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Therapeutic interventions for COVID-19: a living overview of reviews
Malahat Khalili1, Maryam Chegeni1, Sara Javadi1
1HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Background:
Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, but safe and effective treatment options remain unavailable. Numerous systematic reviews of varying qualities have tried to summarize the evidence on the available therapeutic interventions for COVID-19. This overview of reviews aims to provide a succinct summary of the findings of systematic reviews on different pharmacological and non-pharmacological therapeutic interventions for COVID-19.
Methods:
We searched PubMed, Embase, Google Scholar, Cochrane Database of Systematic Reviews, and WHO database of publications on COVID-19 from 1 December 2019 through to 11 June 2020 for peer-reviewed systematic review studies that reported on potential pharmacological or non-pharmacological therapies for COVID-19. Quality assessment was completed using A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) measure.
Results:
Out of 816 non-duplicate studies, 45 were included in the overview. Antiviral and antibiotic agents, corticosteroids, and anti-malarial agents were the most common drug classes used to treat COVID-19; however, there was no direct or strong evidence to support their efficacy. Oxygen therapy and ventilatory support was the most common non-pharmacological supportive care. The quality of most of the included reviews was rated as low or critically low.
Conclusion:
This overview of reviews demonstrates that although some therapeutic interventions may be beneficial to specific subgroups of COVID-19 patients, the available data are insufficient to strongly recommend any particular treatment option to be used at a population level. Future systematic reviews on COVID-19 treatments should adhere to the recommended systematic review methodologies and ensure that promptness and comprehensiveness are balanced.The reviews of this paper are available via the supplemental material section.
Insights
Current COVID-19 treatments lack strong evidence of efficacy. This review found insufficient data to recommend specific therapies at a population level, highlighting the need for high-quality systematic reviews.
Area of Science:
- Infectious Diseases
- Public Health
- Evidence-Based Medicine
Background:
- Coronavirus disease 2019 (COVID-19) has become a global pandemic.
- Safe and effective treatments for COVID-19 are still lacking.
- Existing systematic reviews on COVID-19 therapies vary in quality.
Purpose of the Study:
- To provide a succinct summary of systematic reviews on COVID-19 treatments.
- To evaluate pharmacological and non-pharmacological interventions for COVID-19.
- To assess the quality of existing evidence.
Main Methods:
- Searched multiple databases (PubMed, Embase, Cochrane, WHO) for systematic reviews.
- Included studies published from December 2019 to June 2020.
- Assessed review quality using the AMSTAR-2 tool.
Main Results:
- 45 systematic reviews were included from 816 studies.
- Common drug classes (antivirals, antibiotics, corticosteroids, anti-malarials) showed no strong efficacy evidence.
- Oxygen therapy and ventilatory support were common non-pharmacological interventions.
- Most included reviews were of low or critically low quality.
Conclusions:
- Insufficient data exists to strongly recommend any COVID-19 treatment for population-wide use.
- Some interventions may benefit specific patient subgroups.
- Future systematic reviews must balance promptness with methodological rigor.
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