatment of outpatients with asymptomatic or uncomplicated COVID-19: a double-blind randomized, placebo-controlled, phase 2 trial
	Small RCT 116 mITT patients in the USA, 59 treated with favipiravir, showing no significant differences with treatment. risk of hospitalization, 89.0% lower, RR 0.11, p = 0.06, treatment 0 of 75 (0.0%), control 4 of 74 (5.4%), relative risk is not 0 because of continuity correction due to zero events. risk of ER visit, 29.5% lower, RR 0.70, p = 0.56, treatment 5 of 75 (6.7%), control 7 of 74 (9.5%). risk of no recovery, 16.0% lower, RR 0.84, p = 0.43, treatment 65, control 70, initial resolution of symptoms. viral shedding, 31.6% higher, RR 1.32, p = 0.24, treatment 59, control 57. Holubar et al., 11/24/2021, Double Blind Randomized Controlled Trial, USA, North America, preprint, 26 authors.
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Nov 23	PrEP	Ahmed et al., BioMed Research International, doi:10.1155/2021/1676914 (Peer Reviewed)	cases, ↓99.3%, p=0.08	Factors Affecting the Incidence, Progression, and Severity of COVID-19 in Type 1 Diabetes Mellitus
	Details Retrospective type 1 diabetes patients in Saudi Arabia showing reduced risk of cases with HCQ prophylaxis.
Nov 23	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Ahmed et al., BioMed Research International, doi:10.1155/2021/1676914 (Peer Reviewed)
	Factors Affecting the Incidence, Progression, and Severity of COVID-19 in Type 1 Diabetes Mellitus
	Retrospective type 1 diabetes patients in Saudi Arabia showing reduced risk of cases with HCQ prophylaxis. risk of case, 99.3% lower, RR 0.007, p = 0.08, treatment 0 of 50 (0.0%) cases, 13 of 50 (26.0%) controls, case control OR. Ahmed et al., 11/23/2021, retrospective, Saudi Arabia, Middle East, peer-reviewed, 7 authors.
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Nov 23	Late	Ozer et al., Journal of Medical Virology, doi:10.1002/jmv.27469 (Peer Reviewed)	death, ↓75.0%, p=0.09	Effectiveness and Safety of Ivermectin in COVID‐19 Patients: A Prospective Study at A Safety‐Net Hospital
	Details Small prospective PSM study in the USA, showing 75% lower mortality with ivermectin treatment, without reaching statistical significance, significantly shorter ventilation and ICU time, and longer hospitalization time. Authors leave the ..
Nov 23	Details Source PDF Late treatment study Late treatment study
	Ozer et al., Journal of Medical Virology, doi:10.1002/jmv.27469 (Peer Reviewed)
	Effectiveness and Safety of Ivermectin in COVID‐19 Patients: A Prospective Study at A Safety‐Net Hospital
	Small prospective PSM study in the USA, showing 75% lower mortality with ivermectin treatment, without reaching statistical significance, significantly shorter ventilation and ICU time, and longer hospitalization time. Authors leave the statistically significant improvements in ventilation and ICU time out of the abtract and conclusions, and incorrectly state that there were no differences in other outcomes (there were no statistically significant differences) [1]. Authors are ambiguous on the primary outcome, referring to the primary mortality outcome in one case, and "clinical outcomes, measured by the rate of intubation, length of hospital stay, and mechanical ventilation duration" in another case. The longer hospitalization time may be partially due to the greater mortality in the control group. [1] nature.com/articles/d41586-019-00857-9 risk of death, 75.0% lower, RR 0.25, p = 0.09, treatment 2 of 60 (3.3%), control 8 of 60 (13.3%), PSM. risk of mechanical ventilation, 12.6% lower, RR 0.87, p = 0.20, treatment 3 of 60 (5.0%), control 2 of 60 (3.3%), OR converted to RR, PSM, multivariable. ventilation time, 83.3% lower, relative time 0.17, p = 0.002, treatment 60, control 60. risk of ICU admission, 48.7% lower, RR 0.51, p = 0.42, treatment 6 of 60 (10.0%), control 3 of 60 (5.0%), OR converted to RR, PSM, multivariable. ICU time, 70.6% lower, relative time 0.29, p < 0.001, treatment 60, control 60. hospitalization time, 9.0% higher, relative time 1.09, p = 0.09, treatment 60, control 60, PSM, multivariable. Ozer et al., 11/23/2021, prospective, USA, North America, peer-reviewed, 12 authors, dosage 200μg/kg days 1, 3.
