Therapeutic Interventions Implemented During the First Year of the COVID-19 Pandemic: A Systematic Review of Evidence

Abstract

The aim of this study was to review the knowledge and evidence on the therapeutic effectiveness of some agents currently utilized for treating coronavirus disease-2019 (COVID-19). The literature search was performed using the databases PubMed, Scopus, Google Scholar, and the Cochrane Library. The publications identified were screened to select cohort studies, randomised controlled trials, meta-analyses, narrative and systematic reviews. End points displaying the results of epidemiological and statistical methods were evaluated to specify the strength of evidence. Eleven randomised controlled trials, a controlled trial, five cohort studies, four reviews, two systematic reviews, a systematic review-meta- analysis, and a meta-analysis were included. These 25 studies covered treatments with antimalarials, anticoagulation, antivirals, corticosteroids, interferons, monoclonal antibodies, and convalescent plasma. The outcomes assessed included all-cause and in-hospital mortality, death or mechanical ventilation within 28 days, mean or median day to viral clearance, median and day-28 recovery time, and improvement in oxygen support class. The results showed evidence for the efficacy of remdesivir and corticosteroids in critically ill patients. Only corticosteroids showed efficacy regarding reduced mortality. Favipiravir, anticoagulation, interferons and monoclonal antibodies were agents with weaker evidence of therapeutic efficacy. The key findings of this review highlight evidence regarding the efficacy of remdesivir and corticosteroids for hospitalised patients.