Current evidence for COVID-19 therapies: a systematic literature review

Area of Science:

• Pharmacology
• Infectious Diseases
• Clinical Trials

Background:

• The urgent need for effective treatments for coronavirus disease 2019 (COVID-19) necessitates a comprehensive review of existing clinical trial data.
• Assessing pharmacological interventions is key to managing the pandemic and improving patient outcomes.

Purpose of the Study:

• To systematically review and synthesize evidence from clinical trials on pharmacological interventions for COVID-19.
• To evaluate the efficacy of various therapies in reducing mortality, hospitalization, and the need for ventilation.

Main Methods:

• A systematic review of clinical trials published between December 1, 2019, and October 14, 2020.
• Qualitative synthesis of data on mortality, hospitalization, and ventilation requirements for different pharmacological interventions.

Main Results:

• Dexamethasone demonstrated significant reductions in mortality, hospitalization, and ventilation needs, especially in severe cases.
• Interferons and remdesivir showed some benefit in reducing mortality, hospitalization, and ventilation needs, particularly when administered early.
• Bromhexine, a mucolytic drug, also indicated potential benefits. Lopinavir/ritonavir and hydroxychloroquine generally showed no significant efficacy over standard care.
• Many trials exhibited a moderate-to-high risk of bias, with limitations in blinding, duration, and sample size.

Conclusions:

• High-quality, well-designed clinical trials are essential to strengthen the evidence base for COVID-19 therapeutic interventions.
• Tailoring treatments to the specific stage and severity of COVID-19 is crucial for maximizing therapeutic efficacy.