Prophylaxis for COVID-19: a systematic review.
Identifieur interne : 000457 ( Main/Corpus ); précédent : 000456; suivant : 000458Prophylaxis for COVID-19: a systematic review.
Auteurs : Mikaela Smit ; Annalisa Marinosci ; Thomas Agoritsas ; Alexandra CalmySource :
- Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [ 1469-0691 ] ; 2021.
English descriptors
- KwdEn :
- Animals (MeSH), Antibodies, Monoclonal (therapeutic use), Antibodies, Neutralizing (therapeutic use), Antibodies, Viral (therapeutic use), Antimalarials (therapeutic use), Antiviral Agents (therapeutic use), COVID-19 (prevention & control), Humans (MeSH), Hydroxychloroquine (therapeutic use), Post-Exposure Prophylaxis (MeSH), Pre-Exposure Prophylaxis (MeSH), Randomized Controlled Trials as Topic (MeSH), SARS-CoV-2 (immunology), Vaccines (MeSH).
- MESH :
- chemical , therapeutic use : Antibodies, Monoclonal, Antibodies, Neutralizing, Antibodies, Viral, Antimalarials, Antiviral Agents, Hydroxychloroquine.
- immunology : SARS-CoV-2.
- prevention & control : COVID-19.
- Animals, Humans, Post-Exposure Prophylaxis, Pre-Exposure Prophylaxis, Randomized Controlled Trials as Topic, Vaccines.
Abstract
BACKGROUND
While the landscape of vaccine and treatment candidates against the novel coronavirus disease 2019 (COVID-19) has been reviewed systematically, prophylactic candidates remain unexplored.
OBJECTIVES
To map pre- and postexposure prophylactic (PrEP and PEP) candidate for COVID-19.
DATA SOURCES
PubMed/Medline, Embase, International Committee of Medical Journal Editors and International Clinical Trials Registry Platform clinical trial registries and medRxiv.
STUDY ELIGIBILITY CRITERIA AND PARTICIPANTS
All studies in humans or animals and randomized controlled trials (RCTs) in humans reporting primary data on prophylactic candidates against COVID-19, excluding studies focused on key populations.
INTERVENTIONS
PrEP and PEP candidate for COVID-19.
METHODS
Systematic review and qualitative synthesis of COVID-19 PrEP and PEP studies and RCTs complemented by search of medRxiv and PubMed and Embase for studies reporting RCT outcomes since systematic review search completion.
RESULTS
We identified 13 studies (from 2119 database records) and 117 RCTs (from 5565 RCTs listed in the registries) that met the inclusion criteria. Non-RCT studies reported on cross-sectional studies using hydroxychloroquine (HCQ) in humans (n = 2) or reported on animal studies (n = 7), most of which used antibodies. All five completed RCTs focused on the use of HCQ as either PrEP or PEP, and these and the cross-sectional studies reported no prophylactic effect. The majority of ongoing RCTs evaluated HCQ or other existing candidates including non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, anti(retro)virals or use of vitamins and supplements.
CONCLUSIONS
The key message from completed studies and RCTs seems to be that HCQ does not work. There is little evidence regarding other compounds, with all RCTs using candidates other than HCQ still ongoing. It remains to be seen if the portfolio of existing molecules being evaluated in RCTs will identify successful prophylaxis against COVID-19 or if there is a need for the development of new candidates.
