Potential effectiveness and safety of antiviral agents in children with coronavirus disease 2019: a rapid review and meta-analysis.
Identifieur interne : 001344 ( Main/Corpus ); précédent : 001343; suivant : 001345Potential effectiveness and safety of antiviral agents in children with coronavirus disease 2019: a rapid review and meta-analysis.
Auteurs : Qianling Shi ; Qi Zhou ; Xia Wang ; Jing Liao ; Yang Yu ; Zijun Wang ; Shuya Lu ; Yanfang Ma ; Yangqin Xun ; Xufei Luo ; Weiguo Li ; Toshio Fukuoka ; Hyeong Sik Ahn ; Myeong Soo Lee ; Zhengxiu Luo ; Enmei Liu ; Yaolong Chen ; Qubei Li ; Kehu Yang ; Quanlin GuanSource :
- Annals of translational medicine [ 2305-5839 ] ; 2020.
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 oseltamivir had no effect on mortality (RR =0.87; 95% CI, 0.55 to 1.38). Ribavirin combined with interferon was also not effective in adults with MERS and associated with adverse reactions.
Conclusions
There is no evidence showing the effectiveness of antiviral agents for children with COVID-19, and the clinical efficacy of existing antiviral agents is still uncertain. We do not suggest clinical routine use of antivirals for COVID-19 in children, with the exception of clinical trials.
DOI: 10.21037/atm-20-3301
PubMed: 32566561
PubMed Central: PMC7290634
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Potential effectiveness and safety of antiviral agents in children with coronavirus disease 2019: a rapid review and meta-analysis.</title><author><name sortKey="Shi, Qianling" sort="Shi, Qianling" uniqKey="Shi Q" first="Qianling" last="Shi">Qianling Shi</name><affiliation><nlm:affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhou, Qi" sort="Zhou, Qi" uniqKey="Zhou Q" first="Qi" last="Zhou">Qi Zhou</name><affiliation><nlm:affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Xia" sort="Wang, Xia" uniqKey="Wang X" first="Xia" last="Wang">Xia Wang</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liao, Jing" sort="Liao, Jing" uniqKey="Liao J" first="Jing" last="Liao">Jing Liao</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yu, Yang" sort="Yu, Yang" uniqKey="Yu Y" first="Yang" last="Yu">Yang Yu</name><affiliation><nlm:affiliation>The Second School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Zijun" sort="Wang, Zijun" uniqKey="Wang Z" first="Zijun" last="Wang">Zijun Wang</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lu, Shuya" sort="Lu, Shuya" uniqKey="Lu S" first="Shuya" last="Lu">Shuya Lu</name><affiliation><nlm:affiliation>Department of Pediatric, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu 610072, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ma, Yanfang" sort="Ma, Yanfang" uniqKey="Ma Y" first="Yanfang" last="Ma">Yanfang Ma</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xun, Yangqin" sort="Xun, Yangqin" uniqKey="Xun Y" first="Yangqin" last="Xun">Yangqin Xun</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Luo, Xufei" sort="Luo, Xufei" uniqKey="Luo X" first="Xufei" last="Luo">Xufei Luo</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Public Health, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Weiguo" sort="Li, Weiguo" uniqKey="Li W" first="Weiguo" last="Li">Weiguo Li</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Fukuoka, Toshio" sort="Fukuoka, Toshio" uniqKey="Fukuoka T" first="Toshio" last="Fukuoka">Toshio Fukuoka</name><affiliation><nlm:affiliation>Emergency and Critical Care Center, Department of General Medicine, Department of Research and Medical Education at Kurashiki Central Hospital, Kurashiki, Japan.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Advisory Committee in Cochrane Japan, Tokyo, Japan.</nlm:affiliation></affiliation></author><author><name sortKey="Ahn, Hyeong Sik" sort="Ahn, Hyeong Sik" uniqKey="Ahn H" first="Hyeong Sik" last="Ahn">Hyeong Sik Ahn</name><affiliation><nlm:affiliation>Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Korea Cochrane Centre, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Myeong Soo" sort="Lee, Myeong Soo" uniqKey="Lee M" first="Myeong Soo" last="Lee">Myeong Soo Lee</name><affiliation><nlm:affiliation>Korea Institute of Oriental Medicine, Daejeon, Korea.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>University of Science and Technology, Daejeon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Luo, Zhengxiu" sort="Luo, Zhengxiu" uniqKey="Luo Z" first="Zhengxiu" last="Luo">Zhengxiu Luo</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Enmei" sort="Liu, Enmei" uniqKey="Liu E" first="Enmei" last="Liu">Enmei Liu</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Yaolong" sort="Chen, Yaolong" uniqKey="Chen Y" first="Yaolong" last="Chen">Yaolong Chen</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Lanzhou University, An Affiliate of the Cochrane China Network, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chinese GRADE Center, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Qubei" sort="Li, Qubei" uniqKey="Li Q" first="Qubei" last="Li">Qubei Li</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yang, Kehu" sort="Yang, Kehu" uniqKey="Yang K" first="Kehu" last="Yang">Kehu Yang</name><affiliation><nlm:affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Guan, Quanlin" sort="Guan, Quanlin" uniqKey="Guan Q" first="Quanlin" last="Guan">Quanlin Guan</name><affiliation><nlm:affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Oncology Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32566561</idno><idno type="pmid">32566561</idno><idno type="doi">10.21037/atm-20-3301</idno><idno type="pmc">PMC7290634</idno><idno type="wicri:Area/Main/Corpus">001344</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001344</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Potential effectiveness and safety of antiviral agents in children with coronavirus disease 2019: a rapid review and meta-analysis.