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Nov 21	Levels	Asgari et al., Acta Medica Iranica, doi:10.18502/acta.v59i11.7779 (Peer Reviewed)	death, ↓72.5%, p=0.03	Vitamin D Insufficiency in Disease Severity and Prognosis of the Patients With SARS Corona Virus-2 Infection
	Details Retrospective 98 moderate/severe hospitalized COVID-19+ patients in Iran, showing significantly increased risk of mortality and severity with vitamin D deficiency. IR.AJAUMS.REC.1399.060.
Nov 21	Details Source PDF Levels Analysis of outcomes based on serum levels
	Asgari et al., Acta Medica Iranica, doi:10.18502/acta.v59i11.7779 (Peer Reviewed)
	Vitamin D Insufficiency in Disease Severity and Prognosis of the Patients With SARS Corona Virus-2 Infection
	Retrospective 98 moderate/severe hospitalized COVID-19+ patients in Iran, showing significantly increased risk of mortality and severity with vitamin D deficiency. IR.AJAUMS.REC.1399.060. risk of death, 72.5% lower, RR 0.27, p = 0.03, adjusted, RR approximated with OR. risk of progression, 65.6% lower, RR 0.34, p = 0.02, adjusted, RR approximated with OR. Asgari et al., 11/21/2021, retrospective, Iran, Middle East, peer-reviewed, 6 authors, 21 May, 2020 - 4 September, 2020.
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Nov 19	In Vitro	Tandel et al., bioRxiv, doi:10.1101/2021.11.18.469078 (Preprint) (In Vitro)	in vitro	Metformin Suppresses SARS-CoV-2 in Cell Culture
	Details In Vitro study showing metformin inhibits SARS-CoV-2 in Caco2 cells. Metformin reduced viral titers by nearly 99%, and by about 90% when cells were treated prior to infection.
Nov 19	Details Source PDF In Vitro In Vitro
	Tandel et al., bioRxiv, doi:10.1101/2021.11.18.469078 (Preprint) (In Vitro)
	Metformin Suppresses SARS-CoV-2 in Cell Culture
	In Vitro study showing metformin inhibits SARS-CoV-2 in Caco2 cells. Metformin reduced viral titers by nearly 99%, and by about 90% when cells were treated prior to infection. Tandel et al., 11/19/2021, preprint, 3 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
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Nov 19	Late	Chuah et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab962 (Peer Reviewed)	death, ↑1154.0%, p=0.08	Efficacy of Early Treatment with Favipiravir on Disease Progression among High Risk COVID-19 Patients: A Randomized, Open-Label Clinical Trial
	Details RCT 500 hospitalized patients in Malaysia, showing no significant differences with favipiravir treatment.
Nov 19	Details Source PDF Late treatment study Late treatment study
	Chuah et al., Clinical Infectious Diseases, doi:10.1093/cid/ciab962 (Peer Reviewed)
	Efficacy of Early Treatment with Favipiravir on Disease Progression among High Risk COVID-19 Patients: A Randomized, Open-Label Clinical Trial
	RCT 500 hospitalized patients in Malaysia, showing no significant differences with favipiravir treatment. risk of death, 1154.0% higher, RR 12.54, p = 0.08, treatment 5 of 250 (2.0%), control 0 of 250 (0.0%), OR converted to RR, continuity correction due to zero event. risk of mechanical ventilation, 19.5% higher, RR 1.20, p = 0.76, treatment 6 of 250 (2.4%), control 5 of 250 (2.0%), OR converted to RR. risk of ICU admission, 8.5% higher, RR 1.09, p = 0.84, treatment 13 of 250 (5.2%), control 12 of 250 (4.8%), OR converted to RR. Chuah et al., 11/19/2021, Randomized Controlled Trial, Malaysia, Europe, peer-reviewed, 18 authors.
