COVID-19 early treatment: real-time analysis of 1,232 studies

All studies Early treatment Mortality Early mortality Recently added Recent studies Adoption

Analysis of 30 COVID-19 early treatments, and database of 277 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. Recently added: Vitamin D: Chiodini Desai Sotrovimab: Rockett Casirivimab/i..: Suzuki Conv. Plasma: Sullivan (more..)


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%

66%

64%

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 21	Early	Rockett et al., medRxiv, doi:10.1101/2021.12.18.21267628 (Preprint)		Resistance conferring mutations in SARS-CoV-2 delta following sotrovimab infusion
	Details Retrospective 100 sotrovimab patients in Australia, 23 PCR+ more than 10 days post-infusion (68 with status unknown), showing rapid development of spike gene mutations that have been shown to confer high level resistance to sotrovimab in ..
Dec 21	Details Source PDF Early treatment study Early treatment study
	Rockett et al., medRxiv, doi:10.1101/2021.12.18.21267628 (Preprint)
	Resistance conferring mutations in SARS-CoV-2 delta following sotrovimab infusion
	Retrospective 100 sotrovimab patients in Australia, 23 PCR+ more than 10 days post-infusion (68 with status unknown), showing rapid development of spike gene mutations that have been shown to confer high level resistance to sotrovimab in vitro. Rockett et al., 12/21/2021, preprint, 26 authors.
	Share Tweet Submit Corrections or Comments
Dec 21	Early	Suzuki et al., medRxiv, doi:10.1101/2021.12.19.21268078 (Preprint)	death, ↑200.0%, p=1.00	Real-world clinical outcomes of treatment with casirivimab-imdevimab among patients with mild-to-moderate coronavirus disease 2019 during the Delta variant pandemic
	Details Retrospective 949 patients in Japan, 314 treated with casirivimab/imdevimab showing significantly lower risk of deterioration with treatment.
Dec 21	Details Source PDF Early treatment study Early treatment study
	Suzuki et al., medRxiv, doi:10.1101/2021.12.19.21268078 (Preprint)
	Real-world clinical outcomes of treatment with casirivimab-imdevimab among patients with mild-to-moderate coronavirus disease 2019 during the Delta variant pandemic
	Retrospective 949 patients in Japan, 314 treated with casirivimab/imdevimab showing significantly lower risk of deterioration with treatment. risk of death, 200.0% higher, RR 3.00, p = 1.00, treatment 1 of 222 (0.5%), control 0 of 222 (0.0%), continuity correction due to zero event, propensity score matching. risk of death, 59.6% lower, RR 0.40, p = 0.67, treatment 1 of 314 (0.3%), control 5 of 635 (0.8%), unadjusted. risk of progression, 45.2% lower, RR 0.55, p = 0.02, treatment 17 of 222 (7.7%), control 31 of 222 (14.0%), propensity score matching. risk of progression, 49.9% lower, RR 0.50, p = 0.002, treatment 34 of 314 (10.8%), control 70 of 365 (19.2%), OR converted to RR, multivariate. Suzuki et al., 12/21/2021, retrospective, Japan, Asia, preprint, 49 authors, 24 July, 2021 - 30 September, 2021.
	Share Tweet Submit Corrections or Comments
Dec 21	Late	Sullivan et al., medRxiv, doi:10.1101/2021.12.10.21267485 (Preprint)	death, ↓85.7%, p=0.12	Randomized Controlled Trial of Early Outpatient COVID-19 Treatment with High-Titer Convalescent Plasma
	Details RCT 1,181 outpatients in the USA, mean 6 days from symptom onset, showing lower hospitalization with treatment. NCT04373460.
Dec 21	Details Source PDF Late treatment study Late treatment study
	Sullivan et al., medRxiv, doi:10.1101/2021.12.10.21267485 (Preprint)
	Randomized Controlled Trial of Early Outpatient COVID-19 Treatment with High-Titer Convalescent Plasma
	RCT 1,181 outpatients in the USA, mean 6 days from symptom onset, showing lower hospitalization with treatment. NCT04373460. risk of death, 85.7% lower, RR 0.14, p = 0.12, treatment 0 of 592 (0.0%), control 3 of 589 (0.5%), relative risk is not 0 because of continuity correction due to zero events. risk of ICU admission, 25.4% lower, RR 0.75, p = 0.73, treatment 3 of 592 (0.5%), control 4 of 589 (0.7%). risk of hospitalization, 54.3% lower, RR 0.46, p = 0.005, treatment 17 of 592 (2.9%), control 37 of 589 (6.3%). Sullivan et al., 12/21/2021, Double Blind Randomized Controlled Trial, USA, North America, preprint, 58 authors, 3 June, 2020 - 1 October, 2021.
