(cache)COVID-19 early treatment: real-time analysis of 598 studies

All studies Early treatment Mortality Early treatment mortality Recent studies

Treatment

Improvement

Studies

China

India

USA

Indonesia

Pakistan

Brazil

Nigeria

Bangladesh

Russia

Mexico

Japan

Ethiopia

Philippines

Egypt

Vietnam

DR Congo

Germany

Iran

Turkey

Thailand

United Kingdom

France

Italy

South Africa

Kenya

Myanmar

Colombia

South Korea

Spain

Uganda

Argentina

Algeria

Sudan

Ukraine

Iraq

Afghanistan

Canada

Poland

Morocco

Saudi Arabia

Angola

Peru

Uzbekistan

Malaysia

Ghana

Mozambique

Yemen

Nepal

Madagascar

Venezuela

Cameroon

Australia

Côte d'Ivoire

Niger

Taiwan

92%

89%

85%

82%

V.D

81%

IVM

81%

79%

75%

66%

(H)CQ

65%

49%

42%

FPV

38%

V.C

18%

Global adoption of early treatments. Studies and improvement refer to early treatment. Countries ordered by population. Official:

Unofficial:


All studies combined (pooled effects, all stages)
Medication	Improvement	Studies	Authors	Patients
Proxalutamide	92% [87‑95%]	3	20	1,041
Fluvoxamine	89% [15‑99%]	2	13	277
Iota-carrageenan	80% [9‑96%]	1	18	394
Ivermectin	72% [64‑78%]	52	426	17,557
Casiri/imdevimab	70% [52‑81%]	4	4	4,793
Povidone-Iodine	68% [19‑88%]	4	44	1,994
Nitazoxanide	58% [-30‑86%]	6	87	1,464
Bamlanivimab	57% [19‑77%]	6	64	3,121
Budesonide	54% [-96‑89%]	2	48	1,806
Vitamin D	51% [37‑61%]	22	225	22,660
Bromhexine	44% [22‑60%]	5	56	291
Colchicine	43% [15‑62%]	9	182	5,719
Zinc	39% [29‑48%]	10	96	6,913
Favipiravir	29% [7‑46%]	8	169	1,178
Hydroxychloroquine	27% [23‑32%]	237	3,761	363,648
Remdesivir	24% [8‑38%]	14	232	22,358
Vitamin C	18% [1‑33%]	8	96	1,168


Early treatment studies (pooled effects)
Medication	Improvement	Studies	Authors	Patients
Proxalutamide	92% [82‑96%]	2	15	451
Fluvoxamine	89% [15‑99%]	2	13	277
Povidone-Iodine	85% [52‑95%]	3	29	640
Budesonide	82% [21‑96%]	1	24	146
Vitamin D	81% [39‑94%]	2	13	114
Ivermectin	81% [61‑91%]	18	175	1,937
Bromhexine	79% [28‑94%]	2	21	96
Bamlanivimab	75% [46‑88%]	3	40	1,374
Casiri/imdevimab	66% [35‑82%]	2	2	2,879
Hydroxychloroquine	65% [50‑75%]	26	414	44,235
Nitazoxanide	49% [-127‑88%]	5	67	1,414
Zinc	42% [-111‑84%]	2	14	626
Favipiravir	38% [-2‑62%]	3	52	410
Vitamin C	18% [-191‑77%]	1	11	98


All mortality results (all stages)
Medication	Improvement	Studies	Authors	Patients
Proxalutamide	91% [85‑95%]	2	12	804
Bromhexine	91% [-57‑99%]	2	18	178
Povidone-Iodine	88% [50‑97%]	1	6	606
Ivermectin	76% [58‑86%]	18	155	7,267
Vitamin D	62% [41‑75%]	13	116	8,432
Nitazoxanide	60% [-58‑90%]	3	32	923
Bamlanivimab	48% [-171‑90%]	3	24	1,551
Colchicine	43% [15‑62%]	9	182	5,719
Zinc	37% [26‑46%]	6	54	4,591
Remdesivir	26% [7‑41%]	13	225	22,216
Vitamin C	25% [-2‑45%]	5	64	626
Hydroxychloroquine	25% [19‑31%]	146	2,535	250,055
Favipiravir	-15% [-94‑32%]	2	54	465


Early treatment mortality results
Medication	Improvement	Studies	Authors	Patients
Bamlanivimab	92% [-43‑100%]	1	1	769
Bromhexine	91% [-59‑99%]	1	11	78
Povidone-Iodine	88% [50‑97%]	1	6	606
Ivermectin	84% [37‑96%]	4	37	802
Vitamin D	81% [39‑94%]	2	13	114
Proxalutamide	81% [-290‑99%]	1	7	214
Zinc	79% [-47‑97%]	1	3	518
Hydroxychloroquine	72% [57‑82%]	11	158	40,652
Favipiravir	45% [-481‑95%]	1	10	92
Nitazoxanide	41% [-1278‑98%]	2	12	873

