Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID-19: A rapid review and meta-analysis.

This study aimed to examine the efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for coronavirus disease 2019 (COVID-19). PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar were searched to identify the relevant evidence up to November 10, 2022. The reference lists of key studies were also scanned to find additional records. The quality of the studies was evaluated using the Cochrane tools for assessing the risk of bias. The Comprehensive Meta-Analysis software version 3.0 was employed for data analysis. Twenty-three studies involving 314 353 patients were included in the analysis. The findings of the meta-analysis showed a significant difference between the Paxlovid and no-Paxlovid groups in terms of mortality rate (odds ratio [OR] = 0.25; 95% confidence interval [CI]: 0.14-0.45), hospitalization rate (OR = 0.40; 95% CI: 0.24-0.69), polymerase chain reaction negative conversion time (mean difference [MD] = -2.46; 95% CI: -4.31 to -0.61), and hospitalization or death rate (OR = 0.17; 95% CI: 0.06-0.46). However, no significant difference was observed between the two groups in terms of COVID-19 rebound (OR = 0.84; 95% CI: 0.67-1.04), emergency department visit (OR = 0.75; 95% CI: 0.45-1.24), intensive care unit admission (OR = 0.37; 95% CI: 0.13-1.01), and adverse events (OR = 2.20; 95% CI: 0.42-11.47). The results of the present study support the efficacy and safety of Paxlovid in the treatment of patients with COVID-19. Further research is needed to investigate the COVID-19 rebound after Paxlovid treatment.

Efficacy and safety of regdanvimab in patients with mild to moderate COVID-19: A rapid review and meta-analysis.

AIMS: This study aimed to evaluate the efficacy and safety of regdanvimab, an anti-SARS-COV-2 monoclonal antibody approved by the European Medicines Agency in November 2021, for the treatment of confirmed COVID-19 disease. METHODS: Cochrane Library, PubMed, medRxiv and Google Scholar were searched for relevant evidence up to October 27, 2022. The quality of included studies was assessed using the Cochrane risk of bias tools. Data were analysed using RevMan software. RESULTS: Eight studies involving 4793 patients were included. A significant difference was observed between the regdanvimab and no-regdanvimab groups in terms of length of hospital stay (mean difference [MD] = -1.15, 95% confidence interval [CI]: -1.80 to -0.43), clinical recovery (odds ratio [OR] = 2.09, 95% CI: 1.38 to 3.18), disease progression (OR = 0.23, 95% CI: 0.16 to 0.33), the need for oxygen therapy (OR = 0.33, 95% CI: 0.25 to 0.43) and duration of oxygen therapy (MD = -3.00, 95% CI: -4.44 to -1.56). However, no significant difference was detected between 2 groups regarding mortality rate (OR = 0.46, 95% CI: 0.11 to 1.89), need for mechanical ventilation (OR = 0.39, 95% CI: 0.08 to 1.89) and hospital admission rate (OR = 0.61, 95% CI: 0.35 to 1.03). The incidence of adverse events was similar in both groups (OR = 0.96, 95% CI: 0.77 to 1.18). CONCLUSION: Regdanvimab was not effective in reducing mortality and hospital admission rate in patients with mild to moderate COVID-19, but it was effective in improving other efficacy outcomes. Further research is needed to confirm these findings.

Efficacy and safety of sotrovimab in patients with COVID-19: A rapid review and meta-analysis.

The therapeutic potential of sotrovimab in the treatment of coronavirus disease 2019 (COVID-19) is a controversial issue. The aim of this study was to evaluate the efficacy and safety of sotrovimab in COVID-19 patients. To this end, PubMed, Cochrane Library, Embase, Web of Science, medRxiv, and Google Scholar were searched up to 15 August 2022. The reference lists of key studies were also scanned to find additional records. Meta-analysis was performed using Comprehensive Meta-Analysis. Seventeen studies involving 27,429 patients were included. A significant difference was observed in mortality rate (odds ratio [OR] = 0.40; 95% CI: 0.25-0.63, p = 0.00), hospitalisation rate (OR = 0.53; 95% CI: 0.43-0.65. p = 0.00), hospital or death rate (OR = 0.43; 95% CI: 0.25-0.73, p = 0.00), the need for mechanical ventilation (OR = 0.57; 95% CI: 0.33-0.96, p = 0.03), and ICU admission (OR = 0.33; 95% CI: 0.17-0.67, p = 0.00) of the sotrovimab-receiving group compared to those having no sotrovimab. However, no significant difference was observed between the two groups in terms of disease progression (OR = 0.45; 95% CI: 0.16-1.24, p = 0.12) and emergency department visit (OR = 1.01; 95% CI: 0.83-1.24, p = 0.87). The two groups had no significant difference in terms of incidence of adverse events (OR = 0.98; 95% CI: 0.78-1.23, p = 0.88). The findings of the present meta-analysis support that sotrovimab could be an effective and safe treatment option to reduce mortality and hospitalisation rate in both Delta and Omicron Variants of COVID-19.

