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Adjunct Therapy

Articles:

 

Should N-acetylcysteine be used as adjunct treatment for COVID-19? 

  • Key Finding: There is very low-quality direct evidence that suggests the effectiveness of N-acetylcysteine as adjunct treatment for COVID-19. Further studies are needed to demonstrate its efficacy.

 

Is high-flow nasal cannula oxygenation more effective than non-invasive ventilation or conventional oxygen therapy in treating acute hypoxemic respiratory failure in COVID-19 patients?

  • Key Finding: Very low-quality evidence suggests lower mortality (five observational studies) but higher failure rate of respiratory support (two observational studies) in COVID-19 patients given high-flow nasal cannula (HFNC) oxygen compared with noninvasive ventilation (NIV) and conventional oxygenation therapy. Randomized controlled trials are urgently needed in this area.

 

Should corticosteroids be used as an adjunct in the treatment of COVID-19?

  • Key Finding: Contradictory results from low-quality observational studies do not support the routine use of corticosteroids as an adjunct in the treatment of COVID-19 beyond their usual indication. Caution must be exercised to weigh risks and benefits of their use.

 

Should etoposide be used in the treatment of cytokine storm of COVID-19? 

  • Key Finding: There is no direct evidence in the effect of etoposide on possible symptoms of cytokine storm in COVID-19.

 

Should hemoperfusion be used as an adjunct treatment for COVID-19? 

  • Key Finding: There is insufficient evidence to support the routine use of hemoperfusion as an adjunct treatment for COVID-19.

 

Should anticoagulation be used in the treatment of severe COVID-19?

  • Key Finding: Based on low-quality data, there seems to be benefit from the use of anticoagulants for severe COVID-19. This effect needs to be confirmed through randomized controlled trials.

 

Should inhaled Nitric Oxide be used as an adjunct treatment for COVID-19?

  • Key Finding: There is no current evidence to support the use of inhaled nitric oxide for patients with COVID-19.

 

Should Virgin Coconut Oil be used in the adjunctive treatment of COVID-19?

  • Key Finding: There is currently no evidence to support the use of virgin coconut oil in the adjunctive treatment of COVID-19.

 

Should B Vitamins be used in the treatment of COVID-19?

  • Key Finding: There is currently insufficient evidence regarding the effectiveness of B Vitamins in the treatment of COVID-19. Studies on other vitamins are being done, but not on B Vitamins.

 

Should Vitamin C/Ascorbic Acid infusion be used in the treatment of COVID-19?

  • Key Finding: There is no direct evidence available as of this point for efficacy of intravenous vitamin C as an adjunctive treatment in preventing mortality or shortening disease course among adults suspected of, or positive for COVID-19.

 

Should Zinc be used in the treatment of COVID-19?

  • Key Finding: There is no current clinical evidence that zinc or zinc supplements are effective adjunctive treatment for COVID-19.

 

 

Updated as of June 9, 2020

 


Through the volunteer work of more than 50 EBM practitioners, methodologists and students from the UP Institute of Clinical Epidemiology and Asia-Pacific Center for Evidence-Based HealthCare, the Philippine Society of Microbiological and Infectious Diseases (PSMID) had graciously agreed to host these rapid evidence reviews on COVID19. The aim is to retrieve, appraise, summarize and update the available evidence on COVID-related management, to assist the frontline health workers, local policymakers and government officials in their evidence-based critical decision-making.
 
The reviews should not replace individual clinical judgement and the sources cited should be checked. The views are not a substitute for professional medical advice. The views expressed represent the views of the authors and not necessarily those of their host institutions. This may change as new evidences emerges.
 
A discussion of the general methods used can be found here: Rapid Evidence Review General Methods.
 
For any questions or information, please email [email protected].

 

 

 

 

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