The therapeutic effect and safety of the drugs for COVID-19: A systematic review and meta-analysis.
Identifieur interne : 000095 ( Main/Corpus ); précédent : 000094; suivant : 000096The therapeutic effect and safety of the drugs for COVID-19: A systematic review and meta-analysis.
Auteurs : Rong Qiu ; Jingwei Li ; Yuxuan Xiao ; Ziyi Gao ; Yihang Weng ; Qiran Zhang ; Chengdi Wang ; Hanlin Gong ; Weimin LiSource :
- Medicine [ 1536-5964 ] ; 2021.
English descriptors
- KwdEn :
- Angiotensin Receptor Antagonists (adverse effects), Angiotensin Receptor Antagonists (therapeutic use), Angiotensin-Converting Enzyme Inhibitors (adverse effects), Angiotensin-Converting Enzyme Inhibitors (therapeutic use), Antiviral Agents (adverse effects), Antiviral Agents (therapeutic use), COVID-19 (drug therapy), COVID-19 (mortality), Chloroquine (adverse effects), Chloroquine (therapeutic use), Humans (MeSH), Hydroxychloroquine (adverse effects), Hydroxychloroquine (therapeutic use), SARS-CoV-2 (MeSH), Treatment Outcome (MeSH).
- MESH :
- chemical , adverse effects : Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Antiviral Agents, Chloroquine, Hydroxychloroquine.
- chemical , therapeutic use : Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Antiviral Agents, Chloroquine, Hydroxychloroquine.
- drug therapy : COVID-19.
- mortality : COVID-19.
- Humans, SARS-CoV-2, Treatment Outcome.
Abstract
BACKGROUND
Coronavirus disease 2019 (COVID-19) has spread almost all regions of the world and caused great loss to the whole body of mankind. Thus, numerous clinical trials were conducted to find specific medicine for COVID-19 recently. However, it remains unanswered whether they are beneficial.
OBJECTIVE
This study aimed to evaluate the efficiency and safety of the COVID-19 medicine.
METHODS
Studies were determined through searching PubMed, Embase, Cochrane Library, and Medline. The studies of COVID-19 medicine were involved with eligible end points containing mortality, discharge rate, rate of clinical improvement, and rate of serious adverse events.
RESULTS
A total of 33 studies involving 37,879 patients were included in our study, whose intervening measures contained three major types of COVID-19 medicine, ACEI/ARB, antiviral medicine, and chloroquine/hydroxychloroquine. Compared to control group, COVID-19 drugs have no distinct effect on mortality (RR, 0.93; 95% CI, 0.79-1.11, P = .43) and discharge rate (RR, 1.06; 95% CI, 0.98-1.14, P = .13). However, antiviral medicine presents the obvious advantage in clinical improvement (RR, 1.11; 95% CI, 1.01-1.23, P < .05). In addition, the serious adverse events rate (RR, 0.75; 95% CI, 0.63-0.88, P < .05) of COVID-19 medicine is lower than control group.
CONCLUSION
The results indicated antiviral medicine was potential specific medicine for COVID-19 treatment by improving clinical symptoms, but it failed to increase the discharge rate and reduce mortality. Chloroquine/hydroxychloroquine and ACEI/ARB had no significant effect on treatment of COVID-19, thus they were not recommended for routine medication. Moreover, more trials are needed to find effective drugs to lower the mortality of COVID-19 patients.
