Monoclonal antibody and antiviral therapy for treatment of mild-to-moderate COVID-19 in pediatric patients

Vora, Surabhi B; Englund, Janet A.; Trehan, Indi; Waghmare, Alpana; Kong, Ada; Adler, Amanda I; Zerr, Danielle M.

doi:10.1101/2022.03.16.22272511

Cited by 5 publications

(9 citation statements)

References 8 publications

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“…Finally, 37 studies were eligible for review by full text. Twenty-three studies [6][7][8][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] involving 314 353 patients were included in the meta-analysis. All included studies except one 7 were retrospective.…”

Section: Search Resultsmentioning

confidence: 99%

“…Five studies 7,19,28,31,33 involving 2143 patients reported the incidence of adverse events in patients. The pooled analysis showed no significant difference between the two treatment groups in terms of F I G U R E 1 Preferred Reporting Items for Systematic reviews and Meta-Analysis flow diagram of the included studies in the meta-analysis the incidence of any adverse events in patients (OR = 2.20; 95% CI: 0.42-11.47; p = 0.34) (Figure 4).…”

Section: Safety Outcomesmentioning

confidence: 99%

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Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID‐19: A rapid review and meta‐analysis

Amani

2023

Journal of Medical Virology

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This study aimed to examine the efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for coronavirus disease 2019 (COVID‐19). PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar were searched to identify the relevant evidence up to November 10, 2022. The reference lists of key studies were also scanned to find additional records. The quality of the studies was evaluated using the Cochrane tools for assessing the risk of bias. The Comprehensive Meta‐Analysis software version 3.0 was employed for data analysis. Twenty‐three studies involving 314 353 patients were included in the analysis. The findings of the meta‐analysis showed a significant difference between the Paxlovid and no‐Paxlovid groups in terms of mortality rate (odds ratio [OR] = 0.25; 95% confidence interval [CI]: 0.14–0.45), hospitalization rate (OR = 0.40; 95% CI: 0.24–0.69), polymerase chain reaction negative conversion time (mean difference [MD] = −2.46; 95% CI: −4.31 to −0.61), and hospitalization or death rate (OR = 0.17; 95% CI: 0.06–0.46). However, no significant difference was observed between the two groups in terms of COVID‐19 rebound (OR = 0.84; 95% CI: 0.67–1.04), emergency department visit (OR = 0.75; 95% CI: 0.45–1.24), intensive care unit admission (OR = 0.37; 95% CI: 0.13–1.01), and adverse events (OR = 2.20; 95% CI: 0.42–11.47). The results of the present study support the efficacy and safety of Paxlovid in the treatment of patients with COVID‐19. Further research is needed to investigate the COVID‐19 rebound after Paxlovid treatment.

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Section: Search Resultsmentioning

confidence: 99%

Section: Safety Outcomesmentioning

confidence: 99%

Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID‐19: A rapid review and meta‐analysis

Amani

2023

Journal of Medical Virology

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“…Figure 1 shows the flow diagram of study selection according to its title, abstract, and full text. After removing duplicated records, seventeen studies, 19 , 20 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 (two RCTs and fifteen observational studies) with 27,429 patients were included in the meta‐analysis. The main characteristics of included studies are listed in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Data are available online for the included studies. 19,20,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]…”

Section: Author Contributionsmentioning

confidence: 99%

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

Amani

2022

Reviews in Medical Virology

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The therapeutic potential of sotrovimab in the treatment of coronavirus disease 2019 (COVID‐19) is a controversial issue. The aim of this study was to evaluate the efficacy and safety of sotrovimab in COVID‐19 patients. To this end, PubMed, Cochrane Library, Embase, Web of Science, medRxiv, and Google Scholar were searched up to 15 August 2022. The reference lists of key studies were also scanned to find additional records. Meta‐analysis was performed using Comprehensive Meta‐Analysis. Seventeen studies involving 27,429 patients were included. A significant difference was observed in mortality rate (odds ratio [OR] = 0.40; 95% CI: 0.25–0.63, p = 0.00), hospitalisation rate (OR = 0.53; 95% CI: 0.43–0.65. p = 0.00), hospital or death rate (OR = 0.43; 95% CI: 0.25–0.73, p = 0.00), the need for mechanical ventilation (OR = 0.57; 95% CI: 0.33–0.96, p = 0.03), and ICU admission (OR = 0.33; 95% CI: 0.17–0.67, p = 0.00) of the sotrovimab‐receiving group compared to those having no sotrovimab. However, no significant difference was observed between the two groups in terms of disease progression (OR = 0.45; 95% CI: 0.16–1.24, p = 0.12) and emergency department visit (OR = 1.01; 95% CI: 0.83–1.24, p = 0.87). The two groups had no significant difference in terms of incidence of adverse events (OR = 0.98; 95% CI: 0.78–1.23, p = 0.88). The findings of the present meta‐analysis support that sotrovimab could be an effective and safe treatment option to reduce mortality and hospitalisation rate in both Delta and Omicron Variants of COVID‐19.

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Efficacy and safety of paxlovid (nirmatrelvir/ritonavir) in the treatment of COVID‐19: An updated meta‐analysis and trial sequential analysis

Tian

Yang

Song

et al. 2023

Reviews in Medical Virology

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Our study is aimed to access the efficacy and safety outcomes for coronavirus disease 2019 (COVID‐19) patients treated with Paxlovid. According to inclusion and exclusion criteria, databases were used to retrieve articles from 1 January 2020 to 1 January 2023. Article screening, quality evaluation and data extraction were completed and cross‐checked. The meta‐analysis and trial sequential analysis (TSA) were conducted using RevMan, StataMP, and TSA software. A total of 42 original articles were included. Overall meta‐analysis results showed that for death, hospitalisation, death or hospitalisation, emergency department (ED) visit, intensive care unit (ICU) admission, and extra oxygen requirement outcomes, every odds ratio (OR) was <1 and p < 0.05. For rebound outcome, the OR was >1 and p > 0.05. For adverse events (AEs) outcome, the OR was >1 and p < 0.05. In conclusion, Paxlovid effectively reduced the risks of death, hospitalisation, death or hospitalisation, ED visit, ICU admission, and extra oxygen requirement. There was no significant statistical difference considering rebound, but people should pay attention to possible AEs. However, for rebound and AEs outcomes, observations in certain subgroups suggested conclusions contrary to the overall meta‐analysis. Trial sequential analysis indicated these two outcomes have a risk of false negative or false positive conclusions, so additional original studies are needed for further validation.

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Monoclonal antibody and antiviral therapy for treatment of mild-to-moderate COVID-19 in pediatric patients

Cited by 5 publications

References 8 publications

Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID‐19: A rapid review and meta‐analysis

Efficacy and safety of nirmatrelvir/ritonavir (Paxlovid) for COVID‐19: A rapid review and meta‐analysis

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

Efficacy and safety of paxlovid (nirmatrelvir/ritonavir) in the treatment of COVID‐19: An updated meta‐analysis and trial sequential analysis

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