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Review
. 2020;2(8):1120-1131.
doi: 10.1007/s42399-020-00399-6. Epub 2020 Jul 15.

Systematic and Statistical Review of Coronavirus Disease 19 Treatment Trials

Juan A Siordia Jr  1 , Michael Bernaba  1 , Kenji Yoshino  1 , Abid Ulhaque  1 , Sooraj Kumar  1 , Mario Bernaba  1 , Edward Bergin  1
Affiliations
Review

Systematic and Statistical Review of Coronavirus Disease 19 Treatment Trials

Juan A Siordia Jr et al. SN Compr Clin Med. 2020.

Abstract

The following systematic review and meta-analysis compile the current data regarding human controlled COVID-19 treatment trials. An electronic search of the literature compiled studies pertaining to human controlled treatment trials with COVID-19. Medications assessed included lopinavir/ritonavir, arbidol, hydroxychloroquine, tocilizumab, favipiravir, heparin, and dexamethasone. Statistical analyses were performed for common viral clearance endpoints whenever possible. Lopinavir/ritonavir showed no significant effect on viral clearance for COVID-19 cases (OR 0.95 [95% CI 0.50-1.83]). Hydroxychloroquine also showed no significant effect on COVID-19 viral clearance rates (OR 2.16 [95% CI 0.80-5.84]). Arbidol showed no 7-day (OR 1.63 [95% CI 0.76-3.50]) or 14-day viral (OR 5.37 [95% CI 0.35-83.30]) clearance difference compared to lopinavir/ritonavir. Review of literature showed no significant clinical improvement with lopinavir/ritonavir, arbidol, hydroxychloroquine, or remdesivir. Tocilizumab showed mixed results regarding survival. Favipiravir showed quicker symptom improvement compared to lopinavir/ritonavir and arbidol. Heparin and dexamethasone showed improvement with severe COVID-19 cases requiring supplemental oxygenation. Current medications do not show significant effect on COVID-19 viral clearance rates. Tocilizumab showed mixed results regarding survival. Favipiravir shows favorable results compared to other tested medications. Heparin and dexamethasone show benefit especially for severe COVID-19 cases.

Keywords: Arbidol; COVID-19; Coronavirus; Dexamethasone; Favipiravir; Heparin; Hydroxychloroquine; Lopinavir/ritonavir; Remdesivir; SARS-CoV2; Tocilizumab; Treatment; Trials.

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Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flowchart revealing study selection process
Fig. 2
Fig. 2
Positive-to-negative RT-PCR conversion of lopinavir/ritonavir versus control at 14 days
Fig. 3
Fig. 3
Positive-to-negative RT-PCR conversion of arbidol versus lopinavir/ritonavir versus at 7 days
Fig. 4
Fig. 4
Positive-to-negative RT-PCR conversion of arbidol versus lopinavir/ritonavir versus at 14 days
Fig. 5
Fig. 5
Positive-to-negative conversion of hydroxychloroquine versus control at 6–7 days
Fig. 6
Fig. 6
Randomized controlled trials showing positive-to-negative conversion of hydroxychloroquine versus control at 6–7 days
See this image and copyright information in PMC

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