Rapid review and meta-analysis of adverse events associated with molnupiravir in patients with COVID-19.

AIMS: The aim of this study was to evaluate the safety profile of molnupiravir in COVID-19 patients. METHODS: PubMed, Cochrane Library, medRxive and Google Scholar were searched for articles published up to April 25, 2022. Meta-analysis was performed using Comprehensive Meta-Analysis software. RESULTS: Four trials involving 2241 patients met the inclusion criteria. No significant difference was observed between molnupiravir at 200, 400 and 800 mg compared with placebo (200 mg: risk ratio [RR] = 0.97; 95% confidence interval [CI]: 0.78-1.20; P = .80; 400 mg: RR = 0.81; 95% CI: 0.64-1.02; P = .07; 800 mg: RR = 0.94; 95% CI: 0.83-1.06; P = .36) for any adverse events (AEs); at 200, 400 and 800 mg compared with placebo (200 mg: RR = 0.81; 95% CI: 0.41-1.63; P = .57; 400 mg: RR = 0.82; 95% CI: 0.41-1.61; P = .56; 800 mg: RR = 0.80; 95% CI: 0.59-1.08; P = .15) for serious adverse events; at 200, 400 and 800 mg compared with placebo (200 mg: RR = 1.74; 95% CI: 0.48-6.30; P = .39; 400 mg: RR = 1.07; 95% CI: 0.28-4.09; P = .91; 800 mg: RR = 0.47; 95% CI: 0.17-1.28; P = .14) for AEs leading to death; and at 200, 400 and 800 mg compared with placebo (200 mg: RR = 1.50; 95% CI: 0.26-8.55; P = .64; 400 mg: RR = 0.99; 95% CI: 0.17-5.68; P = .99; 800 mg: RR = 0.61; 95% CI: 0.31-1.23; P = .17) for treatment discontinuation due to AEs. CONCLUSION: This meta-analysis showed that the use of three doses of molnupiravir (200, 400 and 800 mg) is safe for COVID-19 patients. Further research is needed to confirm the present findings.

Artesunate, imatinib, and infliximab in COVID‐19: A rapid review and meta‐analysis of current evidence

Background and Objective Despite the pervasive vaccination program against coronavirus disease 2019 (COVID‐19), people who got fully vaccinated are still contaminated by severe acute respiratory syndrome coronavirus 2, making an effective and safe therapeutic intervention a crucial need for the patients' survival. The purpose of the present study is to seek available evidence for the efficacy and safety of three promising medications artesunate, imatinib, and infliximab against COVID‐19. Methods A literature search was conducted in PubMed, Cochrane Library, medRxive, and Google Scholar, and the relevant articles published up to January 2022 were found. Furthermore, the clinical trial databases were screened for finding more citations. Data analysis was carried out applying The Cochrane Collaboration tool and Newcastle–Ottawa scale to assess the included studies. Meta‐analysis was performed using RevMan 5.4.1. Results Five published studies were identified as eligible. Meta‐analysis showed that there was no significant difference between the infliximab and control groups in terms of mortality rate (risk ratio [RR]: 0.65;confidence interval [CI] 95%: 0.40–1.07;p = .09). However, a significant difference was observed between the two groups for the hospital discharge (RR: 1.37;CI 95%: 1.04–1.80;p = .03). No remarkable clinical benefit was observed for using imatinib in COVID‐19 patients. Artesunate showed significant improvement in patients with COVID‐19. Conclusion In the present, limited evidence exists for the efficacy and safety of artesunate, imatinib, and infliximab in patients with COVID‐19. The findings of WHO's Solidarity international trial will provide further information regarding these therapeutic interventions. Our purpose was to review the available evidence of these three drugs in the treatment of coronavirus disease 2019 (COVID‐19). Our findings showed little evidence for the efficacy and safety of artesunate, imatinib, and infliximab in patients with COVID‐19.

Artesunate, imatinib, and infliximab in COVID-19: A rapid review and meta-analysis of current evidence.

