Abstract
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.
Keywords:
COVID-19; HCQ; SARS-CoV-2; hydroxychloroquine; meta-analysis.
© 2020 Wiley Periodicals LLC.
Publication types
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Meta-Analysis
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Systematic Review
MeSH terms
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Adenosine Monophosphate / administration & dosage
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Adenosine Monophosphate / adverse effects
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Adenosine Monophosphate / analogs & derivatives*
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Adrenal Cortex Hormones / administration & dosage*
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Adrenal Cortex Hormones / adverse effects
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Alanine / administration & dosage
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Alanine / adverse effects
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Alanine / analogs & derivatives*
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Antibodies, Monoclonal, Humanized / administration & dosage*
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Antibodies, Monoclonal, Humanized / adverse effects
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Antiviral Agents / administration & dosage*
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Antiviral Agents / adverse effects
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COVID-19 / mortality
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COVID-19 / pathology
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COVID-19 / therapy*
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COVID-19 / virology
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COVID-19 Serotherapy
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Drug Administration Schedule
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Drug Combinations
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Female
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Humans
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Hydroxychloroquine / administration & dosage*
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Hydroxychloroquine / adverse effects
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Immunization, Passive
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Lopinavir / administration & dosage*
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Lopinavir / adverse effects
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Male
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Middle Aged
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Odds Ratio
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Ritonavir / administration & dosage*
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Ritonavir / adverse effects
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SARS-CoV-2 / drug effects
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SARS-CoV-2 / pathogenicity
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Survival Analysis
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Treatment Outcome
Substances
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Adrenal Cortex Hormones
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Antibodies, Monoclonal, Humanized
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Antiviral Agents
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Drug Combinations
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lopinavir-ritonavir drug combination
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Lopinavir
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remdesivir
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Adenosine Monophosphate
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Hydroxychloroquine
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tocilizumab
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Ritonavir
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Alanine