antiviral and associated therapy for COVID-19: living meta-analysis of clinical studies

Study explorer (study characteristics and results) method abbreviations pdf xlsx

display ongoing studies
Study	Ref.	Design	studied treatment	control treatment	patients	study risk of bias	sample sizes	Results
COVID-19 mild to moderate meta-analysis
I-TECH (Lim) NCT04920942		RCT	ivermectin	control	COVID-19 mild to moderate	some concern	241/249	inconclusive	inconclusive 25 % increase in clinical deterioration (PE) with a moderate degree of certainty due to some concern in risk of bias
Abd-Elsalam NCT04403555		RCT	ivermectin	control	COVID-19 mild to moderate	high	82/82	inconclusive
Babalola		RCT	ivermectin	lopinavir/ritonavir	COVID-19 mild to moderate	high	21/20	no results
Bukhari NCT04392713		RCT	ivermectin	standard of care	COVID-19 mild to moderate	high	50/50	suggested	suggested 10.6-fold increase in viral clearance by day 7 but with a low degree of certainty due to high risk of bias
FACCT Trial NCT04392973		RCT	favipiravir	standard of care	COVID-19 mild to moderate	some concern	125/129	inconclusive	inconclusive 15 % decrease in clinical improvement (time to event analysis only) (PE) with a moderate degree of certainty due to some concern in risk of bias
Fontanesi NCT04348409		RCT	nitazoxanide	placebo	COVID-19 mild to moderate	NA	25/25	no results
Holubar M NCT04346628		RCT	favipiravir	placebo	COVID-19 mild to moderate	NA	75/74	inconclusive	inconclusive 24 % decrease in viral clearance ,viral clearance (time to event analysis only) (PE)
Kirti CTRI/2020/08/027225		RCT	ivermectin	placebo	COVID-19 mild to moderate	some concern	57/58	inconclusive	inconclusive 20 % decrease in viral clearance by day 7 (PE) with a moderate degree of certainty due to some concern in risk of bias
Rashad A (AZI vs SoC)		RCT	azithromycin	standard of care	COVID-19 mild to moderate	some concern	107/99	inconclusive
RIVET-COV (Mohan) (12mg and 24mg) CTRI/2020/06/026001		RCT	ivermectin	placebo	COVID-19 mild to moderate	high	104/52	inconclusive	inconclusive 10 % increase in viral clearance ,viral clearance by day 7 (PE) but with a low degree of certainty due to high risk of bias
Shenoy S NCT04529499		RCT	favipiravir	placebo	COVID-19 mild to moderate	high	175/178	inconclusive	inconclusive 1 % decrease in clinical improvement (time to event analysis only) (PE) but with a low degree of certainty due to high risk of bias
Shinkai JapicCTI-205238		RCT	favipiravir	placebo	COVID-19 mild to moderate	some concern	107/49	safety concern	inconclusive 40 % increase in clinical improvement (time to event analysis only) (PE) with a moderate degree of certainty due to some concern in risk of bias statistically significant 18.5-fold increase in adverse events with a moderate degree of certainty due to some concern in risk of bias
Silva NCT04463264		RCT	nitazoxanide	placebo	COVID-19 mild to moderate	high	33/13	inconclusive
Solaymani-Dodaran IRCT20200318046812N1		RCT	favipiravir	lopinavir/ritonavir	COVID-19 mild to moderate	some concern	193/187	inconclusive
Ahmed		RCT	ivermectin	placebo	COVID-19 mild to moderate	high	48/24	suggested	suggested 3.1-fold increase in viral clearance (time to event analysis only),viral clearance by day 14 (PE) but with a low degree of certainty due to high risk of bias Paradoxically comparison of day 7 and 14 virological clearance between ivermectin doxycycline group vs placebo was not statistically significant (HR 2.3[0.6-9.0] and 1.7[0.8-4.0])
AVIFAVIR NCT04434248		RCT	favipiravir	standard of care	COVID 19 hospitalized, COVID-19 mild to moderate	some concern	20/20	suggested	suggested 2.9-fold increase in viral clearance ,viral clearance by day 7 (PE) with a moderate degree of certainty due to some concern in risk of bias Adverse drug reactions to AVIFAVIR were reported in 7/40 (17.5%) patients, including diarrhea, nausea, vomiting, chest pain and an increase in liver transaminase levels. The adverse drug reactions were mild to moderate and caused early discontinuation of the study drug in 2/40 (5.0%) patients.
Chaccour NCT04390022		RCT	ivermectin	placebo	COVID 19 outpatients, COVID-19 mild to moderate	low	12/12	inconclusive	inconclusive 8 % decrease in viral clearance ,viral clearance by day 7 (PE) with a high degree of certainty due to low risk of bias
Chachar NCT04739410		RCT	ivermectin	standard of care	COVID-19 mild to moderate	high	25/25	inconclusive	inconclusive 19 % increase in clinical improvement,clinical improvement (7-day) (PE) but with a low degree of certainty due to high risk of bias
COALITION I Covid-19 Brazil (AZI, Cavalcanti) NCT04322123		RCT	azithromycin	standard of care	COVID-19 mild to moderate	some concern	172/159	inconclusive	inconclusive 18 % decrease in clinical improvement,clinical improvement (14-day) (PE) with a moderate degree of certainty due to some concern in risk of bias
Dabbous HM NCT04349241		RCT	favipiravir	standard of care	COVID-19 mild to moderate	some concern	50/50	inconclusive
ELACOI (Lopinavir/ritonavir) NCT04252885		RCT	umifenovir (arbidol)	lopinavir/ritonavir	COVID-19 mild to moderate	some concern	35/34	inconclusive	inconclusive 84 % increase in viral clearance by day 14 (PE) with a moderate degree of certainty due to some concern in risk of bias inconclusive 8 % increase in viral clearance by day 7 (PE) with a moderate degree of certainty due to some concern in risk of bias