	Share Tweet Submit Corrections or Comments
Dec 21	Late	Chew et al., medRxiv, doi:10.1101/2021.12.17.21268009 (Preprint)	hosp., ↓25.5%, p=0.60	Bamlanivimab reduces nasopharyngeal SARS-CoV-2 RNA levels but not symptom duration in non-hospitalized adults with COVID-19
	Details RCT 317 outpatients in the USA showing faster viral load and inflammatory biomarker decline, but no significant differences in clinical outcomes. ACTIV-2/A5401. NCT04518410. Supplementary data is not currently available.
Dec 21	Details Source PDF Late treatment study Late treatment study
	Chew et al., medRxiv, doi:10.1101/2021.12.17.21268009 (Preprint)
	Bamlanivimab reduces nasopharyngeal SARS-CoV-2 RNA levels but not symptom duration in non-hospitalized adults with COVID-19
	RCT 317 outpatients in the USA showing faster viral load and inflammatory biomarker decline, but no significant differences in clinical outcomes. ACTIV-2/A5401. NCT04518410. Supplementary data is not currently available. risk of hospitalization, 25.5% lower, RR 0.75, p = 0.60, treatment 6 of 159 (3.8%), control 8 of 158 (5.1%), combined. risk of hospitalization, 52.1% lower, RR 0.48, p = 0.43, treatment 2 of 48 (4.2%), control 4 of 46 (8.7%), 7000mg, day 28. risk of hospitalization, 0.9% higher, RR 1.01, p = 1.00, treatment 4 of 111 (3.6%), control 4 of 112 (3.6%), 700mg, day 28. relative time to symptom improvement, 13.5% higher, relative time 1.14, p = 0.97, treatment 48, control 46, 7000mg. relative time to symptom improvement, 17.1% higher, relative time 1.17, p = 0.08, treatment 111, control 112, 700mg. viral load, 25.6% lower, relative load 0.74, p = 0.002, treatment 48, control 46, 7000mg, day 3. viral load, 35.3% lower, relative load 0.65, p = 0.07, treatment 111, control 112, 700mg, day 3. Chew et al., 12/21/2021, Randomized Controlled Trial, USA, North America, preprint, 23 authors, 19 August, 2020 - 17 November, 2020.
	Share Tweet Submit Corrections or Comments
Dec 21	Meta	Lee et al., medRxiv, doi:10.1101/2021.12.17.21268008 (Preprint) (meta analysis)	meta-analysis	Fluvoxamine for Outpatient COVID-19 to Prevent Hospitalization: A Systematic Review and Meta-Analysis
	Details Systematic review and meta analysis of outpatient RCTs, showing hospitalization RR 0.75 [0.57-0.97]. For discussion see [1].
Dec 21	Details Source PDF Meta Meta
	Lee et al., medRxiv, doi:10.1101/2021.12.17.21268008 (Preprint) (meta analysis)
	Fluvoxamine for Outpatient COVID-19 to Prevent Hospitalization: A Systematic Review and Meta-Analysis
	Systematic review and meta analysis of outpatient RCTs, showing hospitalization RR 0.75 [0.57-0.97]. For discussion see [1]. [1] twitter.com/Covid19Crusher/status/1473623109525815296 Lee et al., 12/21/2021, preprint, 7 authors.
	Share Tweet Submit Corrections or Comments
Dec 20	In Vitro	Sheward et al., bioRxiv, doi:10.1101/2021.12.19.473354 (Preprint) (In Vitro)	in vitro	Variable loss of antibody potency against SARS-CoV-2 B.1.1.529 (Omicron)
	Details In Vitro study showing that omicron is substantially resistant to neutralization by monoclonal antibodies REGN10933, REGN10987, Ly-CoV016 and Ly-CoV555. S309 (the parent of Sotrovimab) had only 2-fold loss in potency.
Dec 20	Details Source PDF In Vitro In Vitro
	Sheward et al., bioRxiv, doi:10.1101/2021.12.19.473354 (Preprint) (In Vitro)
	Variable loss of antibody potency against SARS-CoV-2 B.1.1.529 (Omicron)
	In Vitro study showing that omicron is substantially resistant to neutralization by monoclonal antibodies REGN10933, REGN10987, Ly-CoV016 and Ly-CoV555. S309 (the parent of Sotrovimab) had only 2-fold loss in potency. Sheward et al., 12/20/2021, preprint, 11 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
	Share Tweet Submit Corrections or Comments
Dec 17	News	Kintor, News Comments (News)	news	开拓药业普克鲁胺治疗新冠预计本月发布临床数据
	Details News report noting that real-world results for proxalutamide in Paraguay show signfiicantly lower mortality and are consistent with the results of previous studies in Brazil.
