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Meta-Analysis
. 2022 Apr;20(4):585-609.
doi: 10.1080/14787210.2022.1997587. Epub 2021 Dec 29.

Comparative effectiveness of pharmacological interventions on mortality and the average length of hospital stay of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials

Abolfazl Akbari  1 , Mahya Razmi  2 , Alireza Sedaghat  3 , Seyyed Mohammad Matin Alavi Dana  1 , Mahdi Amiri  1 , Ali Mohammad Halvani  1 , Soroush Yazdani  1 , Sajad Sahab-Negah  4   5   6
Affiliations
Meta-Analysis

Comparative effectiveness of pharmacological interventions on mortality and the average length of hospital stay of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials

Abolfazl Akbari et al. Expert Rev Anti Infect Ther. 2022 Apr.

Abstract

Introduction: Up to now, numerous randomized controlled trials (RCTs) have examined various drugs as possible treatments for Coronavirus Disease 2019 (COVID-19), but the results were diverse and occasionally even inconsistent with each other. To this point,we performed a systematic review and meta-analysis to assess the comparative effectiveness of pharmacological agents in published RCTs.

Areas covered: A literature search was performed using PubMed, SCOPUS, EMBASE, and Web of Science databases. RCTs evaluating mortality and the average length of hospital stay to standard of care (SOC)/placebo/control were included. RCTs mainly were classified into five categories of drugs, including anti-inflammatory, antiviral, antiparasitic, antibody and antibiotics. Meta-analysis was done on 5 drugs classes and sub-group meta-analysis was done on single drugs and moderate or severe stage of disease.

Expert opinion: Mortality and the average length of hospital stay of COVID-19 patients were significantly reduced with anti-inflammatory drugs (odds ratio [OR]: 0.77, 95% confidence interval [CI]: 0.69 to 0.85, P<0.00001, and mean difference [MD]: -1.41, CI:-1.75 to -1.07, P<0.00001, respectively) compared to SOC/control/placebo. Furthermore, antiparasitic was associated with reduced length of hospital stay (MD: -0.65, CI: -1.26 to -0.03, P<0.05) in comparison to SOC/placebo/control. However, no effectiveness was found in other pharmacological interventions.

Keywords: COVID-19; Pharmacological intervention; meta-analysis; randomized controlled trial; systematic review; treatment.

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Figures

Figure 1.
Figure 1.
PRIZMA flow diagram of study selection. (Abbreviation: LOH: Length of Hospitalization).
Figure 2.
Figure 2.
Quality assessment final score base on Joanna Brigs Institute (JBI) checklist (Each ‘Yes’ answer had a + 1 score, each ‘Unclear’ answer had a 0 score and each ‘No’ answer had a − 1 score) .
Figure 3.
Figure 3.
Meta-analysis of intervention versus control on mortality.
Figure 4.
Figure 4.
Meta-analysis of intervention versus control on length of hospitalization.
See this image and copyright information in PMC

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