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Treatment

Articles:

 

Antiviral

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

  • Key Finding: There is insufficient evidence to recommend arbidol for patients with COVID-19

 

Should camostat mesilate be used in the treatment of COVID-19? 

  • Key Finding: There is currently insufficient evidence on the use of camostat mesilate in the treatment of COVID-19 patients.

 

Should Hydroxychloroquine (HCQ) or Chloroquine (CQ) be used in the treatment of COVID-19?

  • Key Finding: There is insufficient evidence to support the routine use of CQ or HCQ for the treatment of COVID-19.

 

Should lopinavir/ritonavir be used in the treatment of COVID-19? 

  • Key Finding: Based from two RCTs, there is inconclusive evidence on clinical improvement, 28-day mortality and viral shedding among patients with mild to moderate and severe COVID-19 treated with lopinavir/ritonavir.

 

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

  • Key Finding: Based on pooled published results of two randomized controlled clinical trials, remdesivir showed modest benefit in clinical improvement among patients with severe/hospitalized COVID-19 infection. Data suggest there might be benefit on mortality but needs more studies to strengthen the conclusion.

 

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

  • Key Finding: In one randomized controlled trial, Favipiravir, copared to Arbidol, did not show significant difference in the clinical recovery rate for patients with moderate to severe COVID-19 infections. In one non-randomized open-label trial, Favipiravir significantly reduced viral clearance with higher chest CT scan improvement rates compared to Lopinavir/Ritonavir in patients with non-severe COVID-19. However both studies have serious methodologic issues and results should be interpreted with caution.

 

Immunomodulator

Should mesenchymal stem cell therapy be used in the treatment of COVID-19?

  • Key Finding: There is some short-term benefit from the use of mesenchymal stem cell therapy for severe COVID-19 in a low-quality small randomized controlled trial. This needs further study to confirm benefit and ssafety.

 

Should convalescent plasma therapy be used in the treatment of critically ill patients with COVID-19?

  • Key Finding: There is insufficient evidence to support the routine use and efficacy of convalescent plasma on critically-ill patients with COVID-19 at this time.

 

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

  • Key Finding: There is currently insufficient evidence on the use of colchicine in the treatment of COVID-19 patients, but there are 4 ongoing trials awaiting completion this 2020.

 

Should Intravenous Immunoglobulin G (IVIg) be used in the treatment of COVID-19?

  • Key Finding: There is presently limited evidence on the use of intravenous immunoglobulin G in COVID-19 positive patients. There is an ongoing clinical trial on the use of intravenous immunoglobulin G in COVID-19 patients.

 

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

  • Key Finding: Currently, there is insufficient evidence to conclude on the efficacy and safety of interferons (IFNs) in the treatment of COVID-19.

 

Should Leronlimab (PRO 140) be used in the treatment of COVID-19?

  • Key Finding: There is no evidence that Leronlimab is an effective treatment for COVID-19.

 

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

  • Key Finding: There is insufficient evidence to conclude on the efficacy and safety of tocilizumab for COVID-19. Although some benefit for patients with severe COVID-19 has been noted, more well-designed prospective clinical trials or observational studies are needed.

 

Combination

Should hydrochloroquine (HCQ) or chloroquine (CQ) in combination with lopinavir/ritonavir (LPV/r) be used in the treatment of COVID-19?

  • Key Finding: There is currently no evidence to support the use of HCQ or CQ in combination with LPV/r in the treatment of COVID-19 infection.

 

Should lopinavir/ritonavir combined with interferon-beta be used in the treatment of COVID-19?

  • Key Finding: Currently, there is NO EVIDENCE on combined lopinavir/ritonavir and interferon-beta among patients with COVID-19. There are on-going clinical trials on this combined antiviral therapy: two randomized and a non-randomized controlled trial for patients with COVID-19.

 

Should hydroxychloroquine with azithromycin be used in the treatment of COVID-19?

  • Key Finding: There is no high-quality evidence proving the efficacy and safety of hydroxychloroquine with azithromycin for the treatment of COVID-19, and treatment with the cobination should only be in the realm of compassionate use.

 

 

 

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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