Potential effectiveness and safety of antiviral agents in children with coronavirus disease 2019: a rapid review and meta-analysis

Abstract

Background: The COVID-19 outbreak presents a new, life-threatening disease. Our aim was to assess the potential effectiveness and safety of antiviral agents for COVID-19 in children. Methods: Electronic databases (MEDLINE, Embase, Web of Science, the Cochrane library, CBM, CNKI, and Wanfang Data) from their inception to March 31, 2020 were searched for randomized controlled trials (RCTs), clinical controlled trials and cohort studies of interventions with antiviral agents for children (less than 18 years of age) with COVID-19.Results: A total of 23 studies with 6,008 patients were included. There was no direct evidence and all of evidence were indirect. The risks of bias in all studies were moderate to high in general. The effectiveness and safety of antiviral agents for children with COVID-19 is uncertain: For adults with COVID-19, lopinavir/ritonavir had no effect on mortality [risk ratio (RR) =0.77; 95% confidence interval (CI), 0.45 to 1.30]. Arbidol and hydroxychloroquine (HCQ) had no benefit on probability of negative PCR test (RR =1.27; 95% CI, 0.93 to 1.73; RR =0.93; 95% CI, 0.73 to 1.18) respectively. For adults with SARS, interferon was associated with reduced corticosteroid dose [weighted mean difference (WMD) = −0.14 g; 95% CI, −0.21 to −0.07] but had no effect on mortality (RR =0.72; 95% CI, 0.28 to 1.88); ribavirin did not reduce mortality (RR =0.68; 95% CI, 0.43 to 1.06) and was associated with high risk of severe adverse reactions; and

Virus-Receptor Interactions of Glycosylated SARS-CoV-2 Spike and Human ACE2 Receptor

“…Furthermore, human SARS-CoV-2 at the whole-genome level is >95% identical to a bat coronavirus (RaTG13), the natural reservoir host for multiple coronaviruses ( Xia, 2020 ; Zhang et al., 2020 ; Zhou et al., 2020 ). Given the rapid appearance and spread of this virus, there is no current validated vaccine or SARS-CoV-2-specific targeting therapy that is clinically approved, although statins, heparin, and steroids look promising for lowering fatality rates, and antivirals likely reduce the duration of symptomatic disease presentation ( Alijotas-Reig et al., 2020 ; Beigel et al., 2020 ; Beun et al., 2020 ; Dashti-Khavidaki and Khalili, 2020 ; Fedson et al., 2020 ; Shi et al., 2020 ; Tang et al., 2020 ).…”

Virus-Receptor Interactions of Glycosylated SARS-CoV-2 Spike and Human ACE2 Receptor

“…Furthermore, human SARS-CoV-2 at the whole genome level is >95% identical to a bat coronavirus (RaTG13), the natural reservoir host for multiple coronaviruses (1, 4,5). Given the rapid appearance and spread of this virus, there is no current validated vaccine or SARS-CoV-2specific targeting therapy clinically approved although statins, heparin, and steroids look promising for lowering fatality rates and antivirals likely reduce the duration of symptomatic disease presentation (6)(7)(8)(9)(10)(11)(12).…”

Therapeutic interventions for COVID-19: a living overview of reviews

“…A range of study designs was included across different systematic reviews; most of which included retrospective/prospective observational studies and case series/case reports. The target population was confirmed cases of COVID-19 patients and included children in three reviews 43 , 46 , 47 and adult patients in the remaining studies. None of the included reviews reported on pregnant women.…”

“…arbidol hydrochloride, 20 , 23 , 28 , 30 , 31 , 33 , 34 , 44 , 46 , 49 , 53 , 56 , 58 , 60 and favipiravir), 20 , 23 , 46 , 53 , 58 neuraminidase inhibitors (e.g. oseltamivir), 19 , 23 , 31 , 33 , 44 , 46 , 53 , 56 , 60 nucleoside analogues (e.g. ribavirin), 23 , 28 , 31 , 33 , 34 , 44 , 46 , 56 , 58 nucleotide analogues (e.g.…”