Efficacy of various treatment modalities for nCOV-2019: A systematic review and meta-analysis.
Eur J Clin Invest
; 50(11): e13383, 2020 Nov.
Article
Dans Anglais
| MEDLINE | ID: covidwho-719366
ABSTRACT
BACKGROUND:
Several therapeutic agents have been investigated for treatment of novel coronavirus 2019 (nCOV-2019). We conducted a systematic review and meta-analysis to assess the efficacy of various treatment modalities in nCOV-2019 patients.METHODS:
A literature search was conducted before 29 June 2020 in PubMed, Google Scholar and Cochrane library databases. A fixed-effect model was applied if I2 < 50%, else results were combined using random-effect model. Risk ratio (RR) or standardized mean difference (SMD) along with 95% confidence interval (95% CI) was used to pool the results. Between-study heterogeneity was explored using influence and sensitivity analyses, and publication bias was assessed using funnel plots. Entire statistical analysis was conducted in R version 3.6.2.RESULTS:
Fifty studies involving 15 in vitro and 35 clinical studies including 9170 nCOV-2019 patients were included. Lopinavir-ritonavir was significantly associated with shorter mean time to clinical recovery (SMD -0.32; 95% CI -0.57 to -0.06), remdesivir was significantly associated with better overall clinical recovery (RR 1.17; 95% CI 1.07 to 1.29), and tocilizumab was associated with less all-cause mortality (RR 0.38; 95% CI 0.16 to 0.93). Hydroxychloroquine was associated with longer time to clinical recovery and less overall clinical recovery. It additionally had higher all-cause mortality and more total adverse events.CONCLUSION:
Our meta-analysis suggests that except in vitro studies, no treatment has shown overall favourable outcomes in nCOV-2019 patients. Lopinavir-ritonavir, remdesivir and tocilizumab may have some benefits, while hydroxychloroquine administration may cause harm in nCOV-2019 patients. Results from upcoming large clinical trials may further clarify role of these drugs.Mots clés
Texte intégral:
Disponible
Collection:
Bases de données internationales
Base de données:
MEDLINE
Sujet Principal:
Antiviraux
/
Pneumopathie virale
/
Infections à coronavirus
Type d'étude:
Étude diagnostique
/
Étude observationnelle
/
Étude pronostique
/
Essai contrôlé randomisé
/
Révision
/
Examen systématique/Méta-analyse
Les sujets:
Covid long
Limites du sujet:
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Europe
langue:
Anglais
Revue:
Eur J Clin Invest
Année:
2020
Type de document:
Article
Pays d'affiliation:
Eci.13383
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