DOI: 10.1016/j.cmi.2021.01.013
PubMed: 33476807
PubMed Central: PMC7813508
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pubmed:33476807Le document en format XML
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Electronic address: mikaela.smit@hcuge.ch.</nlm:affiliation></affiliation></author><author><name sortKey="Marinosci, Annalisa" sort="Marinosci, Annalisa" uniqKey="Marinosci A" first="Annalisa" last="Marinosci">Annalisa Marinosci</name><affiliation><nlm:affiliation>HIV/AIDS Unit, Department of Infectious Diseases, Geneva, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Agoritsas, Thomas" sort="Agoritsas, Thomas" uniqKey="Agoritsas T" first="Thomas" last="Agoritsas">Thomas Agoritsas</name><affiliation><nlm:affiliation>Department of Medicine, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Health Research Methods, Evidence and Impact, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Calmy, Alexandra" sort="Calmy, Alexandra" uniqKey="Calmy A" first="Alexandra" last="Calmy">Alexandra Calmy</name><affiliation><nlm:affiliation>HIV/AIDS Unit, Department of Infectious Diseases, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33476807</idno><idno type="pmid">33476807</idno><idno type="doi">10.1016/j.cmi.2021.01.013</idno><idno type="pmc">PMC7813508</idno><idno type="wicri:Area/Main/Corpus">000457</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000457</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Prophylaxis for COVID-19: a systematic review.</title><author><name sortKey="Smit, Mikaela" sort="Smit, Mikaela" uniqKey="Smit M" first="Mikaela" last="Smit">Mikaela Smit</name><affiliation><nlm:affiliation>HIV/AIDS Unit, Department of Infectious Diseases, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: mikaela.smit@hcuge.ch.</nlm:affiliation></affiliation></author><author><name sortKey="Marinosci, Annalisa" sort="Marinosci, Annalisa" uniqKey="Marinosci A" first="Annalisa" last="Marinosci">Annalisa Marinosci</name><affiliation><nlm:affiliation>HIV/AIDS Unit, Department of Infectious Diseases, Geneva, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Agoritsas, Thomas" sort="Agoritsas, Thomas" uniqKey="Agoritsas T" first="Thomas" last="Agoritsas">Thomas Agoritsas</name><affiliation><nlm:affiliation>Department of Medicine, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Health Research Methods, Evidence and Impact, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Calmy, Alexandra" sort="Calmy, Alexandra" uniqKey="Calmy A" first="Alexandra" last="Calmy">Alexandra Calmy</name><affiliation><nlm:affiliation>HIV/AIDS Unit, Department of Infectious Diseases, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases</title><idno type="eISSN">1469-0691</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Animals (MeSH)</term><term>Antibodies, Monoclonal (therapeutic use)</term><term>Antibodies, Neutralizing (therapeutic use)</term><term>Antibodies, Viral (therapeutic use)</term><term>Antimalarials (therapeutic use)</term><term>Antiviral Agents (therapeutic use)</term><term>COVID-19 (prevention & control)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Post-Exposure Prophylaxis (MeSH)</term><term>Pre-Exposure Prophylaxis (MeSH)</term><term>Randomized Controlled Trials as Topic (MeSH)</term><term>SARS-CoV-2 (immunology)</term><term>Vaccines (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antibodies, Monoclonal</term><term>Antibodies, Neutralizing</term><term>Antibodies, Viral</term><term>Antimalarials</term><term>Antiviral Agents</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="immunology" xml:lang="en"><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Animals</term><term>Humans</term><term>Post-Exposure Prophylaxis</term><term>Pre-Exposure Prophylaxis</term><term>Randomized Controlled Trials as Topic</term><term>Vaccines</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>While the landscape of vaccine and treatment candidates against the novel coronavirus disease 2019 (COVID-19) has been reviewed systematically, prophylactic candidates remain unexplored.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>To map pre- and postexposure prophylactic (PrEP and PEP) candidate for COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>DATA SOURCES</b></p><p>PubMed/Medline, Embase, International Committee of Medical Journal Editors and International Clinical Trials Registry Platform clinical trial registries and medRxiv.</p></div><div type="abstract" xml:lang="en"><p><b>STUDY ELIGIBILITY CRITERIA AND PARTICIPANTS</b></p><p>All studies in humans or animals and randomized controlled trials (RCTs) in humans reporting primary data on prophylactic candidates against COVID-19, excluding studies focused on key populations.</p></div><div type="abstract" xml:lang="en"><p><b>INTERVENTIONS</b></p><p>PrEP and PEP candidate for COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Systematic review and qualitative synthesis of COVID-19 PrEP and PEP studies and RCTs complemented by search of medRxiv and PubMed and Embase for studies reporting RCT outcomes since systematic review search completion.