Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications.
Identifieur interne : 000B78 ( Main/Exploration ); précédent : 000B77; suivant : 000B79Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications.
Auteurs : Abdullahi Rabiu Abubakar [Nigeria] ; Ibrahim Haruna Sani [Nigeria] ; Brian Godman [Royaume-Uni] ; Santosh Kumar [Inde] ; Salequl Islam [Bangladesh] ; Iffat Jahan [Bangladesh] ; Mainul Haque [Malaisie]Source :
- Infection and drug resistance [ 1178-6973 ] ; 2020.
Abstract
A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.
DOI: 10.2147/IDR.S289037
PubMed: 33402839
PubMed Central: PMC7778508
Affiliations:
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last="Abubakar">Abdullahi Rabiu Abubakar</name><affiliation wicri:level="1"><nlm:affiliation>Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, Nigeria.</nlm:affiliation><country xml:lang="fr">Nigeria</country><wicri:regionArea>Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano</wicri:regionArea><wicri:noRegion>Kano</wicri:noRegion></affiliation></author><author><name sortKey="Sani, Ibrahim Haruna" sort="Sani, Ibrahim Haruna" uniqKey="Sani I" first="Ibrahim Haruna" last="Sani">Ibrahim Haruna Sani</name><affiliation wicri:level="1"><nlm:affiliation>Unit of Pharmacology, College of Health Sciences, Yusuf Maitama Sule University, Kano, Nigeria.</nlm:affiliation><country xml:lang="fr">Nigeria</country><wicri:regionArea>Unit of Pharmacology, College of Health Sciences, Yusuf Maitama Sule University, 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Cumilla</wicri:regionArea><wicri:noRegion>Cumilla</wicri:noRegion></affiliation></author><author><name sortKey="Haque, Mainul" sort="Haque, Mainul" uniqKey="Haque M" first="Mainul" last="Haque">Mainul Haque</name><affiliation wicri:level="1"><nlm:affiliation>Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia.</nlm:affiliation><country xml:lang="fr">Malaisie</country><wicri:regionArea>Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000</wicri:regionArea><wicri:noRegion>57000</wicri:noRegion></affiliation></author></analytic><series><title level="j">Infection and drug resistance</title><idno type="ISSN">1178-6973</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">A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">33402839</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>11</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1178-6973</ISSN><JournalIssue CitedMedium="Print"><Volume>13</Volume><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>Infection and drug resistance</Title><ISOAbbreviation>Infect Drug Resist</ISOAbbreviation></Journal><ArticleTitle>Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications.</ArticleTitle><Pagination><MedlinePgn>4673-4695</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.2147/IDR.S289037</ELocationID><Abstract><AbstractText>A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.</AbstractText><CopyrightInformation>© 2020 Abubakar et al.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Abubakar</LastName><ForeName>Abdullahi Rabiu</ForeName><Initials>AR</Initials><Identifier Source="ORCID">0000-0002-9740-7856</Identifier><AffiliationInfo><Affiliation>Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, Nigeria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sani</LastName><ForeName>Ibrahim Haruna</ForeName><Initials>IH</Initials><Identifier Source="ORCID">0000-0003-1153-5900</Identifier><AffiliationInfo><Affiliation>Unit of Pharmacology, College of Health Sciences, Yusuf Maitama Sule University, Kano, Nigeria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Godman</LastName><ForeName>Brian</ForeName><Initials>B</Initials><Identifier Source="ORCID">0000-0001-6539-6972</Identifier><AffiliationInfo><Affiliation>Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kumar</LastName><ForeName>Santosh</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0002-5117-7872</Identifier><AffiliationInfo><Affiliation>Department of Periodontology and Implantology, Karnavati University, Gandhinagar 382422, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Islam</LastName><ForeName>Salequl</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0001-6131-4132</Identifier><AffiliationInfo><Affiliation>Department of Microbiology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jahan</LastName><ForeName>Iffat</ForeName><Initials>I</Initials><Identifier Source="ORCID">0000-0003-0551-3609</Identifier><AffiliationInfo><Affiliation>Department of Physiology, Eastern Medical College, Cumilla, Bangladesh.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Haque</LastName><ForeName>Mainul</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0002-6124-7993</Identifier><AffiliationInfo><Affiliation>Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>12</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>New Zealand</Country><MedlineTA>Infect Drug Resist</MedlineTA><NlmUniqueID>101550216</NlmUniqueID><ISSNLinking>1178-6973</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">clinical-trials</Keyword><Keyword MajorTopicYN="N">dexamethasone</Keyword><Keyword MajorTopicYN="N">efficacy</Keyword><Keyword MajorTopicYN="N">hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">lopinavir/ritonavir</Keyword><Keyword MajorTopicYN="N">remdesivir</Keyword><Keyword MajorTopicYN="N">therapeutic-option</Keyword></KeywordList><CoiStatement>The authors report no conflicts of interest for this work and declare that they do not have any financial involvement or affiliations with any organization, association, or entity directly or indirectly with the subject matter or materials presented in this article. This also includes honoraria, expert testimony, employment, ownership of stocks or options, patents or grants received or pending, or royalties.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>10</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>12</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>1</Month><Day>6</Day><Hour>5</Hour><Minute>52</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>1</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>1</Month><Day>7</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33402839</ArticleId><ArticleId IdType="doi">10.2147/IDR.S289037</ArticleId><ArticleId 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