A network meta-analysis was performed on data extracted from the US Centers for Disease Control and Prevention COVID-19 Research Articles Downloadable Database. 23 trials were included, in which people with suspected, probable, or confirmed covid-19 were randomised to drug treatment or to standard care or placebo. The certainty of the evidence for most comparisons was very low because of risk of bias and serious imprecision.
Glucocorticoids were the only intervention with evidence for a reduction in death compared with standard care and mechanical ventilation (moderate certainty). Three drugs might reduce symptom duration compared with standard care: hydroxychloroquine (low certainty), remdesivir (moderate certainty), and lopinavir-ritonavir (low certainty). Hydroxychloroquine might increase the risk of adverse events compared with the other interventions, and remdesivir probably does not substantially increase the risk of adverse effects leading to drug discontinuation. No other interventions included enough patients to meaningfully interpret adverse effects leading to drug discontinuation.
The value of this resource is in its ‘living’ status. The review will be updated (for up to two years) to reflect emerging evidence.
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