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


4/27	In Vitro	Varese et al., bioRxiv, doi:10.1101/2021.04.27.441512 (Preprint) (In Vitro)	in vitro	Iota-carrageenan prevents the replication of SARS-CoV-2 on an in vitro respiratory epithelium model
	In Vitro Calu-3 (human respiratory epithelial cell line) study showing that iota-carrageenan inhibits SARS-CoV-2.
4/26	Late	Mohandas et al., (Peer Reviewed)	death, ↑81.0%, p=0.007	Clinical review of COVID-19 patients presenting to a quaternary care private hospital in South India: A retrospective study
	Retrospective 3,345 hospitalized patients in India, 11.5% treated with HCQ, showing unadjusted higher mortality with treatment. Confounding by indication and time based confounding (due to declining use over the period when overall treatm..
4/26	Levels	Al-Daghri et al., Journal of Translational Medicine, doi:10.1186/s12967-021-02838-x (Peer Reviewed)		Vitamin D status of Arab Gulf residents screened for SARS-CoV-2 and its association with COVID-19 infection: a multi-centre case–control study
	Case control study with 220 adults showing significantly lower vitamin D levels in PCR+ patients.
4/23	Late	Toya et al., SSRN (Preprint)		A Cross-Country Analysis of the Determinants of COVID-19 Fatalities
	Country based analysis finding lower mortality with the use of HCQ.
4/22	Late	Reis et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.6468 (Peer Reviewed)	death, ↓66.0%, p=1.00	Effect of Early Treatment With Hydroxychloroquine or Lopinavir and Ritonavir on Risk of Hospitalization Among Patients With COVID-19 The TOGETHER Randomized Clinical Trial
	Early terminated RCT in Brazil showing lower mortality and hospitalization with HCQ, but not reaching statistical significance. Although the title includes "early treatment", treatment was relatively late, with most patients bei..
4/21	Late	Zhao et al., International Immunopharmacology, doi:10.1016/j.intimp.2021.107702 (Peer Reviewed)	viral+, ↓59.0%, p=0.06	Favipiravir in the treatment of patients with SARS-CoV-2 RNA recurrent positive after discharge: a multicenter, open-label, randomized trial
	RCT with 55 patients (36 favipiravir, 19 control) who were PCR+ after recovery, showing improved viral clearance with treatment.
4/20	Review	Sukhatme et al., Front. Pharmacol., doi:10.3389/fphar.2021.652688 (Review) (Peer Reviewed)	review	Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19
	Review of mechanisms of action of fluvoxamine and other SSRIs that could be beneficial for COVID-19 treatment, including lower platelet aggregation, decreased mast cell degranulation, interference with endolysosomal viral trafficking, reg..
4/20	Early	Rossignol et al., medRxiv, doi:10.1101/2021.04.19.21255441 (Preprint)	death, ↑206.0%, p=0.49	Early treatment with nitazoxanide prevents worsening of mild and moderate COVID-19 and subsequent hospitalization
	RCT with 184 outpatients treated with an extended release formulation of nitazoxanide, and 195 controls, showing lower hospitalization and progression to severe disease with treatment. There was one COVID-19 related death in the treatment..
4/19	Review	DiNicolantonio et al., Open Heart, doi:10.1136/openhrt-2021-001655 (Review) (Peer Reviewed)	review	Anti-inflammatory activity of ivermectin in late-stage COVID-19 may reflect activation of systemic glycine receptors
	Review suggesting that the effectiveness of ivermectin in the cytokine storm phase of COVID-19 may be, at least in part, an anti-inflammatory effect mediated by increased activation of glycine receptors on leukocytes and possibly vascular..
4/19	Late	Favipiravir Observational Study Group, Fujita Health University (Preprint)		Favipiravir Observational Study Interim Report 3
	Retrospective analysis of favipiravir use in 10,986 hospitalized patients, including analysis of changes in clinical status and side effects. Common adverse events were uric acid level increase and liver function enzyme increase. Authors ..
4/17	Review	Shah Alam et al., International Immunopharmacology, doi:10.1016/j.intimp.2021.107686 (Review) (Peer Reviewed)	review	The role of vitamin D in reducing SARS-CoV-2 infection: An update
	Review of vitamin D for COVID-19 noting that infections are likely to be more prevalent in the winter season; clinical trials show vitamin D as a potential therapeutic agent; vitamin D is beneficial against COVID-19 by reducing inflammato..
4/17	Early	Fujii et al., Journal of Infection and Chemotherapy, doi:10.1016/j.jiac.2021.04.013 (Peer Reviewed)		Early favipiravir treatment was associated with early defervescence in non-severe COVID-19 patients
	Retrospective 41 favipiravir patients finding that early treatment was more successful.
