Is there any potential management against COVID-19? A systematic review and meta-analysis.
Haleh Talaie,Sayed Masoud Hosseini,Maryam Nazari,Yadollah Fakhri,Atieh Mousavizadeh,Hossein Vatanpour,Ali Firoozfar +6 more
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TLDR
All the included interventions significantly declined the mortality and enhanced clinical improvements with no effect on negative conversion and mechanical ventilation demand and especially, immunomodulators and plasma therapy showed favorable outcomes.Abstract:
A recent survey has shown that the COVID-19 pandemic has culminated in dramatical and critical treatment particularly in acute infected patients. In fact, this systematic review-meta-analysis was directly pertained to estimation at the efficient value of some clinical managements to confront the COVID-19 infection. Pubmed, Embase, Scopus, Cochrane, and Scholar databases were searched from inception to July 1, 2020, to identify studies reporting the current treatment process and medications (e.g. hydroxychloroquine, antiviral therapy, convalescent plasma, and immunomodulatory agents) for COVID-19. A random-effects model meta-analysis was performed to calculate the relative risk (RR) with 95% confidence intervals (CI). The outcomes of this study were the frequency of negative conversion cases, clinical improvements, mechanical ventilation demand, intensive care unit (ICU) entry, and mortality. The standard treatment refers to the published guidelines and specialist experience which varies in different articles, and the proposed treatment refers to the kind of interest suggested in the included studies. A number of 45 articles met the eligibility criteria (out of 6793 articles). Among them, 26 articles involving 3263 patients were included in quantitative analysis. Anti-COVID-19 interventions could significantly increase clinical improvement (RR 1.17, 95% CI 1.08–1.27; I2 = 49.8%) and reduce the mortality rate (RR 0.58, 95% CI 0.35–0.95; I2 = 74.8%). Although in terms of negative conversion, ICU entry, and mechanical ventilation demand, clinical intervention had no beneficial effect. The clinical effect of immunomodulatory agents (especially tocilizumab and anakinra) was noticeable compared to other medications with RR of 0.22 (95% CI 0.09–0.53; I2 = 40.9%) for mortality and 1.25 (95% CI 1.07–1.46; I2 = 45.4%) for clinical improvement. Moreover, Antivirals (RR 1.13, 95% CI 1.01–1.26; I2 = 47.0%) and convalescent plasma therapy (RR 1.41, 95% CI 1.01–1.98; I2 = 66.6%) had significant beneficial effects on clinical improvement. Based on our findings, all the included interventions significantly declined the mortality and enhanced clinical improvements with no effect on negative conversion and mechanical ventilation demand. Especially, immunomodulators and plasma therapy showed favorable outcomes.read more
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Remdesivir as a possible therapeutic option for the COVID-19
TL;DR: This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record.
Journal ArticleDOI
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Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.
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Journal ArticleDOI
Interleukin-1 blocking agents for treating COVID-19
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Journal ArticleDOI
Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review of in vitro , in vivo , and clinical trials.
Young Joo Han,Keum Hwa Lee,Sojung Yoon,Seoung Wan Nam,Seohyun Ryu,Dawon Seong,Jaeseok Kim,Jun Young Lee,Jae Won Yang,Jinhee Lee,Ai Koyanagi,Sung Hwi Hong,Elena Dragioti,Joaquim Radua,Lee Smith,Hans Oh,Ramy Abou Ghayda,Andreas Kronbichler,Maria Effenberger,Daniela Kresse,Sara Denicolò,Woosun Kang,Louis Jacob,Hanwul Shin,Jae Il Shin +24 more
TL;DR: There was no therapeutic agent that consistently resulted in positive outcomes across SARS, MERS, and COVID-19 and further RCTs are required.
References
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Journal ArticleDOI
Favipiravir, an antiviral for COVID-19?
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