</title><author><name sortKey="Shi, Qianling" sort="Shi, Qianling" uniqKey="Shi Q" first="Qianling" last="Shi">Qianling Shi</name><affiliation><nlm:affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhou, Qi" sort="Zhou, Qi" uniqKey="Zhou Q" first="Qi" last="Zhou">Qi Zhou</name><affiliation><nlm:affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Xia" sort="Wang, Xia" uniqKey="Wang X" first="Xia" last="Wang">Xia Wang</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liao, Jing" sort="Liao, Jing" uniqKey="Liao J" first="Jing" last="Liao">Jing Liao</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yu, Yang" sort="Yu, Yang" uniqKey="Yu Y" first="Yang" last="Yu">Yang Yu</name><affiliation><nlm:affiliation>The Second School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Wang, Zijun" sort="Wang, Zijun" uniqKey="Wang Z" first="Zijun" last="Wang">Zijun Wang</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lu, Shuya" sort="Lu, Shuya" uniqKey="Lu S" first="Shuya" last="Lu">Shuya Lu</name><affiliation><nlm:affiliation>Department of Pediatric, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu 610072, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ma, Yanfang" sort="Ma, Yanfang" uniqKey="Ma Y" first="Yanfang" last="Ma">Yanfang Ma</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Xun, Yangqin" sort="Xun, Yangqin" uniqKey="Xun Y" first="Yangqin" last="Xun">Yangqin Xun</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Luo, Xufei" sort="Luo, Xufei" uniqKey="Luo X" first="Xufei" last="Luo">Xufei Luo</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>School of Public Health, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Weiguo" sort="Li, Weiguo" uniqKey="Li W" first="Weiguo" last="Li">Weiguo Li</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Fukuoka, Toshio" sort="Fukuoka, Toshio" uniqKey="Fukuoka T" first="Toshio" last="Fukuoka">Toshio Fukuoka</name><affiliation><nlm:affiliation>Emergency and Critical Care Center, Department of General Medicine, Department of Research and Medical Education at Kurashiki Central Hospital, Kurashiki, Japan.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Advisory Committee in Cochrane Japan, Tokyo, Japan.</nlm:affiliation></affiliation></author><author><name sortKey="Ahn, Hyeong Sik" sort="Ahn, Hyeong Sik" uniqKey="Ahn H" first="Hyeong Sik" last="Ahn">Hyeong Sik Ahn</name><affiliation><nlm:affiliation>Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Korea Cochrane Centre, Seoul, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Myeong Soo" sort="Lee, Myeong Soo" uniqKey="Lee M" first="Myeong Soo" last="Lee">Myeong Soo Lee</name><affiliation><nlm:affiliation>Korea Institute of Oriental Medicine, Daejeon, Korea.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>University of Science and Technology, Daejeon, Korea.</nlm:affiliation></affiliation></author><author><name sortKey="Luo, Zhengxiu" sort="Luo, Zhengxiu" uniqKey="Luo Z" first="Zhengxiu" last="Luo">Zhengxiu Luo</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Enmei" sort="Liu, Enmei" uniqKey="Liu E" first="Enmei" last="Liu">Enmei Liu</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Chen, Yaolong" sort="Chen, Yaolong" uniqKey="Chen Y" first="Yaolong" last="Chen">Yaolong Chen</name><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Lanzhou University, An Affiliate of the Cochrane China Network, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chinese GRADE Center, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Qubei" sort="Li, Qubei" uniqKey="Li Q" first="Qubei" last="Li">Qubei Li</name><affiliation><nlm:affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</nlm:affiliation></affiliation></author><author><name sortKey="Yang, Kehu" sort="Yang, Kehu" uniqKey="Yang K" first="Kehu" last="Yang">Kehu Yang</name><affiliation><nlm:affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Guan, Quanlin" sort="Guan, Quanlin" uniqKey="Guan Q" first="Quanlin" last="Guan">Quanlin Guan</name><affiliation><nlm:affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Oncology Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Annals of translational medicine</title><idno type="ISSN">2305-5839</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Background</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>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 oseltamivir had no effect on mortality (RR =0.87; 95% CI, 0.55 to 1.38). Ribavirin combined with interferon was also not effective in adults with MERS and associated with adverse reactions.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusions</b></p><p>There is no evidence showing the effectiveness of antiviral agents for children with COVID-19, and the clinical efficacy of existing antiviral agents is still uncertain. We do not suggest clinical routine use of antivirals for COVID-19 in children, with the exception of clinical trials.