COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Treatment, Primary Prevention Abubakar AR, Sani IH, Godman B, et al. Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications. Infect Drug Resist. 2020 Dec 29;13:4673-4695. doi: 10.2147/IDR.S289037. eCollection 2020.
Abstract

A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.

Ratings
Discipline / Specialty Area Score
Infectious Disease
Family Medicine (FM)/General Practice (GP)
Hospital Doctor/Hospitalists
Internal Medicine
Emergency Medicine
Respirology/Pulmonology
Public Health
Comments from MORE raters

Emergency Medicine rater

This is best read as a narrative review. This article summarizes recent publications related to treatment of COVID-19.

Emergency Medicine rater

This good article is very useful for more emergency physicians and internists. It lacks scope beyond ward medical care to patients with Covid-19.

Family Medicine (FM)/General Practice (GP) rater

This is a clear and extensive review.

Family Medicine (FM)/General Practice (GP) rater

This review is so needed to put together in one place what does and does not work for COVID-19.

Hospital Doctor/Hospitalists rater

This is a well summarized article displaying current therapeutic regiments and their purported efficacy.

Hospital Doctor/Hospitalists rater

I am a big fan of large review articles that are directly relevant to current practice. This article is well organized and well written. When it's published, I will share with my hospitalist colleagues.