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Nov 18	Late	RECOVERY Collaborative Group, The Lancet, doi:10.1016/S0140-6736(21)01825-0 (Peer Reviewed)	death, ↓4.0%, p=0.35	Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
	Details RCT 14,892 late stage patients, 7,351 treated with aspirin, showing slightly improved discharge and hospitalization time, and no significant difference for mortality. Results are limited due to low dose (150mg daily), late treatment (9 d..
Nov 18	Details Source PDF Late treatment study Late treatment study
	RECOVERY Collaborative Group, The Lancet, doi:10.1016/S0140-6736(21)01825-0 (Peer Reviewed)
	Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
	RCT 14,892 late stage patients, 7,351 treated with aspirin, showing slightly improved discharge and hospitalization time, and no significant difference for mortality. Results are limited due to low dose (150mg daily), late treatment (9 days post symptom onset), and 96% concurrent use of low molecular weight heparin. Greater benefits were seen for non-LMWH patients, and for very late (<= 7 days from onset) vs. extremely late (>7 days) treatment. For more discussion see [1]. [1] twitter.com/Covid19Crusher/status/1461272964675031042 risk of death, 4.0% lower, RR 0.96, p = 0.35, treatment 7,351, control 7,541. risk of death, 17.0% lower, RR 0.83, p = 0.35, treatment 7,351, control 7,541, non-LMWH. risk of mechanical ventilation, 5.0% lower, RR 0.95, p = 0.32, treatment 7,351, control 7,541. risk of no hospital discharge, 5.7% lower, RR 0.94, p = 0.006, treatment 7,351, control 7,541. risk of no hospital discharge, 16.0% lower, RR 0.84, p = 0.04, treatment 7,351, control 7,541, non-LMWH. hospitalization time, 11.1% lower, relative time 0.89, treatment 7,351, control 7,541. RECOVERY et al., 11/18/2021, Randomized Controlled Trial, multiple countries, multiple regions, peer-reviewed, 1 author, 1 November, 2020 - 21 March, 2021.
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Nov 17	PrEP	Samajdar et al., Journal of the Association of Physicians India, 69:11 (Peer Reviewed)	cases, ↓74.5%, p<0.0001	Ivermectin and Hydroxychloroquine for Chemo-Prophylaxis of COVID-19: A Questionnaire Survey of Perception and Prescribing Practice of Physicians vis-a-vis Outcomes
	Details Physician survey in India with 164 ivermectin prophylaxis, 129 HCQ prophylaxis, and 81 control patients, showing significantly lower COVID-19 cases with treatment. Details of the treatment and control groups and the definition of cases ar..
Nov 17	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Samajdar et al., Journal of the Association of Physicians India, 69:11 (Peer Reviewed)
	Ivermectin and Hydroxychloroquine for Chemo-Prophylaxis of COVID-19: A Questionnaire Survey of Perception and Prescribing Practice of Physicians vis-a-vis Outcomes
	Physician survey in India with 164 ivermectin prophylaxis, 129 HCQ prophylaxis, and 81 control patients, showing significantly lower COVID-19 cases with treatment. Details of the treatment and control groups and the definition of cases are not provided, and the results are subject to survey bias. Authors also report on community prophylaxis but present only combined ivermectin/HCQ results. risk of case, 74.5% lower, RR 0.25, p < 0.001, treatment 12 of 129 (9.3%), control 29 of 81 (35.8%), OR converted to RR, physician survey. risk of case, 48.6% lower, RR 0.51, p = 0.03, treatment 11 of 109 (10.1%), control 39 of 200 (19.5%), OR converted to RR, combined ivermectin or HCQ in community. Excluded in after exclusion results of meta analysis: minimal details provided, unadjusted results with no group details, results may be significantly affected by survey bias. Samajdar et al., 11/17/2021, retrospective, India, South Asia, peer-reviewed, 9 authors, 1 September, 2020 - 31 December, 2020, dosage not specified.
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Nov 16	In Vitro	Marín-Palma et al., Molecules, doi:10.3390/molecules26226900 (Peer Reviewed) (In Vitro)	in vitro	Curcumin Inhibits In Vitro SARS-CoV-2 Infection In Vero E6 Cells through Multiple Antiviral Mechanisms
	Details In Vitro study showing antiviral and anti-inflammatory effects of curcumin during SARS-CoV-2 infection. Inhibition was seen with Vero E6 cells pre-infection and post-infection, and with D614G and the delta variant. The anti-inflammatory e..
