meta|Evidence - COVID-19
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bromhexine (n=39) vs. standard of care (n=39)
randomized controlled trial high risk of bias
Bromhexine hydrochloride.
Oral bromhexine hydrochloride 8 mg three times a day for two weeks in addition to standard therapy.
Standard of care.
Iranian national COVID-19 treatment protocol and hydroxychloroquine 200 mg/d for two weeks, in addition to supportive and symptomatic therapy.
COVID 19 hospitalized
18 years old or older patients with chest imaging and clinical symptoms consistent with COVID-19 pneumonia. The diagnosis of COVID-19 pneumonia was made by a board-certified pulmonologist based on clinical symptomsand signs, as well as chest CT findings compatible with the COVID-19 pneumonia pattern.
Open-label.
Single center, University Hospital, Tabriz, Iran.
Several inaccuracies and incorrectness in the text, the p value reported are one sided without it was specified,
bromhexine (n=59) vs. standard of care (n=52)
- high risk of bias
Bromhexine
Oral bromhexine hydrochloride 8mg four times a day for 2 weeks in addition of standard therapy.
Standard of care
Lopinavir/ritonavir 400/100 two times per day for 7 days or discharge from hospital and interferon beta-1a 44 μg subcutaneous every other day for five doses in addition to supportive and symptomatic therapy.
All patients received standard of care based on the hospital COVID-19 treatment protocol and best practice guidelines in place at that time.
COVID 19 hospitalized
hospital admission,18 years old or greater at the time of signing the informedconsent, chest imaging and clinical symptoms consistentwith COVID-19 pneumonia, laboratory (reverse transcription polymerase chain reaction (RT-PCR)) confirmed infection with 2019-nCoV, willingness to participate in the study,and no concurrent participation in other clinical trials.
Open-label
Single center, Masih Daneshvari Hospital, Iran.
The primary outcome was clinical improvement within 28 days. Clinical improvement was defined as the time (in days) from initiation of the study treatment (active or placebo) until a decline of two categories on a clinical status scale occurred. The six-category ordinal scale of clinical status which ranged from hospital discharge to death and is itemized as follows:(1) hospital discharge or meeting discharge criteria (discharge criteria are defined as clinical recovery, ie, fever, respiratory rate, oxygen saturation returning to normal, and coughrelief); (2) non-intensive care unit (ICU) hospitalization, notrequiring supplemental oxygen; (3) non-ICU hospitalization, requiring supplemental oxygen (but not noninvasive ventilation/high-flow nasal cannula); (4) ICU/non-ICU hospitalization, requiring noninvasive ventilation/high-flow nasal cannula therapy; (5) ICU hospitalization, requiring invasive mechanical ventilation; and (6) death.
bromhexine (n=12) vs. standard of care (n=6)
randomized controlled trial some concerns about risk of bias
Bromhexine hydrochloride
Patients in the treatment group received BRH tablets (32 mg t.i.d.) three times per day after meals for 14 consecutive days. Treatment was discontinued once the patient met the discharge criteria.
Standard of care
Antiviral drugs, including arbidol hydrochloride granules (0.1 g–0.2 g t.i.d.) and recombinant human interferon α 2b spray (0.083 mL t.i.d.)
All patients were divided into the treatment group (BRH group) or the control group (control group) at a 2:1 ratio. All participants were treated with antiviral drugs, including arbidol hydrochloride granules (0.1 g–0.2 g t.i.d.) and recombinant human interferon α 2b spray (0.083 mL t.i.d.), on the doctors’ discretion according to China’s Novel Coronavirus Pneumonia Diagnosis and Treatment Plan.
COVID-19 mild to moderate
Hospitalized patients with COVID-19 (≥ 18 years but ≤ 80 years) with confirmed or clinically suspected mild or moderatecoronavirus pneumonia (COVID-19), based on China’s Novel Coronavirus Pneumonia Diagnosis and Treatment Plan.
Open-label.
Single center, The Second Affiliated Hospital of Wenzhou Medical University, Zhejiang, China.
Clinical recovery was defined as clinical symptoms (fever and respiratory symptoms) returning to normal over 48 hours. Disease deterioration was defined as the presence of respiratory distress, respiratory rate ≥ 30 times/minute, oxygen saturation ≤ 93% in the resting state, and oxygenation index ≤ 300 mmHg.
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