Dec 17	Details Source PDF News News
	Kintor, News Comments (News)
	开拓药业普克鲁胺治疗新冠预计本月发布临床数据
	News report noting that real-world results for proxalutamide in Paraguay show signfiicantly lower mortality and are consistent with the results of previous studies in Brazil. Kintor et al., 12/17/2021, preprint, 1 author.
	Share Tweet Submit Corrections or Comments
Dec 17	In Vitro	VanBlargan et al., bioRxiv, doi:10.1101/2021.12.15.472828 (Preprint) (In Vitro)	in vitro	An infectious SARS-CoV-2 B.1.1.529 Omicron virus escapes neutralization by several therapeutic monoclonal antibodies
	Details In vitro study (Vero-TMPRSS2 and Vero-hACE2-TMPRSS2) showing complete loss of inhibitory activity for B.1.1.529 omicron with LY-CoV555, LY-CoV016, REGN10933, REGN10987, and CT-P59, ~12-fold decrease for COV2-2196/COV2-2130, and minimal ch..
Dec 17	Details Source PDF In Vitro In Vitro
	VanBlargan et al., bioRxiv, doi:10.1101/2021.12.15.472828 (Preprint) (In Vitro)
	An infectious SARS-CoV-2 B.1.1.529 Omicron virus escapes neutralization by several therapeutic monoclonal antibodies
	In vitro study (Vero-TMPRSS2 and Vero-hACE2-TMPRSS2) showing complete loss of inhibitory activity for B.1.1.529 omicron with LY-CoV555, LY-CoV016, REGN10933, REGN10987, and CT-P59, ~12-fold decrease for COV2-2196/COV2-2130, and minimal change for S309. VanBlargan et al., 12/17/2021, preprint, 10 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
	Share Tweet Submit Corrections or Comments
Dec 16	Early	Jayk Bernal et al., New England Journal of Medicine, doi:10.1056/NEJMoa2116044 (Peer Reviewed)	death, ↓89.0%, p=0.01	Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients
	Details MOVe-OUT RCT, 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].
Dec 16	Details Source PDF Early treatment study Early treatment study
	Jayk Bernal et al., New England Journal of Medicine, doi:10.1056/NEJMoa2116044 (Peer Reviewed)
	Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients
	MOVe-OUT RCT, 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/hosp. (gamma variant), 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. risk of death/hosp. (mu variant), 49.5% lower, RR 0.50, p = 0.15, treatment 6 of 75 (8.0%), control 13 of 82 (15.9%). risk of death/hosp. (delta variant), 23.7% lower, RR 0.76, p = 0.41, treatment 18 of 237 (7.6%), control 22 of 221 (10.0%). risk of death/hosp. (other variants), 42.2% lower, RR 0.58, p = 0.36, treatment 5 of 47 (10.6%), control 7 of 38 (18.4%). Jayk Bernal et al., 12/16/2021, Randomized Controlled Trial, multiple countries, multiple regions, peer-reviewed, 22 authors.
	Share Tweet Submit Corrections or Comments
Dec 15	In Vitro	Liu et al., bioRxiv, doi:10.1101/2021.12.14.472719 (Preprint) (In Vitro)	in vitro	Striking Antibody Evasion Manifested by the Omicron Variant of SARS-CoV-2
	Details In vitro study (Vero-E6-TMPRSS2) showing 18 of 19 monoclonal antibodies were no longer effective or significantly impaired with B.1.1.529 omicron.
Dec 15	Details Source PDF In Vitro In Vitro
	Liu et al., bioRxiv, doi:10.1101/2021.12.14.472719 (Preprint) (In Vitro)
	Striking Antibody Evasion Manifested by the Omicron Variant of SARS-CoV-2
	In vitro study (Vero-E6-TMPRSS2) showing 18 of 19 monoclonal antibodies were no longer effective or significantly impaired with B.1.1.529 omicron. Liu et al., 12/15/2021, preprint, 23 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
	Share Tweet Submit Corrections or Comments
Dec 14	In Vitro	Singh et al., Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, doi:10.1016/j.bbadis.2021.166322 (Peer Reviewed) (In Vitro)	in vitro	The spike protein of SARS-CoV-2 virus induces heme oxygenase-1: Pathophysiologic implications
	Details In Vitro study transfecting SARS-CoV-2 viral spike protein in kidney cell lines, showing syncytia formation and upregulation of the cytoprotective gene HO-1, and that quercetin, which induces HO-1, can reduce syncytia formation. Authors c..