Nov 16	Details Source PDF In Vitro In Vitro
	Marín-Palma et al., Molecules, doi:10.3390/molecules26226900 (Peer Reviewed) (In Vitro)
	Curcumin Inhibits In Vitro SARS-CoV-2 Infection In Vero E6 Cells through Multiple Antiviral Mechanisms
	In Vitro study showing antiviral and anti-inflammatory effects of curcumin during SARS-CoV-2 infection. Inhibition was seen with Vero E6 cells pre-infection and post-infection, and with D614G and the delta variant. The anti-inflammatory effect was shown with peripheral blood mononuclear cells. Marín-Palma et al., 11/16/2021, peer-reviewed, 9 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
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Nov 16	PrEP	Isa et al., medRxiv, doi:10.1101/2021.11.10.21265889 (Preprint)	symp. case, ↓92.6%, p=0.002	Repeat Subcutaneous Administration of REGEN-COV® in Adults is Well-Tolerated and Prevents the Occurrence of COVID-19
	Details RCT 969 patients, 729 treated with monthly subcutaneous casirivimab/imdevimab, showing significantly lower risk of COVID-19 with treatment. There were no grade 3 injection site reactions or hypersensitivity reactions. Slightly more TEAEs ..
Nov 16	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Isa et al., medRxiv, doi:10.1101/2021.11.10.21265889 (Preprint)
	Repeat Subcutaneous Administration of REGEN-COV® in Adults is Well-Tolerated and Prevents the Occurrence of COVID-19
	RCT 969 patients, 729 treated with monthly subcutaneous casirivimab/imdevimab, showing significantly lower risk of COVID-19 with treatment. There were no grade 3 injection site reactions or hypersensitivity reactions. Slightly more TEAEs were reported with treatment (54.9% vs. 48.3%), due to grade 1-2 ISRs. Serious adverse events were rare and occurred with similar percentages for treatment and control groups. There were no deaths. NCT04519437. risk of symptomatic case, 92.6% lower, RR 0.07, p = 0.002, treatment 3 of 729 (0.4%), control 13 of 240 (5.4%), OR converted to RR. risk of case, 92.7% lower, RR 0.07, p = 0.002, treatment 0 of 729 (0.0%), control 10 of 240 (4.2%), OR converted to RR, relative risk is not 0 because of continuity correction due to zero events, seroconversion. Conflicts of interest: employee of the drug patent holder. Isa et al., 11/16/2021, Double Blind Randomized Controlled Trial, USA, North America, preprint, 31 authors.
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Nov 15	PrEP	Oskotsky et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.33090 (Peer Reviewed)	death, ↑57.9%, p=0.62	Mortality Risk Among Patients With COVID-19 Prescribed Selective Serotonin Reuptake Inhibitor Antidepressants
	Details Retrospective database analysis of 83,584 patients in the USA, showing lower mortality with existing fluoxetine use in PSM analysis. There were 11 fluvoxamine patients, showing non-statistically significant higher mortality.
Nov 15	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Oskotsky et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.33090 (Peer Reviewed)
	Mortality Risk Among Patients With COVID-19 Prescribed Selective Serotonin Reuptake Inhibitor Antidepressants
	Retrospective database analysis of 83,584 patients in the USA, showing lower mortality with existing fluoxetine use in PSM analysis. There were 11 fluvoxamine patients, showing non-statistically significant higher mortality. risk of death, 57.9% higher, RR 1.58, p = 0.62, treatment 2 of 11 (18.2%), control 19 of 165 (11.5%), fluvoxamine. risk of death, 26.0% lower, RR 0.74, p = 0.04, treatment 48 of 481 (10.0%), control 956 of 7,215 (13.3%), fluoxetine. Oskotsky et al., 11/15/2021, retrospective, propensity score matching, USA, North America, peer-reviewed, 8 authors.
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Nov 14	In Vitro	Bahun et al., Food Chemistry, doi:10.1016/j.foodchem.2021.131594 (Peer Reviewed) (In Vitro)	in vitro	Inhibition of the SARS-CoV-2 3CLpro main protease by plant polyphenols
	Details In Silico and In Vitro study of plant polyphenols identifying quercetin, curcumin, ellagic acid, epigallocatechin gallate and resveratrol as SARS-CoV-2 3CL^pro inhibitors with IC₅₀ between 11.8µM and 23.4µM. Real-time binding was analyzed..