DOI: 10.1097/MD.0000000000025532
PubMed: 33879694
PubMed Central: PMC8078467
Links to Exploration step
pubmed:33879694Le document en format XML
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sortKey="Gao, Ziyi" sort="Gao, Ziyi" uniqKey="Gao Z" first="Ziyi" last="Gao">Ziyi Gao</name><affiliation><nlm:affiliation>West China Medical School/West China Hospital.</nlm:affiliation></affiliation></author><author><name sortKey="Weng, Yihang" sort="Weng, Yihang" uniqKey="Weng Y" first="Yihang" last="Weng">Yihang Weng</name><affiliation><nlm:affiliation>West China School/Hospital of Stomatology.</nlm:affiliation></affiliation></author><author><name sortKey="Zhang, Qiran" sort="Zhang, Qiran" uniqKey="Zhang Q" first="Qiran" last="Zhang">Qiran Zhang</name><affiliation><nlm:affiliation>West China Medical School/West China Hospital.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Chengdi" sort="Wang, Chengdi" uniqKey="Wang C" first="Chengdi" last="Wang">Chengdi Wang</name><affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine.</nlm:affiliation></affiliation></author><author><name sortKey="Gong, Hanlin" sort="Gong, Hanlin" uniqKey="Gong H" 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for COVID-19: A systematic review and meta-analysis.</title><author><name sortKey="Qiu, Rong" sort="Qiu, Rong" uniqKey="Qiu R" first="Rong" last="Qiu">Rong Qiu</name><affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Jingwei" sort="Li, Jingwei" uniqKey="Li J" first="Jingwei" last="Li">Jingwei Li</name><affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>West China Medical School/West China Hospital.</nlm:affiliation></affiliation></author><author><name sortKey="Xiao, Yuxuan" sort="Xiao, Yuxuan" uniqKey="Xiao Y" first="Yuxuan" last="Xiao">Yuxuan Xiao</name><affiliation><nlm:affiliation>West China School/Hospital of Stomatology.</nlm:affiliation></affiliation></author><author><name sortKey="Gao, Ziyi" sort="Gao, Ziyi" uniqKey="Gao Z" first="Ziyi" last="Gao">Ziyi Gao</name><affiliation><nlm:affiliation>West China Medical School/West China Hospital.</nlm:affiliation></affiliation></author><author><name sortKey="Weng, Yihang" sort="Weng, Yihang" uniqKey="Weng Y" first="Yihang" last="Weng">Yihang Weng</name><affiliation><nlm:affiliation>West China School/Hospital of Stomatology.</nlm:affiliation></affiliation></author><author><name sortKey="Zhang, Qiran" sort="Zhang, Qiran" uniqKey="Zhang Q" first="Qiran" last="Zhang">Qiran Zhang</name><affiliation><nlm:affiliation>West China Medical School/West China Hospital.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Chengdi" sort="Wang, Chengdi" uniqKey="Wang C" first="Chengdi" last="Wang">Chengdi Wang</name><affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine.</nlm:affiliation></affiliation></author><author><name sortKey="Gong, Hanlin" sort="Gong, Hanlin" uniqKey="Gong H" first="Hanlin" last="Gong">Hanlin Gong</name><affiliation><nlm:affiliation>Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Weimin" sort="Li, Weimin" uniqKey="Li W" first="Weimin" last="Li">Weimin Li</name><affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Medicine</title><idno type="eISSN">1536-5964</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Angiotensin Receptor Antagonists (adverse effects)</term><term>Angiotensin Receptor Antagonists (therapeutic use)</term><term>Angiotensin-Converting Enzyme Inhibitors (adverse effects)</term><term>Angiotensin-Converting Enzyme Inhibitors (therapeutic use)</term><term>Antiviral Agents (adverse effects)</term><term>Antiviral Agents (therapeutic use)</term><term>COVID-19 (drug therapy)</term><term>COVID-19 (mortality)</term><term>Chloroquine (adverse effects)</term><term>Chloroquine (therapeutic use)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (adverse effects)</term><term>Hydroxychloroquine (therapeutic use)</term><term>SARS-CoV-2 (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Angiotensin Receptor Antagonists</term><term>Angiotensin-Converting Enzyme Inhibitors</term><term>Antiviral Agents</term><term>Chloroquine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Angiotensin Receptor Antagonists</term><term>Angiotensin-Converting Enzyme Inhibitors</term><term>Antiviral Agents</term><term>Chloroquine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>SARS-CoV-2</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Coronavirus disease 2019 (COVID-19) has spread almost all regions of the world and caused great loss to the whole body of mankind. Thus, numerous clinical trials were conducted to find specific medicine for COVID-19 recently. However, it remains unanswered whether they are beneficial.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>This study aimed to evaluate the efficiency and safety of the COVID-19 medicine.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Studies were determined through searching PubMed, Embase, Cochrane Library, and Medline. The studies of COVID-19 medicine were involved with eligible end points containing mortality, discharge rate, rate of clinical improvement, and rate of serious adverse events.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>A total of 33 studies involving 37,879 patients were included in our study, whose intervening measures contained three major types of COVID-19 medicine, ACEI/ARB, antiviral medicine, and chloroquine/hydroxychloroquine. Compared to control group, COVID-19 drugs have no distinct effect on mortality (RR, 0.93; 95% CI, 0.79-1.11, P = .43) and discharge rate (RR, 1.06; 95% CI, 0.98-1.14, P = .13). However, antiviral medicine presents the obvious advantage in clinical improvement (RR, 1.11; 95% CI, 1.01-1.23, P < .05). In addition, the serious adverse events rate (RR, 0.75; 95% CI, 0.63-0.88, P < .05) of COVID-19 medicine is lower than control group.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The results indicated antiviral medicine was potential specific medicine for COVID-19 treatment by improving clinical symptoms, but it failed to increase the discharge rate and reduce mortality. Chloroquine/hydroxychloroquine and ACEI/ARB had no significant effect on treatment of COVID-19, thus they were not recommended for routine medication. Moreover, more trials are needed to find effective drugs to lower the mortality of COVID-19 patients.