COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

Treatment Thoguluva Chandrasekar V, Venkatesalu B, Patel HK, et al. Systematic review and meta-analysis of effectiveness of treatment options against SARS-CoV-2 infection. J Med Virol. 2021 Feb;93(2):775-785. doi: 10.1002/jmv.26302. Epub 2020 Jul 22.

Treatment options for severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) are limited with no clarity on efficacy and safety profiles. We performed a systematic review and meta-analysis of studies on patients =18 years reporting data on therapeutic interventions in SARS-CoV-2. Primary outcome was all-cause mortality and secondary outcomes were rates of mechanical ventilation, viral clearance, adverse events, discharge, and progression to severe disease. Pooled rates and odds ratios (OR) were calculated. Twenty-nine studies with 5207 patients were included. Pooled all-cause mortality in intervention arm was 12.8% (95% confidence interval [CI]: 8.1%-17.4%). Mortality was significantly higher for studies using hydroxychloroquine (HCQ) for intervention (OR: 1.36; 95% CI: 0.97-1.89). Adverse events were also higher in HCQ subgroup (OR: 3.88; 95% CI: 1.60-9.45). There was no difference in other secondary outcomes. There is a need for well-designed randomized clinical trials for further investigation of every therapeutic intervention for further insight into different therapeutic options.

Discipline / Specialty Area Score
Hospital Doctor/Hospitalists
Internal Medicine
Infectious Disease
Intensivist/Critical Care
Comments from MORE raters

Hospital Doctor/Hospitalists rater

It didn’t include convalescent plasma or steroids.

Internal Medicine rater

This is shooting at a moving target, as studies reported go only through May. However, it is a useful summary showing that no treatment reported showed mortality benefit (and that hydroxychloroquine studies showed increased mortality).

Respirology/Pulmonology rater

This article may be useful just to the authors' academic career.