Nov 14	Details Source PDF In Vitro In Vitro
	Bahun et al., Food Chemistry, doi:10.1016/j.foodchem.2021.131594 (Peer Reviewed) (In Vitro)
	Inhibition of the SARS-CoV-2 3CLpro main protease by plant polyphenols
	In Silico and In Vitro study of plant polyphenols identifying quercetin, curcumin, ellagic acid, epigallocatechin gallate and resveratrol as SARS-CoV-2 3CL^pro inhibitors with IC₅₀ between 11.8µM and 23.4µM. Real-time binding was analyzed with surface plasmon resonance spectroscopy. Bahun et al., 11/14/2021, peer-reviewed, 10 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
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Nov 12	Levels	Sacristán et al., Transplantation Proceedings, doi:10.1016/j.transproceed.2021.08.060 (Peer Reviewed)		Risk of severe COVID-19 infection in kidney transplant recipients
	Details Retrospective 63 COVID+ kidney transplant recipients, showing significantly lower vitamin D levels before infection in patients requiring ICU admission.
Nov 12	Details Source PDF Levels Analysis of outcomes based on serum levels
	Sacristán et al., Transplantation Proceedings, doi:10.1016/j.transproceed.2021.08.060 (Peer Reviewed)
	Risk of severe COVID-19 infection in kidney transplant recipients
	Retrospective 63 COVID+ kidney transplant recipients, showing significantly lower vitamin D levels before infection in patients requiring ICU admission. Sacristán et al., 11/12/2021, peer-reviewed, 9 authors.
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Nov 12	Levels	Gönen et al., Nutrients, doi:10.3390/nu13114047 (Peer Reviewed)	death, ↓65.8%, p=0.62	Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1
	Details Retrospective 867 hospitalized COVID-19 patients in Turkey, showing worse outcomes with vitamin D deficiency (without statistical significance); followed by a prospective study of 210 patients with vitamin D supplementation for those that..
Nov 12	Details Source PDF Levels Analysis of outcomes based on serum levels
	Gönen et al., Nutrients, doi:10.3390/nu13114047 (Peer Reviewed)
	Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1
	Retrospective 867 hospitalized COVID-19 patients in Turkey, showing worse outcomes with vitamin D deficiency (without statistical significance); followed by a prospective study of 210 patients with vitamin D supplementation for those that were deficient, showing significantly lower mortality compared to the retrospective study without treatment. risk of death, 65.8% lower, RR 0.34, p = 0.62, high D levels (≥12ng/mL) 1 of 80 (1.2%), low D levels (<12ng/mL) 3 of 82 (3.7%), retrospective study. risk of ICU admission, 16.9% lower, RR 0.83, p = 1.00, high D levels (≥12ng/mL) 4 of 77 (5.2%), low D levels (<12ng/mL) 5 of 80 (6.2%), retrospective study. hospital stay >8 days, 21.1% lower, RR 0.79, p = 0.11, high D levels (≥12ng/mL) 40 of 78 (51.3%), low D levels (<12ng/mL) 52 of 80 (65.0%), retrospective study. Gönen et al., 11/12/2021, retrospective, Turkey, Europe, peer-reviewed, 20 authors, dosage varies.
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Nov 10	Levels	Asghar et al., Am. J. Trop. Med. Hyg., doi:10.4269/ajtmh.21-0577 (Peer Reviewed)	death, ↓53.1%, p=0.05	Evaluation of Vitamin-D Status and Its Association with Clinical Outcomes Among COVID-19 Patients in Pakistan
	Details Retrospective 91 hospitalized patients in Pakistan, showing vitamin D deficiency associated with mortality in multivariate Cox regression.
