Ongoing Living Update of Potential COVID-19 Therapeutics: Summary of Rapid Systematic Reviews, 16 June 2020

Abstract

Take home message thus far: • We examined 24 therapeutic options thus far; currently, there is no evidence of any important benefit from any therapeutic option (though remdesivir is revealing promise as one option based on 2 randomized controlled trials, and while not peer-reviewed and published, preliminary findings from the RECOVERY Trial (Oxford University Group) using the corticosteroid dexamethasone, indicates a reduction in mortality in COVID-19 patients hospitalized and requiring respiratory support) and that conclusively allows for safe and effective use to mitigate or eliminate the causative agent of COVID-19; the same can be said about prophylaxis. Nearly 200 therapeutic options or their combinations are being investigated in more than 1,700 clinical trials. • Preliminary findings from the RECOVERY Trial showed that low doses of dexamethasone (6 mg of oral or intravenous preparation once daily for 10 days) significantly reduced mortality by one-third in ventilated patients and by one fifth in patients receiving oxygen only. • Patients with COVID19, frequently older adults and with established comorbidities such as diabetes, hypertension, obesity, cardiovascular disease, kidney disease, and liver disease as well as malignancy, are receiving multiple concomitant medications, without considering possible adverse events and interactions. This is an area of research that is being overlooked and the potential toxicity due to concomitant treatments must be urgently addressed. • The use of medications such as ivermectin, antivirals, and immunomodulators, among others, should be done in the context of patient consented, randomized clinical trials that evaluate their safety and efficacy. • Countries should follow WHO guidance on the ethical use of drugs in emergencies, including use on unauthorized indications and compassionate use...