Nutritional Advice El Mondo
Objectives:
The goals of this meta-analysis is to evaluate the efficacy and safety of current option of therapies for severe acute respiratory syndrome (SARS), Middle Eastern respiratory syndrome (MERS) besides COVID-19, in an attempt to identify promising therapy for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected patients.
Study design:
This review article included 5 RCTs, 2 prospective cohort studies and 11 retrospective cohort studies with a total of 4,941 patients.
Overall, the quality of evidence on most outcomes was very low.
Because of inadequate inclusive studies, it was not possible to perform a sensitivity analysis to assess the influence of each included study or generate funnel plot to evaluate publication bias.
Results and conclusions:
The investigators found compared with control treatment, anti-coronary virus interventions significantly reduced mortality with 35% [RR = 0.65, 95% CI = 0.44 to 0.96, I2 = 81.3%], remarkably ameliorate clinical improvement [RR = 1.52, 95% CI = 1.05 to 2.19] and radiographical improvement of 62% [RR = 1.62, 95% CI = 1.11 to 2.36, I2 = 11.0 %], without manifesting clear effect on virological eradication, incidence of acute respiratory disease syndrome (ARDS), intubation and adverse events (AEs).
The investigators found subgroup analyses demonstrated that the combination of ribavirin and corticosteroids remarkably decreased mortality with 57% [RR = 0.43, 95% CI = 0.27 to 0.68].
The investigators found the lopinavir/ritonavir-based combination showed superior virological eradication and radiographical improvement with reduced rate of acute respiratory disease syndrome.
The investigators found, likewise, hydroxychloroquine improved radiographical result.
The investigators found for safety, ribavirin could induce more bradycardia, anemia and transaminitis.
The investigators found, meanwhile, hydroxychloroquine could increase AEs rate especially diarrhea.
The investigators concluded there is evidence of lower mortality, better clinical and radiographical improvement in intervention group compared with control group. In subgroup analysis, ribavirin combined with corticosteroids, lopinavir/ritonavir-based therapies and hydroxychloroquine show some benefit in different outcomes. However, considering the very low quality of evidence, the heterogeneity of interventions and indications, it is not possible to draw a clear conclusion for the recommendation of potential therapies for COVID-19.
Original title:
Efficacy and safety of current therapeutic options for COVID-19 - lessons to be learnt from SARS and MERS epidemic: A systematic review and meta-analysis by Zhong H, Wang Y […], Lin HW.
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192121/
Additional information of El Mondo:
Find more information/studies on coronavirus right here.