Nov 10	Details Source PDF Levels Analysis of outcomes based on serum levels
	Asghar et al., Am. J. Trop. Med. Hyg., doi:10.4269/ajtmh.21-0577 (Peer Reviewed)
	Evaluation of Vitamin-D Status and Its Association with Clinical Outcomes Among COVID-19 Patients in Pakistan
	Retrospective 91 hospitalized patients in Pakistan, showing vitamin D deficiency associated with mortality in multivariate Cox regression. risk of death, 53.1% lower, RR 0.47, p = 0.05, high D levels (≥10ng/mL) 73, low D levels (<10ng/mL) 18, multivariate Cox regression. risk of mechanical ventilation, 19.4% lower, RR 0.81, p = 0.32, high D levels (≥10ng/mL) 5 of 73 (6.8%), low D levels (<10ng/mL) 6 of 18 (33.3%), adjusted, multivariate Cox regression. risk of ICU admission, 32.9% lower, RR 0.67, p = 0.54, high D levels (≥10ng/mL) 73, low D levels (<10ng/mL) 18, multivariate Cox regression. Asghar et al., 11/10/2021, retrospective, Pakistan, South Asia, peer-reviewed, 8 authors.
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Nov 9	Late	Shenoy et al., medRxiv, doi:10.1101/2021.11.08.21265884 (Preprint)	death, ↑29.5%, p=0.54	Favipiravir In Adults with Moderate to Severe COVID-19: A Phase 3 Multicentre, Randomized, Double-Blind, Placebo-Controlled Trial
	Details Late stage RCT with 353 hospitalized patients, showing no significant differences with favipiravir treatment overall, however a trend towards benefit was seen within patients treated relatively early, including a statistically significant..
Nov 9	Details Source PDF Late treatment study Late treatment study
	Shenoy et al., medRxiv, doi:10.1101/2021.11.08.21265884 (Preprint)
	Favipiravir In Adults with Moderate to Severe COVID-19: A Phase 3 Multicentre, Randomized, Double-Blind, Placebo-Controlled Trial
	Late stage RCT with 353 hospitalized patients, showing no significant differences with favipiravir treatment overall, however a trend towards benefit was seen within patients treated relatively early, including a statistically significant shorter time to discharge with treatment. risk of death, 29.5% higher, RR 1.29, p = 0.54, treatment 14 of 175 (8.0%), control 11 of 178 (6.2%). risk of mechanical ventilation, 33.0% higher, RR 1.33, p = 0.54, treatment 17 of 175 (9.7%), control 13 of 178 (7.3%). risk of ICU admission, 1.7% higher, RR 1.02, p = 0.54, treatment 20 of 175 (11.4%), control 20 of 178 (11.2%). time to resolution of hypoxia, 1.0% higher, RR 1.01, p = 0.94, treatment 157, control 158. time to hospital discharge, 5.7% lower, RR 0.94, p = 0.60, treatment 175, control 178. time to resolution of hypoxia, 17.4% lower, RR 0.83, p = 0.29, treatment 157, control 158, earlier treatment subgroup. time to hospital discharge, 32.0% lower, RR 0.68, p = 0.01, treatment 175, control 178, earlier treatment subgroup. Shenoy et al., 11/9/2021, Double Blind Randomized Controlled Trial, Kuwait, Middle East, preprint, 8 authors.
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Nov 9	Late	Stone et al., Research Square, doi:10.21203/rs.3.rs-1048271/v1 (Preprint)		Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours
	Details Retrospective severe COVID-19 patients in Zimbabwe treated with ivermectin, doxycycline, and zinc. For 34 with SpO₂ tracking, there was rapid improvement in SpO₂, with 55% recovery towards SpO₂=97 within 12 hours. For all 92 severe cases,..
Nov 9	Details Source PDF Late treatment study Late treatment study
	Stone et al., Research Square, doi:10.21203/rs.3.rs-1048271/v1 (Preprint)
	Rapid increase of SpO2 on room air for 34 severe COVID-19 patients after ivermectin-based combination treatment: 55-62% normalization within 12-24 hours
	Retrospective severe COVID-19 patients in Zimbabwe treated with ivermectin, doxycycline, and zinc. For 34 with SpO₂ tracking, there was rapid improvement in SpO₂, with 55% recovery towards SpO₂=97 within 12 hours. For all 92 severe cases, there was 2 deaths and 2 additional progressions prior to recovery, significantly less than a predicted 7 deaths and 17 deteriorations based on demographics and risk factors. Stone et al., 11/9/2021, preprint, 7 authors.
