meta|Evidence - COVID-19
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camostat mesilate (n=139) vs. placebo (n=69)
randomized controlled trial some concerns about risk of bias
Camostat Mesilate
2x100 mg pills 3 times daily (every 8h) for 5 days.
placebo
2 pills 3 times daily for 5 days.
2:1 ratio. Some patients received remdesivir and/or dexamethasone as standard of care. All participants also received prophylactic or therapeutic anticoagulatory treatment.
COVID 19 all comers
documented COVID-19 infection as evidenced by positive PCR (or comparable clinical assay) for SARS-coV-2 ; less than 48 hours since time of hospital admission OR if hospital-acquired COVID-19 is suspected, less than 48 hrs since onset of symptoms
Double-blind
Denmark (8 sites), Sweden (1 site).
Phase IIa. The scale consisted of the following categories: 1, not hospitalized with resumption of normal activities; 2, not hospitalized, but unable to resume normal activities; 3, hospitalized, not requiring supplemental oxygen; 4, hospitalized, requiring supplemental oxygen; 5, hospitalized, requiring high-flow oxygen therapy or noninvasive ventilation;6, hospitalized, requiring invasive mechanical ventilation; and 7,death. After discharged, phone interviews were conducted up to day 30 to monitor treatment adherence and clinical status.
Aspirin (n=7351) vs. standard of care (n=7541)
randomized controlled trial some concerns about risk of bias
Aspirin
Usual care plus 150mg aspirin once per day by mouth (or nasogastric tube) or by rectum until discharge.
Usual care
As a platform trial, and in a factorial design, patients could be simultaneously randomly assigned to the following other treatment groups: azithromycin, colchicine,or dimethyl fumarate versus usual care; convalescent plasma or casirivimab and imdevimab versus usual care; and baricitinib versus usual care. Until Jan 24, 2021, the trial also allowed asubsequent randomisation for patients with progressive COVID-19 (evidence of hypoxia and a hyperinflammatory state) to tocilizumab versus usual care. 210 patients (3%) allocated to usual care received at least one dose of aspirin.
COVID 19 hospitalized
Open-label.
177 hospitals in the UK, 2 hospitals in Indonesia, and 2 hospitals in Nepal.
povidone-iodine (n=5) vs. control (n=5)
randomized controlled trial risk of bias NA
30 seconds, 3 times/day gargling using 1% povidone-iodine (PVP-I), essential oils and tap water
control
COVID 19 hospitalized
open-label
Kuala Lumpur
Cannabidiol (n=53) vs. placebo (n=52)
randomized controlled trial some concerns about risk of bias
Cannabidiol
300mg/day Cannabidiol plus standard of care during 14 days.
Placebo
Placebo plus standard of care during 14 days.
COVID-19 mild to moderate
Double-blind.
2 sites in Sao Paulo, Brazil.
Primary endpoint was measured with the COVID-19 Scale or the natural course of the resolution of typical clinical symptoms, and assessed on days 14, 21, and 28 after enrollment.
sabizabulin (n=134) vs. placebo (n=70)
randomized controlled trial some concerns about risk of bias
daily oral doses of sabizabulin 9mg for 21 days
placebo
COVID-19 mild to moderate
double-blind
27 centers, worldwide
met the prespecified superiority criterion for efficacy at the time of the interim analysis with 150 patients
planned interim analysis
alpha lipoic acid (n=8) vs. standard of care (n=9)
randomized controlled trial high risk of bias
α-Lipoic acid for
α-Lipoic acid ((1200 mg/d, intravenous infusion) once daily plus standard care
conventional therapy and placebo
equal volume saline infusion (placebo) for 7 days
COVID-19 severe or critically
open-blind
single center, JinYinTan Hospital, Wuhan, China
aviptadil (n=-9) vs. placebo (n=-9)
randomized controlled trial risk of bias NA
COVID-19 severe or critically
the Data Safety and Monitoring Board (DSMB) of the ACTIV-3b (TESICO) clinical trial recommended halting analysis of Zyesami (aviptadil) in critical Covid-19 patients due to futility
pyridostigmine (n=94) vs. placebo (n=94)
randomized controlled trial some concerns about risk of bias
Pyridostigmine
Oral pyridostigmine at a dose of 60 mg/day until the occurrence of any of the prespecified outcomes, hospital discharge, or 14 in-hospital days.
Placebo
Matching placebo (pharmaceutical-grade starch). One tablet P.O. once per day for 14 days.
All patients received best standard of care available for severe COVID-19 in participating centers.
COVID-19 severe or critically
Adults (≥18 years old), with confirmed SARS-CoV-2 infection based on a positive RT-PCR test, requiring in-hospital care, Imaging study compatible with pneumonia, At least one of the following criteria: a). Dyspnea b). Lung infiltrates occupying > 50% of lung fields by CT scan c) PaO2/FiO2 ratio < 300 mmHg d). Peripheral oxygen saturation (SpO2) < 90% while breathing room air, a ≥ 3% drop in baseline SpO2, or the need of increased flow rates of supplemental oxygen in the case of chronic hypoxia; and the need for supplemental oxygen therapy according to the treating medical team’s judgment. e). Alteration of one or more of the following laboratory parameters: D-dimer > 1 μg/mL, Ferritin level > 300 ng/mL, C-reactive protein (CRP) > 3 mg/L, Lactate dehydrogenase (LDH) > 245 U/L, Lymphopenia, defined as < 800 lymphocytes/uL, Creatine kinase (CK) level > 800 IU/L
Double-blind.
Multicenter, 2 hospitals in Mexico City, Mexico.
Phase 2/3.
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