BACKGROUND AND OBJECTIVE: Despite the pervasive vaccination program against coronavirus disease 2019 (COVID-19), fully vaccinated people are still being infected by severe acute respiratory syndrome coronavirus 2, making an effective and safe therapeutic intervention a crucial need for the patients' survival. The purpose of the present study is to seek available evidence for the efficacy and safety of three promising medications artesunate, imatinib, and infliximab against COVID-19. METHODS: A literature search was conducted in PubMed, Cochrane Library, medRxive, and Google Scholar up to January 2022. Furthermore, the clinical trial databases were screened to find more citations. The Cochrane Collaboration tool and Newcastle-Ottawa scale were used to assess the included studies. Meta-analysis was performed using RevMan 5.4.1. RESULTS: Five published studies were identified as eligible. Meta-analysis showed that there was no significant difference between the infliximab and control groups in terms of mortality rate (risk ratio [RR]: 0.65; 95% confidence interval [CI]: 0.40-1.07; p = 0.09). However, a significant difference was observed between the two groups for the hospital discharge (RR: 1.37; 95% CI: 1.04-1.80; p = 0.03). No remarkable clinical benefit was observed in favor of using imatinib for COVID-19 patients. Artesunate showed significant improvement in patients with COVID-19. CONCLUSION: In the present, limited evidence exists for the efficacy and safety of artesunate, imatinib, and infliximab in patients with COVID-19. The findings of WHO's Solidarity international trial will provide further information regarding these therapeutic interventions.

Efficacy and safety of arbidol (umifenovir) in patients with COVID-19: A systematic review and meta-analysis.

OBJECTIVE: To provide the latest evidence for the efficacy and safety of arbidol (umifenovir) in COVID-19 treatment. METHODS: A literature systematic search was carried out in PubMed, Cochrane Library, Embase, and medRxiv up to May 2021. The Cochrane risk of bias tool and Newcastle-Ottawa scale were used to assess the quality of included studies. Meta-analysis was performed using RevMan 5.3. RESULTS: Sixteen studies were met the inclusion criteria. No significant difference was observed between arbidol and non-antiviral treatment groups neither for primary outcomes, including the negative rate of PCR (NR-PCR) on Day 7 (risk ratio [RR]: 0.94; 95% confidence interval (CI): 0.78-1.14) and Day 14 (RR: 1.10; 95% CI: 0.96-1.25), and PCR negative conversion time (PCR-NCT; mean difference [MD]: 0.74; 95% CI: -0.87 to 2.34), nor secondary outcomes (p > .05). However, arbidol was associated with higher adverse events (RR: 2.24; 95% CI: 1.06-4.73). Compared with lopinavir/ritonavir, arbidol showed better efficacy for primary outcomes (p < .05). Adding arbidol to lopinavir/ritonavir also led to better efficacy in terms of NR-PCR on Day 7 and PCR-NCT (p < .05). There was no significant difference between arbidol and chloroquine in primary outcomes (p > .05). No remarkable therapeutic effect was observed between arbidol and other agents (p > .05). CONCLUSION: The present meta-analysis showed no significant benefit of using arbidol compared with non-antiviral treatment or other therapeutic agents against COVID-19 disease. High-quality studies are needed to establish the efficacy and safety of arbidol for COVID-19.

Hydroxychloroquine plus standard of care compared with standard of care alone in COVID-19: a meta-analysis of randomized controlled trials.

The efficacy and safety of Hydroxychloroquine (HCQ) in treating coronavirus disease (COVID-19) is disputed. This systematic review and meta-analysis aimed to examine the efficacy and safety of HCQ in addition to standard of care (SOC) in COVID-19. PubMed, the Cochrane Library, Embase, Web of sciences, and medRxiv were searched up to March 15, 2021. Clinical studies registry databases were also searched for identifying potential clinical trials. The references list of the key studies was reviewed to identify additional relevant resources. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Jadad checklist. Meta-analysis was performed using RevMan software (version 5.3). Eleven randomized controlled trials with a total number of 8161 patients were identified as eligible for meta-analysis. No significant differences were observed between the two treatment groups in terms of negative rate of polymerase chain reaction (PCR) (Risk ratio [RR]: 0.99, 95% confidence interval (CI) 0.90, 1.08; P = 0.76), PCR negative conversion time (Mean difference [MD]: - 1.06, 95% CI - 3.10, 0.97; P = 0.30), all-cause mortality (RR: 1.09, 95% CI 1.00, 1.20; P = 0.06), body temperature recovery time (MD: - 0.64, 95% CI - 1.37, 0.10; P = 0.09), length of hospital stay (MD: - 0.17, 95% CI - 0.80, 0.46; P = 0.59), use of mechanical ventilation (RR: 1.12, 95% CI 0.95, 1.32; P = 0.19), and disease progression (RR = 0.82, 95% CI 0.37, 1.85; P = 0.64). However, there was a significant difference between two groups regarding adverse events (RR: 1.81, 95% CI 1.36, 2.42; P < 0.05). The findings suggest that the addition of HCQ to SOC has no benefit in the treatment of hospitalized patients with COVID-19. Additionally, it is associated with more adverse events.