tetano
Editor, Senior Moderator
Expert Rev Anti Infect Ther
. 2021 Oct 25.
doi: 10.1080/14787210.2022.1997587. Online ahead of print.
Comparative effectiveness of pharmacological interventions on mortality and the average length of hospital stay of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials
Abolfazl Akbari[SUP] 1 [/SUP], Mahya Razmi[SUP] 2 [/SUP], Alireza Sedaghat[SUP] 3 [/SUP], Seyyed Mohammad Matin Alavi Dana[SUP] 1 [/SUP], Mahdi Amiri[SUP] 1 [/SUP], Ali Mohammad Halvani[SUP] 1 [/SUP], Soroush Yazdani[SUP] 1 [/SUP], Sajad Sahab-Negah[SUP] 4 5 6 [/SUP]
Affiliations
Abstract
Introduction: Up to now, numerous randomized controlled trials (RCTs) have examined various drugs as possible treatments for Coronavirus Disease 2019 (COVID-19), but the results were diverse and occasionally even inconsistent with each other. To this point, decisive consensus on treatment is requiring. Therefore, we performed a systematic review and meta-analysis (SR-MAs) to assess the comparative effectiveness of pharmacological agents in published RCTs.
Areas covered: A literature search was performed using PubMed, SCOPUS, EMBASE, and Web of Science databases. RCTs evaluating mortality and the average length of hospital stay to standard of care (SOC)/placebo/control were included in our meta-analysis. RCTs mainly were classified into five categories of drugs, including anti-inflammatory, antiviral, antiparasitic, antibody and antibiotics. Meta-analysis was done on 5 drugs classes and sub-group meta-analysis was done on single drugs and moderate or severe stage of disease.
Expert opinion: : Mortality and the average length of hospital stay of COVID-19 patients was significantly reduced with anti-inflammatory drugs (odds ratio [OR]: 0.77, 95% confidence interval [CI]: 0.69 to 0.85, P<0.00001, and mean difference [MD]: -1.41, CI:-1.75 to -1.07, P<0.00001, respectively) compared to SOC/control/placebo. Furthermore, antiparasitic was associated with reduced length of hospital stay (MD: -0.65, CI: -1.26 to -0.03, P<0.05) in comparison to SOC/placebo/control. However, no difference was found in other pharmacological interventions in comparison to SOC/placebo/control in outcomes.
Keywords: COVID-19; Meta-Analysis; Pharmacological Intervention; Randomized Controlled Trial; Systematic Review; Treatment.
. 2021 Oct 25.
doi: 10.1080/14787210.2022.1997587. Online ahead of print.
Comparative effectiveness of pharmacological interventions on mortality and the average length of hospital stay of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials
Abolfazl Akbari[SUP] 1 [/SUP], Mahya Razmi[SUP] 2 [/SUP], Alireza Sedaghat[SUP] 3 [/SUP], Seyyed Mohammad Matin Alavi Dana[SUP] 1 [/SUP], Mahdi Amiri[SUP] 1 [/SUP], Ali Mohammad Halvani[SUP] 1 [/SUP], Soroush Yazdani[SUP] 1 [/SUP], Sajad Sahab-Negah[SUP] 4 5 6 [/SUP]
Affiliations
- PMID: 34694949
- DOI: 10.1080/14787210.2022.1997587
Abstract
Introduction: Up to now, numerous randomized controlled trials (RCTs) have examined various drugs as possible treatments for Coronavirus Disease 2019 (COVID-19), but the results were diverse and occasionally even inconsistent with each other. To this point, decisive consensus on treatment is requiring. Therefore, we performed a systematic review and meta-analysis (SR-MAs) to assess the comparative effectiveness of pharmacological agents in published RCTs.
Areas covered: A literature search was performed using PubMed, SCOPUS, EMBASE, and Web of Science databases. RCTs evaluating mortality and the average length of hospital stay to standard of care (SOC)/placebo/control were included in our meta-analysis. RCTs mainly were classified into five categories of drugs, including anti-inflammatory, antiviral, antiparasitic, antibody and antibiotics. Meta-analysis was done on 5 drugs classes and sub-group meta-analysis was done on single drugs and moderate or severe stage of disease.
Expert opinion: : Mortality and the average length of hospital stay of COVID-19 patients was significantly reduced with anti-inflammatory drugs (odds ratio [OR]: 0.77, 95% confidence interval [CI]: 0.69 to 0.85, P<0.00001, and mean difference [MD]: -1.41, CI:-1.75 to -1.07, P<0.00001, respectively) compared to SOC/control/placebo. Furthermore, antiparasitic was associated with reduced length of hospital stay (MD: -0.65, CI: -1.26 to -0.03, P<0.05) in comparison to SOC/placebo/control. However, no difference was found in other pharmacological interventions in comparison to SOC/placebo/control in outcomes.
Keywords: COVID-19; Meta-Analysis; Pharmacological Intervention; Randomized Controlled Trial; Systematic Review; Treatment.