ELACOI (lopinavir/ritonavir) NCT04252885		RCT	lopinavir/ritonavir	standard of care	COVID-19 mild to moderate	some concern	21/7	inconclusive
GS-US-540-5773 (Goldman) NCT04292899		RCT	remdesivir	remdesivir	COVID-19 mild to moderate	some concern	200/197	suggested	suggested 53 % increase in clinical improvement (14-day) with a moderate degree of certainty due to some concern in risk of bias
GS-US-540-5774, 10 days NCT04292730		RCT	remdesivir	standard of care	COVID-19 mild to moderate	some concern	197/200	safety concern	suggested 58 % increase in clinical improvement (14-day) with a moderate degree of certainty due to some concern in risk of bias suggested 88 % increase in clinical improvement (28-day) with a moderate degree of certainty due to some concern in risk of bias statistically significant 63 % increase in adverse events with a moderate degree of certainty due to some concern in risk of bias The primary endpoint was not met, no odds ratio is reported because the proportional odds assumption was not met
GS-US-540-5774, 5 days NCT04292730		RCT	remdesivir	standard of care	COVID-19 mild to moderate	some concern	199/200	conclusif	demonstrated 65 % increase in clinical improvement (PE) with a moderate degree of certainty due to some concern in risk of bias
Hung et al. NCT04276688		RCT	lopinavir/ritonavir, ribavirin and interferon beta-1b	lopinavir/ritonavir	COVID-19 mild to moderate	some concern	86/41	conclusif	demonstrated 3.4-fold increase in viral clearance ,viral clearance (time to event analysis only) (PE) with a moderate degree of certainty due to some concern in risk of bias suggested 2.9-fold increase in clinical improvement,clinical improvement (time to event analysis only) with a moderate degree of certainty due to some concern in risk of bias
Khamis		RCT	favipiravir plus interferon	standard of care	COVID-19 mild to moderate	some concern	44/45	inconclusive
Krolewiecki NCT004381884		RCT	ivermectin	standard of care	COVID-19 mild to moderate	some concern	30/15	inconclusive
Li T NCT04273763		RCT	bromhexine	standard of care	COVID-19 mild to moderate	some concern	12/6	suggested	inconclusive 52 % decrease in clinical deterioration (PE) with a moderate degree of certainty due to some concern in risk of bias suggested 9.0-fold increase in hospital discharge with a moderate degree of certainty due to some concern in risk of bias
NCT04542694 NCT04542694		RCT	favipiravir	standard of care	COVID-19 mild to moderate	some concern	100/100	suggested	suggested 1.1-fold increase in clinical improvement,clinical improvement (7-day) (PE) with a moderate degree of certainty due to some concern in risk of bias suggested 12.0-fold increase in viral clearance with a moderate degree of certainty due to some concern in risk of bias
Ren ChiCTR2000029853		RCT	azvudine	antiviral and associated therapy	COVID-19 mild to moderate	some concern	10/10	suggested	suggested 27.5-fold increase in viral clearance ,viral clearance by day 7 (PE) with a moderate degree of certainty due to some concern in risk of bias
Rocco NCT04552483		RCT	nitazoxanide	placebo	COVID-19 mild to moderate	high	238/237	inconclusive	inconclusive 19 % decrease in clinical improvement,clinical improvement (7-day) (PE) but with a low degree of certainty due to high risk of bias
Ruzhentsova T NCT04501783		RCT	favipiravir	standard of care	COVID-19 mild to moderate	some concern	112/56	suggested	suggested 63 % increase in clinical improvement,clinical improvement (time to event analysis only) (PE) with a moderate degree of certainty due to some concern in risk of bias inconclusive 28 % increase in viral clearance ,viral clearance (time to event analysis only) (PE) with a moderate degree of certainty due to some concern in risk of bias suggested 28 % increase in clinical improvement (14-day) with a moderate degree of certainty due to some concern in risk of bias suggested 50 % increase in clinical improvement (7-day) with a moderate degree of certainty due to some concern in risk of bias
Shahbaznejad IRCT20111224008507N3		RCT	ivermectin	standard of care	COVID-19 mild to moderate	some concern	35/38	inconclusive
Udwadia CTRI/2020/05/025114		RCT	favipiravir	standard of care	COVID 19 hospitalized, COVID-19 mild to moderate	some concern	75/75	safety concern	inconclusive 37 % increase in viral clearance ,viral clearance (time to event analysis only) (PE) with a moderate degree of certainty due to some concern in risk of bias suggested 75 % increase in clinical improvement,clinical improvement (time to event analysis only),clinical improvement (28-day) with a moderate degree of certainty due to some concern in risk of bias suggested 94 % decrease in mechanical ventilation (time to event analysis only),mechanical ventilation with a moderate degree of certainty due to some concern in risk of bias statistically significant 5.4-fold increase in adverse events with a moderate degree of certainty due to some concern in risk of bias
5 studies excluded by filtering options (0 RCT / 5 OBS)

PE: primary endpoint; (a): to be demonstrated a result must be statistically significant on a primary endpoint (with multiplicity adjustment if necessary);
Study risk of bias assessed for the study primary endpoint(s) or the main endpoints in case of no formally defined primary endpoint(s).

Study explorer (study characteristics and results) method abbreviations pdf xlsx

COVID-19 mild to moderate meta-analysis