COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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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.