Antiviral drugs for coronavirus disease 2019 (COVID-19): a systematic review with network meta-analysis.
Expert Rev Anti Infect Ther
; 20(2): 267-278, 2022 02.
Article
em En
| MEDLINE
| ID: mdl-34323632
ABSTRACT
BACKGROUND:
To better inform clinical practice, we summarized the findings from randomized controlled trials (RCTs) of antivirals for COVID-19.METHODS:
We systematically searched for literature up to September 2020, and included English-language publications of RCTs among hospitalized COVID-19 patients. We conducted network meta-analysis combining results of both the direct and indirect comparisons of interventions. The efficacy outcomes were clinical progression, all-cause mortality, and viral clearance, and safety outcomes were diarrhea, nausea, and vomiting. We generated treatment rankings (best to worst) and summarized rank probabilities using rankogram.RESULTS:
We included 15 RCTs (14,418 patients) from 7,237 retrieved citations. There was no evidence for efficacy of the assessed antivirals compared with placebo/no treatment or with another antiviral for all efficacy outcomes. Lopinavir (400 mg)/ritonavir (100 mg) significantly increased diarrhea, nausea, and vomiting compared with placebo/no treatment and other antivirals, and was ranked worst for these outcomes, while triazavirin (250 mg), baloxavir marboxil (80 mg), and remdesivir (100 mg - 10 days) ranked best, respectively. CONCLUSIONS AND RELEVANCE The available evidence does not support the use of any antiviral drugs for COVID-19. Cautious interpretations of the findings are, however, advised considering the paucity of the evidence. More RCTs are needed for a stronger evidence base.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
3_ND
/
4_TD
Base de dados:
MEDLINE
Assunto principal:
Antivirais
/
Tratamento Farmacológico da COVID-19
Tipo de estudo:
Clinical_trials
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Expert Rev Anti Infect Ther
Ano de publicação:
2022
Tipo de documento:
Article