TY - JOUR T1 - Evaluation of current medical approaches for COVID-19: a systematic review and meta-analysis JF - BMJ Supportive & Palliative Care JO - BMJ Support Palliat Care DO - 10.1136/bmjspcare-2020-002554 SP - bmjspcare-2020-002554 AU - Meng Wang AU - Ting Wu AU - Zhihong Zuo AU - Yaxian You AU - Xinyuan Yang AU - Liangyu Pan AU - Ying Hu AU - Xuan Luo AU - Liping Jiang AU - Zanxian Xia AU - Meichun Deng Y1 - 2020/09/21 UR - http://spcare.bmj.com/content/early/2020/09/20/bmjspcare-2020-002554.abstract N2 - 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. ER -