Background Because of the lack of vaccination, it is urgent to find effective antiviral agents for COVID-19 treatment.
Method Online databases were searched for articles published before or on 22 June 2020. Studies reporting the effectiveness and safety of antiviral agents for COVID-19 were analysed.
Results A total of 42 studies were included in this analysis. Hydroxychloroquine (HCQ) was not associated with the incidence of death (risk ratio (RR)=1.08; 95% CI 0.81 to 1.44) and severe cases (RR=1.05; 95% CI 0.61 to 1.81). Patients treated with HCQ obtained few benefits with respect to the clearance of viral RNA and were more likely to have adverse reactions. HCQ treatment could shorten the body temperature recovery time (weighted mean difference = −1.04; 95% CI −1.64 to −0.45). Lopinavir/ritonavir (LPV/r) (RR=0.90; 95% CI 0.76 to 1.07) and Arbidol (RR=1.09; 95% CI 0.92 to 1.29) were not associated with the negative conversion rate. Integrative Chinese-Western medicine alleviated clinical symptoms and decreased the incidence of severe cases (RR=0.38; 95% CI 0.25 to 0.59). Remdesivir treatment reduced the 14-day mortality rate of patients with severe COVID-19 (RR=0.64; 95% CI 0.44 to 0.94). Convalescent plasma (CP) tended to increase the negative conversion rate (RR=2.47; 95% CI 1.70 to 3.57).
Conclusion HCQ, LPV/r and Arbidol bring little benefit in COVID-19 treatment. Integrative Chinese-Western medicine improved the clinical symptoms of patients with COVID-19. Remdesivir and CP might be the potential treatments for patients with severe COVID-19. However, large-scale clinical randomised trials are needed to validate our conclusions.
- hospital care
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MW, TW and ZZ contributed equally.
Contributors MW, TW, ZZ, YY, XY, LP, YH, XL, LJ, ZX and MD contributed to the material collection, data analysis and manuscript writing. All authors read and approved the final manuscript.
Funding This work was supported by the National Natural Science Foundation of China under contract (Nos. 31672290, 31100764, 30901874), the National Key Research and Development Program of China (2016YFD0500300), Zhejiang University Special Scientific Research Fund for COVID-19 Prevention and Control (2020XGZX033), the Natural Science Foundation of Hunan Province, China (No. 2016JJ3180), Open-End Fund for the Valuable and Precision Instruments of Central South University (Nos. CSUZC2020043).
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.