Dec 14	Details Source PDF In Vitro In Vitro
	Singh et al., Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, doi:10.1016/j.bbadis.2021.166322 (Peer Reviewed) (In Vitro)
	The spike protein of SARS-CoV-2 virus induces heme oxygenase-1: Pathophysiologic implications
	In Vitro study transfecting SARS-CoV-2 viral spike protein in kidney cell lines, showing syncytia formation and upregulation of the cytoprotective gene HO-1, and that quercetin, which induces HO-1, can reduce syncytia formation. Authors conclude that quercetin may be protective for AKI in COVID-19. Singh et al., 12/14/2021, peer-reviewed, 9 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
	Share Tweet Submit Corrections or Comments
Dec 14	Ex Vivo	Amssayef et al., Cardiovascular & Hematological Disorders-Drug Targets, doi:10.2174/1871529X21666211214153308 (Peer Reviewed) (Ex Vivo)	ex vivo	Vitamin C inhibits Angiotensin-Converting Enzyme-2 in Isolated Rat Aortic Ring
	Details Ex Vivo study showing vitamin C inhibiting vascular ACE2.
Dec 14	Details Source PDF Ex Vivo Ex Vivo
	Amssayef et al., Cardiovascular & Hematological Disorders-Drug Targets, doi:10.2174/1871529X21666211214153308 (Peer Reviewed) (Ex Vivo)
	Vitamin C inhibits Angiotensin-Converting Enzyme-2 in Isolated Rat Aortic Ring
	Ex Vivo study showing vitamin C inhibiting vascular ACE2. Amssayef et al., 12/14/2021, peer-reviewed, 3 authors. Ex Vivo studies are an important part of preclinical research, however results may be very different in vivo.
	Share Tweet Submit Corrections or Comments
Dec 14	Late	Welén et al., European Urology, doi:10.1016/j.eururo.2021.12.013 (Peer Reviewed)	death, ↓79.6%, p=0.26	A Phase 2 Trial of the Effect of Antiandrogen Therapy on COVID-19 Outcome: No Evidence of Benefit, Supported by Epidemiology and In Vitro Data
	Details Very small late stage RCT with 10 control patients and 29 enzalutamide patients, showing mixed results. Discharge and hospitalization time favored the control group, while viral load reduction was better with treatment on days 4&6 (day 4 ..
Dec 14	Details Source PDF Late treatment study Late treatment study
	Welén et al., European Urology, doi:10.1016/j.eururo.2021.12.013 (Peer Reviewed)
	A Phase 2 Trial of the Effect of Antiandrogen Therapy on COVID-19 Outcome: No Evidence of Benefit, Supported by Epidemiology and In Vitro Data
	Very small late stage RCT with 10 control patients and 29 enzalutamide patients, showing mixed results. Discharge and hospitalization time favored the control group, while viral load reduction was better with treatment on days 4&6 (day 4 ΔCt −5.6 p = 0.084), and the only death occurred in the control group. 27% of enzalutamide patients had diabetes compared to 0% of the control group. Retrospective 7,894 COVID+ prostate cancer patients, analyzing patients on antiandrogen treatment, ADT, and ADT + abiraterone acetate or enzalutamide, showing mixed results and higher mortality for ADT + abiraterone acetate or enzalutamide. In Vitro HBEC study showing no significant differences (p = 0.084). The supplementary data is not currently available. NCT04475601. risk of death, 79.6% lower, RR 0.20, p = 0.26, treatment 0 of 29 (0.0%), control 1 of 10 (10.0%), relative risk is not 0 because of continuity correction due to zero events, RCT result. risk of mechanical ventilation, 31.0% lower, RR 0.69, p = 1.00, treatment 2 of 29 (6.9%), control 1 of 10 (10.0%), RCT result. risk of no hospital discharge, 132.6% higher, RR 2.33, p = 0.03, treatment 29, control 10, RCT result. hospitalization time, 50.0% higher, relative time 1.50, p = 0.01, treatment 29, control 10. risk of death, 2.0% lower, RR 0.98, p = 0.94, treatment 21 of 358 (5.9%), control 167 of 4,980 (3.4%), adjusted, retrospective study, antiandrogen treatment. risk of death, 11.0% lower, RR 0.89, p = 0.66, treatment 20 of 334 (6.0%), control 167 of 4,980 (3.4%), adjusted, retrospective study, ADT. risk of death, 151.0% higher, RR 2.51, p < 0.001, treatment 24 of 152 (15.8%), control 167 of 4,980 (3.4%), adjusted, retrospective study, ADT and abiraterone acetate or enzalutamide. risk of ICU admission, 28.0% higher, RR 1.28, p = 0.28, treatment 24 of 358 (6.7%), control 216 of 4,980 (4.3%), adjusted, retrospective study, antiandrogen treatment. risk of ICU admission, 13.0% lower, RR 0.87, p = 0.62, treatment 16 of 334 (4.8%), control 216 of 4,980 (4.3%), adjusted, retrospective study, ADT. risk of ICU admission, 21.0% lower, RR 0.79, p = 0.60, treatment 6 of 152 (3.9%), control 216 of 4,980 (4.3%), adjusted, retrospective study, ADT and abiraterone acetate or enzalutamide. risk of hospitalization, 23.0% higher, RR 1.23, p = 0.09, treatment 126 of 358 (35.2%), control 1,108 of 4,980 (22.2%), adjusted, retrospective study, antiandrogen treatment. risk of hospitalization, 24.0% higher, RR 1.24, p = 0.09, treatment 126 of 334 (37.7%), control 1,108 of 4,980 (22.2%), adjusted, retrospective study, ADT. risk of hospitalization, 40.0% higher, RR 1.40, p = 0.06, treatment 66 of 152 (43.4%), control 1,108 of 4,980 (22.2%), adjusted, retrospective study, ADT and abiraterone acetate or enzalutamide. Welén et al., 12/14/2021, Randomized Controlled Trial, Sweden, Europe, peer-reviewed, 27 authors.
	Share Tweet Submit Corrections or Comments
Dec 13	Late	Jamir et al., Cureus, doi:10.7759/cureus.20394 (Peer Reviewed)	death, ↑53.0%, p=0.13	Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India
	Details Retrospective 266 COVID-19 ICU patients in India, showing significantly lower mortality with PVP-I oral gargling and topical nasal use, and non-statistically significant higher mortality with ivermectin and lower mortality with remdesivir.
Dec 13	Details Source PDF Late treatment study Late treatment study
	Jamir et al., Cureus, doi:10.7759/cureus.20394 (Peer Reviewed)
	Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India
	Retrospective 266 COVID-19 ICU patients in India, showing significantly lower mortality with PVP-I oral gargling and topical nasal use, and non-statistically significant higher mortality with ivermectin and lower mortality with remdesivir. risk of death, 53.0% higher, RR 1.53, p = 0.13, treatment 32 of 76 (42.1%), control 69 of 190 (36.3%), adjusted, multivariable Cox regression. Jamir et al., 12/13/2021, retrospective, India, South Asia, peer-reviewed, 6 authors, June 2020 - October 2010, dosage not specified.
	Share Tweet Submit Corrections or Comments
Dec 14	Early	Pfizer Press Release (News)	hosp., ↓70.1%, p=0.05	Pfizer announces additional phase 2/3 study results confirming robust efficacy of novel COVID-19 oral antiviral treatment candidate in reducing risk or hospitalization or death
	Details EPIC-SR trial interim results, 428 patients treated with paxlovid (PF-07321332 + ritonavir) and 426 control patients, showing lower hospitalization with treatment. NCT05011513.
Dec 14	Details Source PDF Early treatment study Early treatment study
	Pfizer Press Release (News)
	Pfizer announces additional phase 2/3 study results confirming robust efficacy of novel COVID-19 oral antiviral treatment candidate in reducing risk or hospitalization or death
	EPIC-SR trial interim results, 428 patients treated with paxlovid (PF-07321332 + ritonavir) and 426 control patients, showing lower hospitalization with treatment. NCT05011513. risk of hospitalization, 70.1% lower, RR 0.30, p = 0.05, treatment 3 of 428 (0.7%), control 10 of 426 (2.3%). Pfizer et al., 12/14/2021, Double Blind Randomized Controlled Trial, multiple countries, multiple regions, preprint, 1 author.
	Share Tweet Submit Corrections or Comments
Dec 11	PrEP	Kerr et al., Research Gate (Preprint)	death, ↓48.0%, p=0.0001	Ivermectin prophylaxis used for COVID-19 reduces COVID-19 infection and mortality rates: A 220,517-subject, populational-level retrospective citywide
	Details PSM retrospective 220,517 patients in Brazil,133,051 taking ivermectin as part of a citywide prophylaxis program, showing significantly lower hospitalization and mortality with treatment. CAAE:47124221.2.0000.5485.