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We identified 13 studies (from 2119 database records) and 117 RCTs (from 5565 RCTs listed in the registries) that met the inclusion criteria. Non-RCT studies reported on cross-sectional studies using hydroxychloroquine (HCQ) in humans (n = 2) or reported on animal studies (n = 7), most of which used antibodies. All five completed RCTs focused on the use of HCQ as either PrEP or PEP, and these and the cross-sectional studies reported no prophylactic effect. The majority of ongoing RCTs evaluated HCQ or other existing candidates including non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, anti(retro)virals or use of vitamins and supplements.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The key message from completed studies and RCTs seems to be that HCQ does not work. There is little evidence regarding other compounds, with all RCTs using candidates other than HCQ still ongoing. It remains to be seen if the portfolio of existing molecules being evaluated in RCTs will identify successful prophylaxis against COVID-19 or if there is a need for the development of new candidates.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33476807</PMID><DateCompleted><Year>2021</Year><Month>04</Month><Day>19</Day></DateCompleted><DateRevised><Year>2021</Year><Month>04</Month><Day>19</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1469-0691</ISSN><JournalIssue CitedMedium="Internet"><Volume>27</Volume><Issue>4</Issue><PubDate><Year>2021</Year><Month>Apr</Month></PubDate></JournalIssue><Title>Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases</Title><ISOAbbreviation>Clin Microbiol Infect</ISOAbbreviation></Journal><ArticleTitle>Prophylaxis for COVID-19: a systematic review.</ArticleTitle><Pagination><MedlinePgn>532-537</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1198-743X(21)00040-9</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.cmi.2021.01.013</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">While the landscape of vaccine and treatment candidates against the novel coronavirus disease 2019 (COVID-19) has been reviewed systematically, prophylactic candidates remain unexplored.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To map pre- and postexposure prophylactic (PrEP and PEP) candidate for COVID-19.</AbstractText><AbstractText Label="DATA SOURCES" NlmCategory="METHODS">PubMed/Medline, Embase, International Committee of Medical Journal Editors and International Clinical Trials Registry Platform clinical trial registries and medRxiv.</AbstractText><AbstractText Label="STUDY ELIGIBILITY CRITERIA AND PARTICIPANTS" NlmCategory="UNASSIGNED">All studies in humans or animals and randomized controlled trials (RCTs) in humans reporting primary data on prophylactic candidates against COVID-19, excluding studies focused on key populations.</AbstractText><AbstractText Label="INTERVENTIONS" NlmCategory="METHODS">PrEP and PEP candidate for COVID-19.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Systematic review and qualitative synthesis of COVID-19 PrEP and PEP studies and RCTs complemented by search of medRxiv and PubMed and Embase for studies reporting RCT outcomes since systematic review search completion.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We identified 13 studies (from 2119 database records) and 117 RCTs (from 5565 RCTs listed in the registries) that met the inclusion criteria. Non-RCT studies reported on cross-sectional studies using hydroxychloroquine (HCQ) in humans (n = 2) or reported on animal studies (n = 7), most of which used antibodies. All five completed RCTs focused on the use of HCQ as either PrEP or PEP, and these and the cross-sectional studies reported no prophylactic effect. The majority of ongoing RCTs evaluated HCQ or other existing candidates including non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, anti(retro)virals or use of vitamins and supplements.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The key message from completed studies and RCTs seems to be that HCQ does not work. There is little evidence regarding other compounds, with all RCTs using candidates other than HCQ still ongoing. It remains to be seen if the portfolio of existing molecules being evaluated in RCTs will identify successful prophylaxis against COVID-19 or if there is a need for the development of new candidates.</AbstractText><CopyrightInformation>Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Smit</LastName><ForeName>Mikaela</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>HIV/AIDS Unit, Department of Infectious Diseases, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address: mikaela.smit@hcuge.ch.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marinosci</LastName><ForeName>Annalisa</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>HIV/AIDS Unit, Department of Infectious Diseases, Geneva, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Agoritsas</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Medicine, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Health Research Methods, Evidence and Impact, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Calmy</LastName><ForeName>Alexandra</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>HIV/AIDS Unit, Department of Infectious Diseases, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, 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