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Nov 8	Late	Tehrani et al., Urology Journal, doi:10.22037/uj.v18i.6863 (Peer Reviewed)	death, ↓87.1%, p=0.13	An investigation into the Effects of Intravenous Vitamin C on Pulmonary CT Findings and Clinical Outcomes of Patients with COVID 19 Pneumonia A Randomized Clinical Trial
	Details RCT 54 late stage patients, 18 treated with IV vitamin C (2g every 6h for 5 days), showing significant relative improvements in oxygen saturation and respiratory rate.
Nov 8	Details Source PDF Late treatment study Late treatment study
	Tehrani et al., Urology Journal, doi:10.22037/uj.v18i.6863 (Peer Reviewed)
	An investigation into the Effects of Intravenous Vitamin C on Pulmonary CT Findings and Clinical Outcomes of Patients with COVID 19 Pneumonia A Randomized Clinical Trial
	RCT 54 late stage patients, 18 treated with IV vitamin C (2g every 6h for 5 days), showing significant relative improvements in oxygen saturation and respiratory rate. risk of death, 87.1% lower, RR 0.13, p = 0.13, treatment 0 of 18 (0.0%), control 4 of 26 (15.4%), relative risk is not 0 because of continuity correction due to zero events. hospitalization time, 17.6% lower, relative time 0.82, p = 0.23, treatment 18, control 26. Tehrani et al., 11/8/2021, Randomized Controlled Trial, Iran, Middle East, peer-reviewed, 10 authors.
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Nov 8	PEP	Regeneron Press Release (News)	hosp., ↓92.3%, p=0.03	New phase 3 analyses show that a single dose of REGEN-COV® (casirivimab and imdevimab) provides long-term protection against COVID-19
	Details Long-term results for PEP RCT NCT04452318, with 841 baseline seronegative casirivimab/imdevimab patients and 842 placebo patients, showing significantly lower cases with treatment.
Nov 8	Details Source PDF Post Exposure Prophylaxis study Post Exposure Prophylaxis study
	Regeneron Press Release (News)
	New phase 3 analyses show that a single dose of REGEN-COV® (casirivimab and imdevimab) provides long-term protection against COVID-19
	Long-term results for PEP RCT NCT04452318, with 841 baseline seronegative casirivimab/imdevimab patients and 842 placebo patients, showing significantly lower cases with treatment. risk of hospitalization, 92.3% lower, RR 0.08, p = 0.03, treatment 0 of 841 (0.0%), control 6 of 842 (0.7%), relative risk is not 0 because of continuity correction due to zero events, 8 months. risk of case, 81.5% lower, RR 0.19, p < 0.001, treatment 20 of 841 (2.4%), control 108 of 842 (12.8%), months 1-8. risk of case, 81.6% lower, RR 0.18, p < 0.001, treatment 7 of 841 (0.8%), control 38 of 842 (4.5%), months 2-8. risk of hospitalization/ER, 88.9% lower, RR 0.11, p = 0.06, treatment 0 of 753 (0.0%), control 4 of 752 (0.5%), relative risk is not 0 because of continuity correction due to zero events, day 29. risk of symptomatic case, 81.4% lower, RR 0.19, p < 0.001, treatment 11 of 753 (1.5%), control 59 of 752 (7.8%), day 29. recovery time, 62.5% lower, relative time 0.37, p < 0.001, treatment 753, control 752, short-term followup, relative time with symptoms. time to viral-, 69.2% lower, relative time 0.31, p < 0.001, treatment 753, control 752, short-term followup, relative time with high viral load. Regeneron et al., 11/8/2021, Double Blind Randomized Controlled Trial, multiple countries, multiple regions, preprint, 1 author.
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We aim to cover the most promising early treatments for COVID-19. We use pre-specified effect extraction criteria that prioritizes more serious outcomes, for details see methods. For specific outcomes and different treatment stages see the individual pages. Not all treatments are covered here, effectiveness has been reported for many other treatments in studies. Of the 1,184 studies, 785 present results comparing with a control group, 692 are treatment studies, and 93 analyze outcomes based on serum levels. There are 17 animal studies, 40 in silico studies, 58 in vitro studies, and 66 meta analyses.

Please send us corrections, updates, or comments. Vaccines and treatments are both extremely valuable and complementary. All practical, effective, and safe means should be used. Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. Treatment protocols for physicians are available from the FLCCC.

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

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

Other Treatments		Global Adoption