Prophylaxis against covid-19: living systematic review and network meta-analysis.
Jessica J Bartoszko,Reed A C Siemieniuk,Elena Kum,Anila Qasim,Dena Zeraatkar,Long Ge,Mi Ah Han,Behnam Sadeghirad,Arnav Agarwal,Arnav Agarwal,Thomas Agoritsas,Derek K. Chu,Rachel Couban,Andrea Darzi,Tahira Devji,Maryam Ghadimi,Kimia Honarmand,Ariel Izcovich,Assem M. Khamis,Francois Lamontagne,Mark Loeb,Maura Marcucci,Shelley McLeod,Sharhzad Motaghi,Srinivas Murthy,Reem A. Mustafa,John Neary,Hector Pardo-Hernandez,Gabriel Rada,Bram Rochwerg,Charlotte Switzer,Britta Tendal,Lehana Thabane,Per Olav Vandvik,Robin W.M. Vernooij,Andrés Viteri-García,Ying Wang,Liang Yao,Zhikang Ye,Gordon H Guyatt,Romina Brignardello-Petersen +40 more
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TLDR
In this paper, the authors compared the effects of drug prophylaxis on SARS-CoV-2 infection and covid-19 using living systematic review and network meta-analysis.Abstract:
Objective To determine and compare the effects of drug prophylaxis on SARS-CoV-2 infection and covid-19. Design Living systematic review and network meta-analysis. Data sources World Health Organization covid-19 database, a comprehensive multilingual source of global covid-19 literature to 25 March 2021, and six additional Chinese databases to 20 February 2021. Study selection Randomised trials of people at risk of covid-19 who were assigned to receive prophylaxis or no prophylaxis (standard care or placebo). Pairs of reviewers independently screened potentially eligible articles. Methods Random effects bayesian network meta-analysis was performed after duplicate data abstraction. Included studies were assessed for risk of bias using a modification of the Cochrane risk of bias 2.0 tool, and certainty of evidence was assessed using the grading of recommendations assessment, development, and evaluation (GRADE) approach. Results The first iteration of this living network meta-analysis includes nine randomised trials—six of hydroxychloroquine (n=6059 participants), one of ivermectin combined with iota-carrageenan (n=234), and two of ivermectin alone (n=540), all compared with standard care or placebo. Two trials (one of ramipril and one of bromhexine hydrochloride) did not meet the sample size requirements for network meta-analysis. Hydroxychloroquine has trivial to no effect on admission to hospital (risk difference 1 fewer per 1000 participants, 95% credible interval 3 fewer to 4 more; high certainty evidence) or mortality (1 fewer per 1000, 2 fewer to 3 more; high certainty). Hydroxychloroquine probably does not reduce the risk of laboratory confirmed SARS-CoV-2 infection (2 more per 1000, 18 fewer to 28 more; moderate certainty), probably increases adverse effects leading to drug discontinuation (19 more per 1000, 1 fewer to 70 more; moderate certainty), and may have trivial to no effect on suspected, probable, or laboratory confirmed SARS-CoV-2 infection (15 fewer per 1000, 64 fewer to 41 more; low certainty). Owing to serious risk of bias and very serious imprecision, and thus very low certainty of evidence, the effects of ivermectin combined with iota-carrageenan on laboratory confirmed covid-19 (52 fewer per 1000, 58 fewer to 37 fewer), ivermectin alone on laboratory confirmed infection (50 fewer per 1000, 59 fewer to 16 fewer) and suspected, probable, or laboratory confirmed infection (159 fewer per 1000, 165 fewer to 144 fewer) remain very uncertain. Conclusions Hydroxychloroquine prophylaxis has trivial to no effect on hospital admission and mortality, probably increases adverse effects, and probably does not reduce the risk of SARS-CoV-2 infection. Because of serious risk of bias and very serious imprecision, it is highly uncertain whether ivermectin combined with iota-carrageenan and ivermectin alone reduce the risk of SARS-CoV-2 infection. Systematic review registration This review was not registered. The protocol established a priori is included as a supplement. Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication.read more