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32566561</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>28</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">2305-5839</ISSN><JournalIssue CitedMedium="Print"><Volume>8</Volume><Issue>10</Issue><PubDate><Year>2020</Year><Month>May</Month></PubDate></JournalIssue><Title>Annals of translational medicine</Title><ISOAbbreviation>Ann Transl Med</ISOAbbreviation></Journal><ArticleTitle>Potential effectiveness and safety of antiviral agents in children with coronavirus disease 2019: a rapid review and meta-analysis.</ArticleTitle><Pagination><MedlinePgn>624</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.21037/atm-20-3301</ELocationID><Abstract><AbstractText Label="Background" NlmCategory="UNASSIGNED">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.</AbstractText><AbstractText Label="Methods" NlmCategory="UNASSIGNED">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.</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">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 oseltamivir had no effect on mortality (RR =0.87; 95% CI, 0.55 to 1.38). Ribavirin combined with interferon was also not effective in adults with MERS and associated with adverse reactions.</AbstractText><AbstractText Label="Conclusions" NlmCategory="UNASSIGNED">There is no evidence showing the effectiveness of antiviral agents for children with COVID-19, and the clinical efficacy of existing antiviral agents is still uncertain. We do not suggest clinical routine use of antivirals for COVID-19 in children, with the exception of clinical trials.</AbstractText><CopyrightInformation>2020 Annals of Translational Medicine. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Shi</LastName><ForeName>Qianling</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhou</LastName><ForeName>Qi</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Xia</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liao</LastName><ForeName>Jing</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yu</LastName><ForeName>Yang</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>The Second School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wang</LastName><ForeName>Zijun</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lu</LastName><ForeName>Shuya</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Pediatric, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu 611731, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu 610072, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ma</LastName><ForeName>Yanfang</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Xun</LastName><ForeName>Yangqin</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Luo</LastName><ForeName>Xufei</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Public Health, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Weiguo</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fukuoka</LastName><ForeName>Toshio</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Emergency and Critical Care Center, Department of General Medicine, Department of Research and Medical Education at Kurashiki Central Hospital, Kurashiki, Japan.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Advisory Committee in Cochrane Japan, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ahn</LastName><ForeName>Hyeong Sik</ForeName><Initials>HS</Initials><AffiliationInfo><Affiliation>Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Korea Cochrane Centre, Seoul, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Myeong Soo</ForeName><Initials>MS</Initials><AffiliationInfo><Affiliation>Korea Institute of Oriental Medicine, Daejeon, Korea.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>University of Science and Technology, Daejeon, Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Luo</LastName><ForeName>Zhengxiu</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Enmei</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Yaolong</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Lanzhou University, An Affiliate of the Cochrane China Network, Lanzhou 730000, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Chinese GRADE Center, Lanzhou 730000, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Qubei</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yang</LastName><ForeName>Kehu</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guan</LastName><ForeName>Quanlin</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Oncology Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>COVID-19 Evidence and Recommendations Working Group</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>China</Country><MedlineTA>Ann Transl Med</MedlineTA><NlmUniqueID>101617978</NlmUniqueID><ISSNLinking>2305-5839</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Antiviral agents</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">children</Keyword><Keyword MajorTopicYN="N">meta-analysis</Keyword><Keyword MajorTopicYN="N">rapid review</Keyword></KeywordList><CoiStatement>Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-3301). MSL serves as the unpaid editorial board member of Annals of Translational Medicine from Nov 2019 to Oct 2021. 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