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33879694</PMID><DateCompleted><Year>2021</Year><Month>04</Month><Day>27</Day></DateCompleted><DateRevised><Year>2021</Year><Month>05</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1536-5964</ISSN><JournalIssue CitedMedium="Internet"><Volume>100</Volume><Issue>16</Issue><PubDate><Year>2021</Year><Month>Apr</Month><Day>23</Day></PubDate></JournalIssue><Title>Medicine</Title><ISOAbbreviation>Medicine (Baltimore)</ISOAbbreviation></Journal><ArticleTitle>The therapeutic effect and safety of the drugs for COVID-19: A systematic review and meta-analysis.</ArticleTitle><Pagination><MedlinePgn>e25532</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/MD.0000000000025532</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Coronavirus disease 2019 (COVID-19) has spread almost all regions of the world and caused great loss to the whole body of mankind. Thus, numerous clinical trials were conducted to find specific medicine for COVID-19 recently. However, it remains unanswered whether they are beneficial.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">This study aimed to evaluate the efficiency and safety of the COVID-19 medicine.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Studies were determined through searching PubMed, Embase, Cochrane Library, and Medline. The studies of COVID-19 medicine were involved with eligible end points containing mortality, discharge rate, rate of clinical improvement, and rate of serious adverse events.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">A total of 33 studies involving 37,879 patients were included in our study, whose intervening measures contained three major types of COVID-19 medicine, ACEI/ARB, antiviral medicine, and chloroquine/hydroxychloroquine. Compared to control group, COVID-19 drugs have no distinct effect on mortality (RR, 0.93; 95% CI, 0.79-1.11, P = .43) and discharge rate (RR, 1.06; 95% CI, 0.98-1.14, P = .13). However, antiviral medicine presents the obvious advantage in clinical improvement (RR, 1.11; 95% CI, 1.01-1.23, P < .05). In addition, the serious adverse events rate (RR, 0.75; 95% CI, 0.63-0.88, P < .05) of COVID-19 medicine is lower than control group.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The results indicated antiviral medicine was potential specific medicine for COVID-19 treatment by improving clinical symptoms, but it failed to increase the discharge rate and reduce mortality. Chloroquine/hydroxychloroquine and ACEI/ARB had no significant effect on treatment of COVID-19, thus they were not recommended for routine medication. Moreover, more trials are needed to find effective drugs to lower the mortality of COVID-19 patients.</AbstractText><CopyrightInformation>Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Qiu</LastName><ForeName>Rong</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Jingwei</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>West China Medical School/West China Hospital.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xiao</LastName><ForeName>Yuxuan</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>West China School/Hospital of Stomatology.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gao</LastName><ForeName>Ziyi</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>West China Medical School/West China Hospital.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weng</LastName><ForeName>Yihang</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>West China School/Hospital of Stomatology.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Qiran</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>West China Medical School/West China Hospital.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Chengdi</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gong</LastName><ForeName>Hanlin</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Weimin</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>2019TX310002</GrantID><Agency>CAMS Innovation Fund for Medical Science</Agency><Country></Country></Grant><Grant><GrantID>2020ZYD009</GrantID><Agency>National Guided Science and Technology Development Project of Sichuan Province</Agency><Country></Country></Grant><Grant><GrantID>2017-CY02-00030-GX</GrantID><Agency>the Science and Technology Project of Chengdu</Agency><Country></Country></Grant><Grant><GrantID>2020HXBH084</GrantID><Agency>Postdoctoral Program of West China Hospital, Sichuan University</Agency><Country></Country></Grant><Grant><GrantID>C2021116604</GrantID><Agency>Grant of Innovative Research Project for College Students, Sichuan University, Ministry of Education</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Medicine (Baltimore)</MedlineTA><NlmUniqueID>2985248R</NlmUniqueID><ISSNLinking>0025-7974</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D057911">Angiotensin Receptor Antagonists</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000806">Angiotensin-Converting Enzyme Inhibitors</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>886U3H6UFF</RegistryNumber><NameOfSubstance UI="D002738">Chloroquine</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D057911" MajorTopicYN="N">Angiotensin Receptor Antagonists</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000806" MajorTopicYN="N">Angiotensin-Converting Enzyme Inhibitors</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002738" MajorTopicYN="N">Chloroquine</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><CoiStatement>The authors have no conflict of interest to disclose.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>11</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>03</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>4</Month><Day>21</Day><Hour>6</Hour><Minute>20</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>4</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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