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FXR inhibition may protect from SARS-CoV-2 infection by reducing ACE2
Teresa Brevini,Mailis Maes,Gwilym J. Webb,Binu John,Claudia D. Fuchs,Gustav Buescher,Lu Wang,Chelsea Griffiths,Marnie Brown,William E. Scott,P. Pereyra-Gerber,William Gelson,Stephanie Brown,Scott Dillon,Daniele Muraro,Joanne Sharp,Megan Neary,Helen Box,Lee Tatham,James P. Stewart,Paul Curley,Henry Pertinez,Sally Forrest,Petra Mlcochova,Sagar S. Varankar,Mahnaz Darvish-Damavandi,Victoria Mulcahy,Rhoda E. Kuc,Thomas L Williams,James A. Heslop,Davide Rossetti,Olivia C. Tysoe,Vasileios Galanakis,Marta Vila-Gonzalez,Thomas W. M. Crozier,Johannes Bargehr,Sanjay Sinha,Sara Upponi,Corrina Fear,Lisa Swift,Kourosh Saeb-Parsy,Susan E. Davies,Axel Wester,Hannes Hagström,Espen Melum,D. K. Clements,Peter Humphreys,Joanne Herriott,Edyta Kijak,Helen Cox,Chloe Bramwell,Anthony J. Valentijn,Christopher J. R. Illingworth,Bassam Dahman,Dustin R Bastaich,Raphaella D. Ferreira,Thomas Marjot,Eleanor Barnes,Andrew M. Moon,A. Sidney Barritt,Ravindra K. Gupta,Stephen Baker,Anthony P. Davenport,G. Corbett,Vassilis G. Gorgoulis,Simon J.A. Buczacki,Joo-Hyeon Lee,Nicholas J Matheson,Michael Trauner,Andrew J. Fisher,Paul Gibbs,Andrew J. Butler,Christopher A. Watson,George F. Mells,Gordon Dougan,Andrew Owen,Ansgar W. Lohse,Ludovic Vallier,Fotios Sampaziotis +78 more
TL;DR: In this article , the authors show that the farnesoid X receptor (FXR) is a direct regulator of ACE2 transcription in several tissues affected by COVID-19, including the gastrointestinal and respiratory systems.
Journal ArticleDOI
Antibody and cellular therapies for treatment of covid-19: a living systematic review and network meta-analysis.
Reed A C Siemieniuk,Jessica J Bartoszko,Juan Pablo Diaz Martinez,Elena Kum,Anila Qasim,Dena Zeraatkar,Ariel Izcovich,Sophia O Mangala,Long Ge,Mi Ah Han,Thomas Agoritsas,Donald M. Arnold,Camila Ávila,Derek K. Chu,Rachel Couban,Ellen Cusano,Andrea Darzi,Tahira Devji,Farid Foroutan,Maryam Ghadimi,Assem M. Khamis,Francois Lamontagne,Mark Loeb,Anna Miroshnychenko,Sharhzad Motaghi,Srinivas Murthy,Reem A. Mustafa,Reem A. Mustafa,Gabriel Rada,Bram Rochwerg,Charlotte Switzer,Per Olav Vandvik,Robin W.M. Vernooij,Ying Wang,Liang Yao,Gordon H. Guyatt,Romina Brignardello-Petersen +36 more
TL;DR: In this paper, the authors evaluated the efficacy and safety of antiviral antibody therapies and blood products for the treatment of novel coronavirus disease 2019 (covid-19), with pairwise meta-analysis for outcomes with insufficient data.
Journal ArticleDOI
Self-medication practices to prevent or manage COVID-19: A systematic review.
Alvaro Quincho-Lopez,Christeam A Benites-Ibarra,Maryori M. Hilario-Gomez,Renatta Quijano-Escate,Alvaro Taype-Rondan +4 more
TL;DR: In this paper, the authors conducted a systematic review to assess the prevalence of self-medication to prevent or manage COVID-19, and identified eight studies, all studies were cross-sectional, and only one detailed the question used to assess selfmedication.
Journal ArticleDOI
Efficacy and safety of hydroxychloroquine as pre-and post-exposure prophylaxis and treatment of COVID-19: A systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials.
Paulo Ricardo Saquete Martins-Filho,Lis Campos Ferreira,Luana Heimfarth,Adriano Antunes de Souza Araújo,Lucindo José Quintans-Júnior +4 more
TL;DR: In this article, the authors synthesize the best evidence on the efficacy and safety of Hydroxychloroquine (HCQ) as pre-and post-exposure prophylaxis and treatment of non-hospitalized and hospitalized patients with COVID-19.
Journal ArticleDOI
Triangle of cytokine storm, central nervous system involvement, and viral infection in COVID-19: the role of sFasL and neuropilin-1.
TL;DR: In this paper, a review of pivotal players behind the activation of cytokine storm that are associated with vast CNS injury is presented, and the authors also hypothesize that sFasL may affect neuroinflammatory processes and trigger the cytokine storms in COVID-19.
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