Review of trials currently testing treatment and prevention of COVID-19

Abstract

Background: As COVID-19 cases continue to rise globally, evidence from large randomized controlled trials is still lacking. Currently, numerous trials testing potential treatment and preventative options are being undertaken all over the world.

Objectives: We summarized all registered clinical trials examining treatment and prevention options for COVID-19. Additionally, we evaluated the quality of the retrieved studies.

Data sources: Clinicaltrials.gov, the Chinese Clinical Trial Registry and the European Union Clinical Trials Register were systematically searched.

Study eligibility criteria: Registered clinical trials examining treatment and/or prevention options for COVID-19 were included. No language, country or study design restrictions were applied. We excluded withdrawn or cancelled studies and trials not reporting therapeutic or preventative strategies for COVID-19.

Participants and interventions: No restrictions in terms of participants' age and medical background or type of intervention were enforced.

Methods: The registries were searched using the term 'coronavirus' or 'COVID-19' from their inception until 26 March 2020. Additional manual search of the registries was also performed. Eligible studies were summarized and tabulated. Interventional trials were methodologically analysed, excluding expanded access studies and trials testing traditional Chinese medicine.

Results: In total, 309 trials evaluating therapeutic management options, 23 studies assessing preventive strategies and three studies examining both were retrieved. Finally, 214 studies were methodologically reviewed. Interventional treatment studies were mostly randomized (n = 150/198, 76%) and open label (n = 73/198, 37%) with a median number of planned inclusions of 90 (interquartile range 40-200). Major categories of interventions that are currently being investigated are discussed.

Conclusions: Numerous clinical trials have been registered since the onset of the COVID-19 pandemic. Summarized data on these trials will assist physicians and researchers to promote patient care and guide future research efforts for COVID-19 pandemic containment.

Keywords: Anti-inflammatory; Antivirals; COVID-19; Clinical trials; Immunomodulators; Novel coronavirus; Pneumonia; Prevention; SARS-CoV-2; Treatment.

Graphical abstract

Fig. 1

Systematic review flow chart.

Fig. 2

Currently tested therapeutic molecules targeting different steps of SARS-CoV-2 life cycle. Numbers in parentheses refer to the number of the registered trials per intervention.

Fig. 3

General and supportive therapeutic interventions tested for novel coronavirus disease (COVID-19). Numbers in parentheses refer to the number of the registered trials per intervention.

Fig. 4

Number of trials reported by the median of the total number of planned inclusions per trial for the most common treatments.

Fig. 5

Number of trials per total number of planned inclusions for the ten most frequently assessed treatments. The size of the circle corresponds to the addition of the total numbers of planned inclusions for all trials evaluating one of the treatments.