4/16	PrEP	Morgenstern et al., medRxiv, doi:10.1101/2021.04.10.21255248 (Preprint)	hosp., ↓80.0%, p=0.50	Retrospective cohort study of Ivermectin as a SARS-CoV-2 pre-exposure prophylactic method in Healthcare Workers
	Propensity matched retrospective prophylaxis study of healthcare workers in the Dominican Republic showing significantly lower cases with treatment, and no hospitalization with treatment (versus 2 in the PSM matched control group). The ca..
4/15	PrEP	Alzahrani et al., Rheumatology International , doi:10.1007/s00296-021-04857-9 (Peer Reviewed)	death, ↓58.8%, p=1.00	Clinical characteristics and outcome of COVID-19 in patients with rheumatic diseases
	Retrospective 47 rheumatic disease patients not finding significant differences with HCQ.
4/15	PrEP	Figueroa et al., medRxiv, doi:10.1101/2021.04.13.21255409 (Preprint)	symp. case, ↓79.8%, p=0.04	Efficacy of a nasal spray containing Iota-Carrageenan in the prophylaxis of COVID-19 in hospital personnel dedicated to patients care with COVID-19 disease A pragmatic multicenter, randomized, double-blind, placebo-controlled trial (CARR-COV-02)
	Prophylaxis RCT with 394 healthcare workers, 196 treated with iota-carrageenan, showing significantly lower symptomatic cases with treatment. There were no deaths or hospitalizations. There was a significant number of PCR- symptomatic cas..
4/15	Levels	Skalny et al., Metabolites, doi:10.3390/metabo11040244 (Peer Reviewed)		Serum Zinc, Copper, and Other Biometals Are Associated with COVID-19 Severity Markers
	Analysis of serum metal levels in 150 COVID-19 patients and 44 controls, finding that COVID-19 severity was associated with lower serum Ca, Fe, Se, Zn levels when compared to controls.
4/15	PrEP	Alegiani et al., Rheumatology, doi:10.1093/rheumatology/keab348 (Peer Reviewed)	death, ↑8.0%, p=0.64	Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy
	Retrospective database analysis case control study of rheumatic patients. When compared with other cDMARDs, HCQ users had significantly lower hospitalization, however there was no significant difference in mortality. Results differ signif..
4/14	Late	Hakamifard et al., Immunopathologia Persa, doi:10.34172/ipp.2021.xx (Peer Reviewed)	ICU, ↓46.3%, p=0.46	The effect of vitamin E and vitamin C in patients with COVID-19 pneumonia; a randomized controlled clinical trial
	RCT with 38 patients treated with vitamin C and vitamin E, and 34 control patients, showing lower ICU admission with treatment, but not statistically significant.
4/14	PEP	Seet et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.04.035 (Peer Reviewed)	severe case, ↓49.8%, p=0.01	Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial
	Prophylaxis RCT in Singapore with 3,037 low risk patients, showing lower serious cases, lower symptomatic cases, and lower confirmed cases of COVID-19 with all treatments (ivermectin, HCQ, PVP-I, and Zinc + vitamin C) compared to vitamin ..
4/12	PEP	Regeneron Press Release (Preprint)	hosp./ER, ↓88.9%, p=0.06	Phase 3 prevention trial showed 81% reduced risk of symptomatic SARS-CoV-2 infections with subcutaneous administration of REGEN-COV™ (casirivimab and imdevimab)
	Press release for a phase 3 prophylaxis trial reporting lower hospitalization/ER and symptomatic cases, and faster recovery with 1,200mg subcutaneous casirivimab with imdevimab.
4/12	Late	Yu et al., medRxiv, doi:10.1101/2021.04.10.21254672 (Preprint)	hosp./death, ↓17.5%, p=0.24	Inhaled budesonide for COVID-19 in people at higher risk of adverse outcomes in the community: interim analyses from the PRINCIPLE trial
	Interim results from the PRINCIPLE trial, 751 treated with budesonide starting a median of 6 days after symptom onset, showing lower hospitalization/death, and faster recovery with treatment.
4/10	In Silico	Bello et al., Journal of Biomolecular Structure and Dynamics, doi:10.1080/07391102.2021.1911857 (Peer Reviewed)		Elucidation of the inhibitory activity of ivermectin with host nuclear importin α and several SARS-CoV-2 targets
	In Silico analysis finding that the in vitro activity of ivermectin may explained by acting as an inhibitor of importin-α, dimeric 3CLpro, and Nsp9.

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. Treatments with only 3 or fewer studies are shown in grey. Not all treatments are covered here, effectiveness has been reported for many other treatments in studies. Of the 598 studies, 445 present results comparing with a control group, 393 are treatment studies, and 52 analyze outcomes based on serum levels.

Please send us corrections, updates, or comments. Vaccines and treatments are both extremely valuable and complementary; multiple approaches are required to cover all people and all existing and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. Treatment protocols for physicians are available from the FLCCC.

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