tetano
Editor, Senior Moderator
J Med Virol
. 2021 Jan 19.
doi: 10.1002/jmv.26811. Online ahead of print.
A complementary critical appraisal on systematic reviews regarding the most efficient therapeutic strategies for current COVID-19 (SARS-CoV-2) pandemic
Dorna Kheirabadi[SUP] 1 [/SUP], Fatemeh Haddad[SUP] 2 [/SUP], Razieh Sadat Mousavi-Roknabadi[SUP] 3 [/SUP], Mohammad Rezaeisadrabadi[SUP] 4 [/SUP], Hamidreza Dehghan[SUP] 5 [/SUP], Aylar Fazlzadeh[SUP] 6 [/SUP]
Affiliations
Abstract
Background: This critical appraisal aims to clarify which systematic reviews on COVID-19 treatment are based on high-value evidence. Hereby, the most profitable medicines can be suggested.
Methods: The Mesh term of "COVID-19 drug treatment" [Supplementary Concept] and "COVID-19 drug treatment" sequentially utilized as search strategies in Medline and Science direct on October 18[SUP]th[/SUP] , 2020.Searches were confined to systematic reviews/meta-analysis. Cochrane database was searched on November 1[SUP]st[/SUP] , 2020 by "COVID". With adding up 4 articles from other resources, 84 systematic reviews considered for initial screening. Finally, 22 articles fulfilled the criteria and were assessed using PRISMA guidelines.
Results: increasing number of clinical trials from onset of COVID-19 pandemic has revealed that hydroxychloroquine and chloroquine are not only profitable but also deleterious. Lopinavir/ritonavir failed to maintain their initial efficacy in improving clinical symptoms and mortality rate. Steroids and tocilizumab were suggested in patients with intensely severe symptoms. Steroids reduced mechanical ventilation and death in severely ill patients. Plasma or immunoglobulins effects are absolutely controversial. Favorable impressions of remdesivir have been relied on for the early onset of this drug. Hypotension and abnormal liver function tests realized as its side effects. Favipiravir has resulted in higher viral clearance than remdesivir. However, this claim needs to be proved with subsequent clinical trials.
Conclusions: currently, remdesivir and favipiravir are advantageous drugs that should be administered in the early phases. Their side effects are not well known and need to be found in following research projects. Steroids and tocilizumab have been considered beneficial in the cytokine storm phase. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Coronavirus; Pandemic; Treatment.
. 2021 Jan 19.
doi: 10.1002/jmv.26811. Online ahead of print.
A complementary critical appraisal on systematic reviews regarding the most efficient therapeutic strategies for current COVID-19 (SARS-CoV-2) pandemic
Dorna Kheirabadi[SUP] 1 [/SUP], Fatemeh Haddad[SUP] 2 [/SUP], Razieh Sadat Mousavi-Roknabadi[SUP] 3 [/SUP], Mohammad Rezaeisadrabadi[SUP] 4 [/SUP], Hamidreza Dehghan[SUP] 5 [/SUP], Aylar Fazlzadeh[SUP] 6 [/SUP]
Affiliations
- PMID: 33463727
- DOI: 10.1002/jmv.26811
Abstract
Background: This critical appraisal aims to clarify which systematic reviews on COVID-19 treatment are based on high-value evidence. Hereby, the most profitable medicines can be suggested.
Methods: The Mesh term of "COVID-19 drug treatment" [Supplementary Concept] and "COVID-19 drug treatment" sequentially utilized as search strategies in Medline and Science direct on October 18[SUP]th[/SUP] , 2020.Searches were confined to systematic reviews/meta-analysis. Cochrane database was searched on November 1[SUP]st[/SUP] , 2020 by "COVID". With adding up 4 articles from other resources, 84 systematic reviews considered for initial screening. Finally, 22 articles fulfilled the criteria and were assessed using PRISMA guidelines.
Results: increasing number of clinical trials from onset of COVID-19 pandemic has revealed that hydroxychloroquine and chloroquine are not only profitable but also deleterious. Lopinavir/ritonavir failed to maintain their initial efficacy in improving clinical symptoms and mortality rate. Steroids and tocilizumab were suggested in patients with intensely severe symptoms. Steroids reduced mechanical ventilation and death in severely ill patients. Plasma or immunoglobulins effects are absolutely controversial. Favorable impressions of remdesivir have been relied on for the early onset of this drug. Hypotension and abnormal liver function tests realized as its side effects. Favipiravir has resulted in higher viral clearance than remdesivir. However, this claim needs to be proved with subsequent clinical trials.
Conclusions: currently, remdesivir and favipiravir are advantageous drugs that should be administered in the early phases. Their side effects are not well known and need to be found in following research projects. Steroids and tocilizumab have been considered beneficial in the cytokine storm phase. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Coronavirus; Pandemic; Treatment.