EVIDENCE BASED MEDICINE for COVID-19 DRUG TREATMENT

ABSTRACT

In the siege for a drug for covid-19, early signals of drugs' effectiveness were magnified and the need to prove a drug as effective and safe in the frame of randomized clinical trials (RCT) was neglected. Herein the most prominent covid-19 treatments, remdesivir, loponavir/ritonavir, favipiravir and (hydroxy)chloroquine, are presented. Remdesivir, accessible in Slovenia within a compassionate use program, is highlighted as proved effective in shortening the time to clinical improvement in a large RCT with 1059 covid-19 patients, with no important safety signals. On the other hand, the broad use of (hydroxy)chloroquine despite the lacking evidence of effectiveness is discussed in the light of its possible detrimental effects as suggested by recent large observational studies. A further proof of the need for clinical trials, also in Slovenia, to upgrade from»thinking« to»knowing« drugs that are effective and safe in treating patients with covid-19.