Dec 11	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Kerr et al., Research Gate (Preprint)
	Ivermectin prophylaxis used for COVID-19 reduces COVID-19 infection and mortality rates: A 220,517-subject, populational-level retrospective citywide
	PSM retrospective 220,517 patients in Brazil,133,051 taking ivermectin as part of a citywide prophylaxis program, showing significantly lower hospitalization and mortality with treatment. CAAE:47124221.2.0000.5485. risk of death, 48.0% lower, RR 0.52, p < 0.001, treatment 62 of 133,051 (0.0%), control 79 of 87,466 (0.1%), adjusted, risk of COVID-19 death, propensity score matching. risk of death, 45.0% lower, RR 0.55, p < 0.001, treatment 62 of 4,311 (1.4%), control 79 of 3,034 (2.6%), adjusted, mortality rate for cases, propensity score matching. risk of hospitalization, 46.0% lower, RR 0.54, p < 0.001, treatment 105 of 133,051 (0.1%), control 127 of 87,466 (0.1%), adjusted, risk of COVID-19 hospitalization, propensity score matching. risk of hospitalization, 42.0% lower, RR 0.58, p < 0.001, treatment 105 of 4,311 (2.4%), control 127 of 3,034 (4.2%), adjusted, hospitalization rate for cases, propensity score matching. risk of case, 7.0% lower, RR 0.93, p = 0.003, treatment 4,311 of 133,051 (3.2%), control 3,034 of 87,466 (3.5%), adjusted, propensity score matching. Kerr et al., 12/11/2021, retrospective, propensity score matching, population-based cohort, Brazil, South America, preprint, 11 authors, July 2020 - December 2020, dosage 200μg/kg days 1, 2, 16, 17, 0.2mg/kg/day for 2 days every 15 days.
	Share Tweet Submit Corrections or Comments
Dec 10	Levels	Putra et al., European Journal of Medical and Health Sciences, doi:10.24018/ejmed.2021.3.6.1131 (Peer Reviewed)	hosp., ↓25.6%, p=0.59	Vitamin D Levels among Hospitalized and Non-Hospitalized COVID-19 Patients in Dr. M. Djamil General Hospital Padang
	Details Case control study in Indonesia with 31 moderate to critical hospitalized COVID-19 patients, and 31 asymptomatic or mild non-hospitalized COVID-19 patients, showing lower vitamin D levels in the hospitalized patients, without reaching sta..
Dec 10	Details Source PDF Levels Analysis of outcomes based on serum levels
	Putra et al., European Journal of Medical and Health Sciences, doi:10.24018/ejmed.2021.3.6.1131 (Peer Reviewed)
	Vitamin D Levels among Hospitalized and Non-Hospitalized COVID-19 Patients in Dr. M. Djamil General Hospital Padang
	Case control study in Indonesia with 31 moderate to critical hospitalized COVID-19 patients, and 31 asymptomatic or mild non-hospitalized COVID-19 patients, showing lower vitamin D levels in the hospitalized patients, without reaching statistical significance. risk of hospitalization, 25.6% lower, RR 0.74, p = 0.59, high D levels 9 of 31 (29.0%) cases, 11 of 31 (35.5%) controls, case control OR. Putra et al., 12/10/2021, retrospective, Indonesia, South Asia, peer-reviewed, 3 authors, February 2020 - September 2020.
	Share Tweet Submit Corrections or Comments
Dec 7	Late	Finberg et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab56310 (Peer Reviewed)	death, ↑200.0%, p=1.00	US201 Study: A Phase 2, Randomized Proof-of-Concept Trial of Favipiravir for the Treatment of COVID-19
	Details Small very late treatment RCT in the USA, with 25 favipiravir and 25 control patients, showing faster viral clearance with treatment. The benefit was only seen in patients <8 days from symptom onset. There were no significant differences ..
Dec 7	Details Source PDF Late treatment study Late treatment study
	Finberg et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofab56310 (Peer Reviewed)
	US201 Study: A Phase 2, Randomized Proof-of-Concept Trial of Favipiravir for the Treatment of COVID-19
	Small very late treatment RCT in the USA, with 25 favipiravir and 25 control patients, showing faster viral clearance with treatment. The benefit was only seen in patients <8 days from symptom onset. There were no significant differences in clinical outcomes. The death in the favipiravir group occurred after discharge and was believed to be unrelated to COVID-19 or favipiravir. risk of death, 200.0% higher, RR 3.00, p = 1.00, treatment 1 of 25 (4.0%), control 0 of 25 (0.0%), continuity correction due to zero event. risk of mechanical ventilation, 200.0% higher, RR 3.00, p = 1.00, treatment 1 of 25 (4.0%), control 0 of 25 (0.0%), continuity correction due to zero event. hospitalization time, 19.8% higher, relative time 1.20, treatment 25, control 25. risk of no recovery, 58.1% lower, RR 0.42, p = 0.08, treatment 25, control 25, day 8 mid-recovery, 6-point ordinal scale, RR approximated with OR. risk of no recovery, 46.2% higher, RR 1.46, p = 0.54, treatment 25, control 25, day 15, 6-point ordinal scale, RR approximated with OR. recovery time, 42.9% lower, relative time 0.57, treatment 25, control 25, median time to aggregate NEWS2 score ≤2 or discharge. recovery time, 15.4% higher, relative time 1.15, treatment 25, control 25. time to viral-, 46.7% lower, relative time 0.53, p = 0.04, treatment 25, control 25. Finberg et al., 12/7/2021, Randomized Controlled Trial, USA, North America, peer-reviewed, 10 authors.
