COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

Treatment Qiu R, Li J, Xiao Y, et al. The therapeutic effect and safety of the drugs for COVID-19: A systematic review and meta-analysis. Medicine (Baltimore). 2021 Apr 23;100(16):e25532. doi: 10.1097/MD.0000000000025532.
Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread almost all regions of the world and caused great loss to the whole body of mankind. Thus, numerous clinical trials were conducted to find specific medicine for COVID-19 recently. However, it remains unanswered whether they are beneficial.

OBJECTIVE: This study aimed to evaluate the efficiency and safety of the COVID-19 medicine.

METHODS: Studies were determined through searching PubMed, Embase, Cochrane Library, and Medline. The studies of COVID-19 medicine were involved with eligible end points containing mortality, discharge rate, rate of clinical improvement, and rate of serious adverse events.

RESULTS: A total of 33 studies involving 37,879 patients were included in our study, whose intervening measures contained three major types of COVID-19 medicine, ACEI/ARB, antiviral medicine, and chloroquine/hydroxychloroquine. Compared to control group, COVID-19 drugs have no distinct effect on mortality (RR, 0.93; 95% CI, 0.79-1.11, P?=?.43) and discharge rate (RR, 1.06; 95% CI, 0.98-1.14, P?=?.13). However, antiviral medicine presents the obvious advantage in clinical improvement (RR, 1.11; 95% CI, 1.01-1.23, P?<?.05). In addition, the serious adverse events rate (RR, 0.75; 95% CI, 0.63-0.88, P?<?.05) of COVID-19 medicine is lower than control group.

CONCLUSION: The results indicated antiviral medicine was potential specific medicine for COVID-19 treatment by improving clinical symptoms, but it failed to increase the discharge rate and reduce mortality. Chloroquine/hydroxychloroquine and ACEI/ARB had no significant effect on treatment of COVID-19, thus they were not recommended for routine medication. Moreover, more trials are needed to find effective drugs to lower the mortality of COVID-19 patients.

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

Infectious Disease rater

Nil

Internal Medicine rater

There is a heightened need for Covid-19 data to be rigorous and scrupulously robust. I would be concerned this review lacks the robustness to be reliable in guiding either treatment best practice, or plans for future trials.