ABSTRACT
Introduction: COVID-19 is a disease that is induced by severe acute respiratory syndrome coronavirus (SARS). Its viral infection is spread swiftly around the world and causes many restrictions, health problems, and expensive treatment costs worldwide. Due to its high prevalence and mortality rate, there is a global challenge to find an effective therapeutic protocol for the prevention and treatment of COVID-19. No one could disclaim the immediate need for a standardized protocol for COVID-19 treatment. Methods: Aiming to prepare a comprehensive review of introducing appropriate remedial options for COVID-19, a wide range of investigation on relevant articles established in the English language published through different publications such as PubMed, Medline, Embase, Science Direct, Scopus, and COVID-Evidence . all researchers and clinicians should try to make more precise knowledge about the viral behavior and treatment of COVID-19 to find an effective vaccine to prevent and treatment of this virus. The main objective of the present study is to review and investigate the available evidence for achieving a more precise preventive and treatment protocol to deal with COVID-19. Findings: many available drugs have been reviewed that include Azithromycin, Lopinavir/ritonavir (LPV/r), Remdesivir, Corticosteroids, Chloroquine, Hydroxychloroquine, Hydroxychloroquine sulfate, Immunoglobulin, Ivermectin, Ribavirin, Favipiravir, Interferon. On the other hand, it is recommended to conduct precise clinical trials on current antimicrobial and antiviral agents that are administered for a long time to find an expeditious and effective response to the COVID-19 pandemic. Although disappointing, it should be noted that there is no effective drug regimen or vaccine against the novel coronavirus. In this regard, using other available antiviral drugs for the treatment of COVID-19 may be effective to some extent. In this study, by investigating some available antimicrobial medicines that may diminish COVID-19 infection, we are trying to introduce a general protocol for controlling this disease.
ABSTRACT
This systematic review and meta-analysis was conducted to evaluate the effect of COVID-19 on thyroid function and the role of thyroid hormones alterations in predicting the severity of COVID-19. Online databases, including Scopus, Medline/PubMed, EMBASE, Google Scholar, and Cochrane were searched up to August 2, 2022. After screening titles, abstracts, and full manuscripts, respectively, 30 reports were enrolled. The risk of bias (ROB) was evaluated using the QUADAS-2 tool. In addition, odds ratio (OR) and hazard ratio (HR) analysis for assessing the OR of abnormal thyroid function tests (TFT) in predicting the COVID-19 severity and poor outcomes. Among 30 enrolled studies, ROB of the current study is estimated low to moderate. The average number of patients in each study was 325 (range: 40-3,703), with an overall mean age of 57.6, and the female proportion of 40.4%. Overall, the pooled analysis showed that the prevalence of thyroid dysfunction among 9,707 COVID-19 cases was 15%. Among mild to moderate COVID-19 patients, 6.2% had abnormal TFT, and among patients who experienced severe to critical COVID-19, 20.8% had abnormal TFT. The pooled OR for abnormal TFT and the severity of COVID-19 obtained from 3,865 COVID-19 patients was 3.77 (2.03, 6.99). The pooled HR of TSH level of COVID-19 mortality was 1.57 (0.91, 2.72). Our results demonstrate a high prevalence of thyroid dysfunction in COVID-19, and that among patients severe cases had a 3.77-fold higher risk of abnormal TFT compared to mild to moderate COVID-19. Further studies are required to evaluate the longer-term prognostic role of thyroid dysfunction in severe COVID-19, and investigate potential therapeutic strategies.