Perspectives on the Early Quality of Evidence Guiding the Therapeutic Management of SARS CoV-2: A Systematic Literature Review
Abstract Background:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak is a serious health concern. Repurposing of existing drugs indicated for other conditions seems to be the first choice for immediate therapeutic management. The quality of early evidence favoring the different treatment options needs to be apprised for informed decision making. Methods:In this systematic literature review, we apprised the quality of available evidence for different therapeutic options and also the basis for different treatment guidelines. In order to include all studies that are in different stages of publications, we also included studies from the preprint servers, BioRxiv, MedRxiv and published studies from PubMed. Results:We retrieved 5621 articles and included 20 studies for the systematic review. Based on our study, chloroquine/hydroxychloroquine either alone or in combination with azithromycin, remdesivir, corticosteroids, convalescent sera, ritonavir/lopinavir and arbidol were evaluated as therapeutic options. The data from different study designs reveal contradictory findings except for convalescent sera for which the evidence available is only from case series. Based on these early evidence, various national guidelines recommend remdesivir, convalescent sera, corticosteroids, hydroxychloroquine in different sub set of patients. Conclusion:Establishing consensus with respect to the endpoints to be assessed for respiratory viruses may enhance the quality of evidences in case of future pandemics. Further clinical evidence from the ongoing trials may lead to evolution of treatment guidelines with the addition of more therapeutic options..
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Preprint| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
ResearchSquare.com - (2022) vom: 28. Juli Zur Gesamtaufnahme - year:2022 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Subramanian, Kaushik [VerfasserIn] |
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| doi: |
10.21203/rs.3.rs-40221/v1 |
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XRA034614737 |
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| 520 | |a Abstract Background:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak is a serious health concern. Repurposing of existing drugs indicated for other conditions seems to be the first choice for immediate therapeutic management. The quality of early evidence favoring the different treatment options needs to be apprised for informed decision making. Methods:In this systematic literature review, we apprised the quality of available evidence for different therapeutic options and also the basis for different treatment guidelines. In order to include all studies that are in different stages of publications, we also included studies from the preprint servers, BioRxiv, MedRxiv and published studies from PubMed. Results:We retrieved 5621 articles and included 20 studies for the systematic review. Based on our study, chloroquine/hydroxychloroquine either alone or in combination with azithromycin, remdesivir, corticosteroids, convalescent sera, ritonavir/lopinavir and arbidol were evaluated as therapeutic options. The data from different study designs reveal contradictory findings except for convalescent sera for which the evidence available is only from case series. Based on these early evidence, various national guidelines recommend remdesivir, convalescent sera, corticosteroids, hydroxychloroquine in different sub set of patients. Conclusion:Establishing consensus with respect to the endpoints to be assessed for respiratory viruses may enhance the quality of evidences in case of future pandemics. Further clinical evidence from the ongoing trials may lead to evolution of treatment guidelines with the addition of more therapeutic options. | ||
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