	Share Tweet Submit Corrections or Comments
Dec 4	PrEP	Rao et al., Expert Review of Anti-infective Therapy, doi:10.1080/14787210.2022.2015326 (Peer Reviewed)	cases, ↓11.0%, p=0.68	Hydroxychloroquine as pre-exposure prophylaxis against COVID-19 infection among healthcare workers: a prospective cohort study
	Details Prospective PrEP study with low risk healthcare workers in India showing RR=0.89 [0.53-1.52]. There were no significant adverse effects. Only mean age and gender distribution are provided for baseline characteristics, no severity informat..
Dec 4	Details Source PDF Pre-Exposure Prophylaxis study Pre-Exposure Prophylaxis study
	Rao et al., Expert Review of Anti-infective Therapy, doi:10.1080/14787210.2022.2015326 (Peer Reviewed)
	Hydroxychloroquine as pre-exposure prophylaxis against COVID-19 infection among healthcare workers: a prospective cohort study
	Prospective PrEP study with low risk healthcare workers in India showing RR=0.89 [0.53-1.52]. There were no significant adverse effects. Only mean age and gender distribution are provided for baseline characteristics, no severity information is provided, and no adjustments were made. Authors analyze HCQ use for <8 vs. ≥8 weeks, noting a lack of statistical significance, but not providing the results. risk of case, 11.0% lower, RR 0.89, p = 0.68, treatment 16 of 273 (5.9%), control 67 of 1,021 (6.6%). Excluded in after exclusion results of meta analysis: unadjusted results with minimal group details. Rao et al., 12/4/2021, prospective, India, South Asia, peer-reviewed, 8 authors.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
Nov 30	In Vitro	Ullrich et al., bioRxiv, doi:10.1101/2021.11.28.4702264 (Preprint) (In Vitro)	in vitro	Main protease mutants of SARS-CoV-2 variants remain susceptible to PF-07321332
	Details In Vitro study showing that PF-07321332 maintains efficacy against variants C.37 lambda, B.1.1.318, B.1.2, B.1.351 beta, and P.2 zeta.
Nov 30	Details Source PDF In Vitro In Vitro
	Ullrich et al., bioRxiv, doi:10.1101/2021.11.28.4702264 (Preprint) (In Vitro)
	Main protease mutants of SARS-CoV-2 variants remain susceptible to PF-07321332
	In Vitro study showing that PF-07321332 maintains efficacy against variants C.37 lambda, B.1.1.318, B.1.2, B.1.351 beta, and P.2 zeta. Ullrich et al., 11/30/2021, preprint, 4 authors. In Vitro studies are an important part of preclinical research, however results may be very different in vivo.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
Nov 25	Late	Bozkurt et al., International Journal of Immunopathology and Pharmacology, doi:10.1177/20587384211059677 (Peer Reviewed)		Oral booster probiotic bifidobacteria in SARS-COV-2 patients
	Details Small retrospective 44 hospitalized patients in Turkey, showing improved outcomes with probiotic bifidobacterium, however minimal group details are provided (for example, the age of the control patients is unknown), and no adjustments wer..
Nov 25	Details Source PDF Late treatment study Late treatment study
	Bozkurt et al., International Journal of Immunopathology and Pharmacology, doi:10.1177/20587384211059677 (Peer Reviewed)
	Oral booster probiotic bifidobacteria in SARS-COV-2 patients
	Small retrospective 44 hospitalized patients in Turkey, showing improved outcomes with probiotic bifidobacterium, however minimal group details are provided (for example, the age of the control patients is unknown), and no adjustments were made. Excluded in meta analysis: unadjusted results with key group information missing. Bozkurt et al., 11/25/2021, retrospective, Turkey, Europe, peer-reviewed, 2 authors.
