The therapeutic effect and safety of the drugs for COVID-19: a systematic review and meta-analysis

Abstract

Background: Coronavirus disease 2019 (COVID-19) has spread almost all regions of the world and caused great loss to the whole body of mankind. Thus, numerous clinical trials were conducted to find specific medicine for COVID-19 recently. However, it remains unanswered whether they are beneficial. Objective: This study aimed to evaluate the efficiency and safety of the COVID-19 medicine. Methods: Studies were determined through searching PubMed, Embase, Cochrane Library and Medline. The clinical trials of COVID-19 medicine were involved with eligible end points containing mortality, discharge rate, rate of clinical improvement and rate of serious adverse events. The risk ratio (RR) was adopted for variables as effect magnitude with 95% confidence intervals (CI), and the random‐effects model was adopted for analysis. Results: A total of eleven RCTs and eleven Non-RCTs involving 12,796 patients were included in our study, whose intervening measures contained three major types of COVID-19 medicine, ACEI/ARB, antiviral medicine and chloroquine/hydroxychloroquine. Compared to control group, COVID-19 medicine has the obvious advantage in reducing discharge rate (RR, 1.18; 95% CI, 1.07-1.29, p<0. 05) and clinical improvement rate (RR, 1.15; 95% CI, 1.05-1.26, p<0. 05), no distinct effect on mortality (RR, 0.79; 95% CI, 0.53-1.17, p=0. 24). In addition, the serious adverse events rate (RR, 0.74; 95% CI, 0.62-0.88, p<0. 05) of COVID-19 medicine is lower than control group. Among different types of medicine, significant benefits in lowering the mortality seem to only occur in antiviral medicine. Conclusion: The results indicated antiviral medicine was potential drug of first choice recommended for COVID-19 treatment. Chloroquine/hydroxychloroquine therapy was not recommended for COVID-19 patients. Additionally, the ACEI/ARB could be adopted for COVID-19 treatment when combined with standard treatment.