meta|Evidence - COVID-19
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chloroquine (n=18) vs. standard of care (n=12)
randomized controlled trial high risk of bias
chloroquine
chloroquine phosphate group: First dose of chloroquine phosphate 1 g first day, then 0.5g × 9 days
standard of care
according to the Chinese Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (5th Edition)
3 arms chloroquine, hydroxychloroquine and SoC
COVID 19 all comers
open-label
China, single center
Study planned to recruit 100 subjects with confirmed mild/moderate types ofCOVID-19. Study discontinuated after enrolling only 67 subjects with mild/moderate COVID-19Publication report only data on 48 patients with moderate type of COVID-19
darunavir cobicistat (n=15) vs. standard of care (n=15)
randomized controlled trial high risk of bias
Darunavir and cobicistat
1 pill of darunavir/cobicistat (a single-tablet regimen containing 800 mg of darunavir and 150 mg of cobicistat) per day for 5 days.
Conventional treatments
Patients did not receive oral antiviral drugs.
All the participants received interferon alpha 2b and standard of care as per guideline recommendation in China.
COVID 19 all comers
Diagnosed as pneumonia caused by 2019-ncoV, according to the notice on printing and distributing the diagnosis and treatment plan of pneumonia with new coronavirus infection made by national health commission of the people's republic of China.
Open-label.
Single-center, Shanghai Public Health Clinical Center, China.
After randomization, respiratory samples were collected every 1–2 days until viral clearance. Viral clearance was defined as reverse transcriptase polymerase chain reaction (RT-PCR) negative on at least 2 consecutive oropharyngeal swabs collected at least 1–2 days apart.
Pilot study.
favipiravir (n=44) vs. favipiravir (n=45)
randomized controlled trial high risk of bias
immediate favipiravir
favipiravir administered orally between day 1 and day 10, 1800 mg twice a day on day 1 followed by 800 mg twice a day from day 2
delayed favipiravir
favipiravir administered orally between day 6 and day 15, 1800 mg twice a day on day 6 followed by 800 mg twice a day from day 7
COVID 19 all comers
asymptomatic and minimally symptomatic patientsRT-PCR test positive
open label
25 centres, japan
favipiravir (n=10) vs. standard of care (n=10)
randomized controlled trial some concerns about risk of bias
favipiravir
The first dose was 1600 mg or 2200mg orally, followed by 600 mg each time, three times a day, and the duration of administration was not more than 14 days
standard treatment
antiviral treatment included lopinavir/ritonavir (400 mg/100 mg, bid, po.) or darunavir/cobicistat (800 mg/150 mg, qd, po.) and arbidol (200 mg, tid, po.
3 arms: favipiravir (n=10), baloxavir marboxil (n=10), current antiviral treatment (n=10)
COVID 19 all comers
exclusion of considered as severe disease: has an ongoing respiratory deficiency and subjected to invasive mechanical ventilation; or presence of shock; or admitted to the ICU due to complications;
open-label, randomized
1 center, China
Time to clinical improvement was defined as the time from randomization to an improvement of two points (from the status at randomization) on a seven category ordinal scale or live discharge from the hospital, whichever came first.
favipiravir (n=-9) vs. tocilizumab (n=-9)
randomized controlled trial some concerns about risk of bias
favipavir
Favipiravir: On the 1st day, 1600mg each time, twice a day; from the 2nd to the 7th day, 600mg each time, twice a day
tocilizumab
1 dose 4-8 mg/kg (max 400mg). 2nd dose within 24h if persistent fever
COVID 19 all comers
open label
10 centres, China
3 arms : Favipiravir Combined With Tocilizumab ; Favipiravir; Tocilizumab
favipiravir (n=120) vs. umifenovir (arbidol) (n=120)
randomized controlled trial some concerns about risk of bias
favipiravir
favipiravir tablets (1600 mg/time on the first day, twice a day; 600 mg/time from the second day to the end of the experiment, twice a day)
umifenovir
umifenovir (200 mg each time, 3 times a day, from the first day to the end of the trial)
COVID 19 all comers
double-blind
China, 3 hospitals
Clinical recovery was defined as continuous (>72 hours) recovery of body temperature, respiratory rate, oxygen saturation and cough relief after treatment
Some incorrectness in the paper (for example in the result table (table 2), it is not the rate ratio that is reported but the risk difference). Arise some concern about a selective reporting.
hydroxychloroquine (n=18) vs. standard of care (n=12)
randomized controlled trial high risk of bias
hydroxychloroquine
Hydroxychloroquine sulfate group 0.2 g BID × 10 days
standard of care
according to the Chinese Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (5th Edition)
COVID 19 all comers
open-label
China, single center
Study planned to recruit 100 subjects with confirmed mild/moderate types ofCOVID-19. Study discontinuated after enrolling only 67 subjects with mild/moderate COVID-19Publication report only data on 48 patients with moderate type of COVID-19
nirmatrelvir / ritonavir (Paxlovid) (n=1140) vs. placebo (n=-9)
randomized controlled trial risk of bias NA
paxlovid
placebo
COVID 19 all comers
double blind
interim results from pfizer press release https://www.pfizer.com/news/press-release/press-release-detail/pfizer-announces-additional-phase-23-study-results
remdesivir (n=43) vs. standard of care (n=58)
randomized controlled trial low risk of bias
Remdesivir
Standard of care plus intravenous remdesivir 400 mg on day 1, then 200 mg daily up to 9 days.
Standard of care
Local SoC.
3 arms: remdesivir, hydroxychloroquine, standard of care. All study treatments were stopped at discharge. During the course of the study, local SoC changed as a result of the RECOVERY trial and updated WHO guidelines recommending systemic steroids for severe and critical COVID-19 (September 4th 2020).
COVID 19 all comers
adult patients (≥18 years), with confirmed SARS-2-CoV-2 infection by PCR, admitted to the hospital ward or the intensive care unit (ICU), with no anticipated transfer to a non-study hospital within 72 hours of inclusion. Informed consent by the study subject or legally authorized representative was provided prior to inclusion.
Open-label.
23 hospitals in Norway.
remdesivir (n=43) vs. standard of care (n=58)
randomized controlled trial some concerns about risk of bias
Remdesivir
Standard of care plus 200 mg of intravenous remdesivir on day 1, then 100 mg daily up to 9 days. All study treatments were discontinued at discharge.
Standard care
Local SoC.
3 arms: hydroxychloroquine, remdesivir and standard of care. During the study, local SoC changed as the RECOVERY trial and updated WHO guidelines recommending systemic steroids for severe and critical COVID-19.
COVID 19 all comers
Adult patients (≥18 years) with SARS-CoV-2 infection confirmed by PCR who were admitted to the hospital ward or intensive care unit (ICU) with no anticipated transfer to a nonstudy hospital within 72 hours of inclusion. Informed consent by the study participant or legally authorized representative was provided before inclusion.
Open-label.
23 hospitals in Norway.
From 8 June 2020 on, NOR-Solidarity allocated patients only to SoC and remdesivir (hydroxychloroquine removed because of lack of evidence of its effectiveness).
Add-on Solidarity trial.
umifenovir (arbidol) (n=16) vs. standard of care (n=7)
randomized controlled trial some concerns about risk of bias
arbidol
arbidol (100mg) (oral, 200mg TID for 7-14 days)
standard care
3 arms : lopinavir/ritonavir; arbidol and standard care
COVID 19 all comers
open-label
China, single center
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