Efficacy of pharmacological interventions in COVID‐19: A network meta‐analysis

Abstract

Aims To perform network meta‐analysis for a head‐to‐head comparison of various interventions used in coronavirus disease 2019 (COVID‐19) on mortality, clinical recovery, time to clinical improvement and the occurrence of serious adverse events. Methods Systematic search was performed using online databases with suitable MeSH terms including coronavirus, COVID‐19, randomized controlled trial, hydroxychloroquine, lopinavir/ritonavir, tocilizumab, remdesivir, favipiravir, dexamethasone and interferon‐β. Data were independently extracted by 2 study investigators and analysed. Results Out of 1225 studies screened, 23 were included for qualitative and quantitative analysis. Among the drugs studied, dexamethasone reduces mortality by 10%, with a relative risk of 0.90 (95% confidence interval [0.82–0.97]) and increases clinical recovery by 6% (relative risk 1.06, 95% confidence interval [1.02–1.10]) compared to standard of care. Similarly, remdesivir administered for 10 days increased clinical recovery by 10%, reduced time to clinical improvement by 4 days and lowered the occurrence of serious adverse events by 27% as compared to standard of care. Conclusion In comparison to standard of care, dexamethasone was found to increase clinical recovery and lower mortality; remdesivir was significantly associated with a lower risk of mortality as compared to tocilizumab and higher clinical recovery and shorter time to clinical improvement as compared to hydroxychloroquine and tocilizumab; remdesivir followed by tocilizumab were found to have lesser occurrence of serious adverse events in patients with moderate to severe COVID‐19.

Efficacy and safety of sotrovimab in patients with COVID‐19: A rapid review and meta‐analysis

“…Since the beginning of the coronavirus disease 2019 (COVID‐19) pandemic, many therapeutic interventions have been introduced and evaluated 1–3 . The current evidence shows the effectiveness of monoclonal antibody (mAb) therapy in the prevention and treatment of COVID‐19 4 .…”

“…Since the beginning of the coronavirus disease 2019 (COVID‐19) pandemic, many therapeutic interventions have been introduced and evaluated. 1 , 2 , 3 The current evidence shows the effectiveness of monoclonal antibody (mAb) therapy in the prevention and treatment of COVID‐19. 4 Several anti‐severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) mAb therapies, such as casirivimab/imdevimab, 5 , 6 , 7 bamlanivimab, 8 bamlanivimab/etesevimab, 9 , 10 , 11 and sotrovimab 4 , 12 have been proposed as promising potential treatments for patients with COVID‐19.…”

A Comprehensive Review on Navigating the Neurological Landscape of COVID-19: Insights Into Etiopathogenesis and Clinical Management

“…The narrative review on pharmacological treatment for COVID-19 underscores the ongoing global endeavors to develop efficacious medications and vaccines against the virus. Despite some medicines and vaccines receiving emergency use authorization based on preliminary findings, a definitive treatment regimen for COVID-19 remains elusive, underscoring the complexity of managing the disease [ 68 ].…”

Aggregate Index of Systemic Inflammation (AISI), Disease Severity, and Mortality in COVID-19: A Systematic Review and Meta-Analysis

“…There is very good evidence that immune dysregulation and a state of excessive systemic inflammation predispose patients with coronavirus disease 2019 (COVID- 19) to homeostatic alterations in various organs and tissues and an increased risk of severe clinical manifestations, prolonged hospitalization, and in-hospital mortality [1][2][3][4][5][6][7][8][9][10]. Although these observations have been instrumental in the identification of safe and effective immunomodulatory and anti-inflammatory treatment strategies [11,12], they have also stimulated the search for robust biomarkers of excessive inflammatory response for early risk stratification and appropriate management in this patient group [13,14]. Concomitantly, abnormalities in specific blood cell types, particularly, neutrophilia, lymphopenia, and thrombocytopenia, have led to studies reporting significant associations between derived indices, particularly the neutrophil-to-lymphocyte ratio (NLR), and severe disease and mortality [15][16][17][18].…”