	Share Tweet Submit Corrections or Comments
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). IV vitamin C (sodium ascorbate) was given as 50 mg/kg every six hours on day 1, followed by 100 mg/kg every six hours (four times daily, 400 mg/kg/day) for seven days. 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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
Nov 24	Meta	Sudhakar et al., World Journal of Dentistry, doi:10.5005/jp-journals-10015-1868 (Peer Reviewed) (meta analysis)	meta-analysis	In Vivo Efficacy of Povidone-iodine Mouth Gargles in Reducing Salivary Viral Load in COVID-19 Patients: A Systematic Review
	Details Systematic review of the use of povidone-iodine gargles for COVID-19, concluding that PVP-I effectively reduces SARS-CoV-2 viral load.
Nov 24	Details Source PDF Meta Meta
	Sudhakar et al., World Journal of Dentistry, doi:10.5005/jp-journals-10015-1868 (Peer Reviewed) (meta analysis)
	In Vivo Efficacy of Povidone-iodine Mouth Gargles in Reducing Salivary Viral Load in COVID-19 Patients: A Systematic Review
	Systematic review of the use of povidone-iodine gargles for COVID-19, concluding that PVP-I effectively reduces SARS-CoV-2 viral load. Sudhakar et al., 11/24/2021, peer-reviewed, 5 authors.
	Share Tweet Submit Corrections or Comments
Nov 23	Late	Calderón et al., PAMJ - Clinical Medicine, doi:10.11604/pamj-cm.2021.7.15.30981 (Peer Reviewed)	death, ↑214.8%, p=0.38	Treatment with hydroxychloroquine vs nitazoxanide in patients with COVID-19: brief report
	Details Planned RCT of HCQ vs. HCQ+nitazoxanide which was aborted due to the retracted Surgisphere paper. Authors retrospectively analyze a small set of HCQ vs. nitazoxanide patients (which were protocol deviations in the planned RCT), showing re..
Nov 23	Details Source PDF Late treatment study Late treatment study
	Calderón et al., PAMJ - Clinical Medicine, doi:10.11604/pamj-cm.2021.7.15.30981 (Peer Reviewed)
	Treatment with hydroxychloroquine vs nitazoxanide in patients with COVID-19: brief report
	Planned RCT of HCQ vs. HCQ+nitazoxanide which was aborted due to the retracted Surgisphere paper. Authors retrospectively analyze a small set of HCQ vs. nitazoxanide patients (which were protocol deviations in the planned RCT), showing reduced hospitalization time and ICU admission with nitazoxanide. risk of death, 214.8% higher, RR 3.15, p = 0.38, treatment 5 of 27 (18.5%), control 1 of 17 (5.9%). risk of mechanical ventilation, 651.9% higher, RR 7.52, p = 0.15, treatment 4 of 27 (14.8%), control 0 of 17 (0.0%), continuity correction due to zero event. risk of ICU admission, 145.5% higher, RR 2.45, p < 0.001, treatment 16 of 27 (59.3%), control 0 of 17 (0.0%), adjusted, continuity correction due to zero event. hospitalization time, 107.4% higher, relative time 2.07, p = 0.006, treatment 27, control 17. Calderón et al., 11/23/2021, retrospective, Mexico, North America, peer-reviewed, 7 authors, dosage 200mg bid days 1-7.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments
Nov 23	Levels	Seven et al., The Journal of Maternal-Fetal & Neonatal Medicine, doi:10.1080/14767058.2021.2005564 (Peer Reviewed)	severe case, ↓46.5%, p=0.006	Correlation between 25-hydroxy vitamin D levels and COVID-19 severity in pregnant women: a cross-sectional study
	Details Prospective study of 403 pregnant COVID+ hospitalized women in Turkey, showing higher risk of severe disease or poor prognostic factors with vitamin D deficiency.
Nov 23	Details Source PDF Levels Analysis of outcomes based on serum levels
	Seven et al., The Journal of Maternal-Fetal & Neonatal Medicine, doi:10.1080/14767058.2021.2005564 (Peer Reviewed)
	Correlation between 25-hydroxy vitamin D levels and COVID-19 severity in pregnant women: a cross-sectional study
	Prospective study of 403 pregnant COVID+ hospitalized women in Turkey, showing higher risk of severe disease or poor prognostic factors with vitamin D deficiency. risk of severe disease or poor prognostic factor, 46.5% lower, RR 0.53, p = 0.006. Seven et al., 11/23/2021, prospective, Turkey, Europe, peer-reviewed, 6 authors, September 2020 - November 2020.
	Share Tweet Submit Corrections or Comments
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.
	Share Tweet Submit Corrections or Comments

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 1,232 studies, 810 present results comparing with a control group, 713 are treatment studies, and 97 analyze outcomes based on serum levels. There are 17 animal studies, 40 in silico studies, 69 in vitro studies, and 72 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.

Submit

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