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Evaluation of current medical approaches for COVID-19: a systematic review and meta-analysis.
Wang, Meng; Wu, Ting; Zuo, Zhihong; You, Yaxian; Yang, Xinyuan; Pan, Liangyu; Hu, Ying; Luo, Xuan; Jiang, Liping; Xia, Zanxian; Deng, Meichun.
  • Wang M; Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha, Hunan 410013, China.
  • Wu T; Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, China.
  • Zuo Z; Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China.
  • You Y; Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha, Hunan 410013, China.
  • Yang X; Hunan Province Key Laboratory of Basic and Applied Hematology, Hunan Key Laboratory of Animal Models for Human Diseases, Hunan Key Laboratory of Medical Genetics & Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan 410013, China.
  • Pan L; Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China.
  • Hu Y; Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha, Hunan 410013, China.
  • Luo X; Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, China.
  • Jiang L; Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha, Hunan 410013, China.
  • Xia Z; Department of Biochemistry and Molecular Biology, School of Life Sciences, Central South University, Changsha, Hunan 410013, China.
  • Deng M; Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, China.
BMJ Support Palliat Care ; 11(1): 45-52, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-788171
ABSTRACT

BACKGROUND:

Because of the lack of vaccination, it is urgent to find effective antiviral agents for COVID-19 treatment.

METHOD:

Online databases were searched for articles published before or on 22 June 2020. Studies reporting the effectiveness and safety of antiviral agents for COVID-19 were analysed.

RESULTS:

A total of 42 studies were included in this analysis. Hydroxychloroquine (HCQ) was not associated with the incidence of death (risk ratio (RR)=1.08; 95% CI 0.81 to 1.44) and severe cases (RR=1.05; 95% CI 0.61 to 1.81). Patients treated with HCQ obtained few benefits with respect to the clearance of viral RNA and were more likely to have adverse reactions. HCQ treatment could shorten the body temperature recovery time (weighted mean difference = -1.04; 95% CI -1.64 to -0.45). Lopinavir/ritonavir (LPV/r) (RR=0.90; 95% CI 0.76 to 1.07) and Arbidol (RR=1.09; 95% CI 0.92 to 1.29) were not associated with the negative conversion rate. Integrative Chinese-Western medicine alleviated clinical symptoms and decreased the incidence of severe cases (RR=0.38; 95% CI 0.25 to 0.59). Remdesivir treatment reduced the 14-day mortality rate of patients with severe COVID-19 (RR=0.64; 95% CI 0.44 to 0.94). Convalescent plasma (CP) tended to increase the negative conversion rate (RR=2.47; 95% CI 1.70 to 3.57).

CONCLUSION:

HCQ, LPV/r and Arbidol bring little benefit in COVID-19 treatment. Integrative Chinese-Western medicine improved the clinical symptoms of patients with COVID-19. Remdesivir and CP might be the potential treatments for patients with severe COVID-19. However, large-scale clinical randomised trials are needed to validate our conclusions.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Antirheumatic Agents / COVID-19 / Immunologic Factors / Medicine, Chinese Traditional Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Traditional medicine / Vaccines Limits: Humans Language: English Journal: BMJ Support Palliat Care Year: 2021 Document Type: Article Affiliation country: Bmjspcare-2020-002554

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Antirheumatic Agents / COVID-19 / Immunologic Factors / Medicine, Chinese Traditional Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Traditional medicine / Vaccines Limits: Humans Language: English Journal: BMJ Support Palliat Care Year: 2021 Document Type: Article Affiliation country: Bmjspcare-2020-002554