The impact of therapeutics on mortality in hospitalised patients with COVID-19: systematic review and meta-analyses informing the European Respiratory Society living guideline

Megan L. Crichton, Pieter C. Goeminne, Krizia Tuand, Thomas Vandendriessche, Thomy Tonia, Nicolas Roche, James D. Chalmers (Lead / Corresponding author),

Research output: Contribution to journalReview articlepeer-review

7 Citations (Scopus)
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Abstract

Hospitalised patients with coronavirus disease 2019 (COVID-19) have a high mortality rate. There are an increasing number of published randomised controlled trials for anti-inflammatory, anti-viral and other treatments. The European Respiratory Society Living Guidelines for the Management of Hospitalised Adults with COVID-19 were published recently, providing recommendations on appropriate pharmacotherapy.

Patient, Intervention, Comparator and Outcomes questions for key interventions were identified by an international panel and systematic reviews were conducted to identify randomised controlled trials meeting the inclusion criteria. The importance of end-points were rated, and mortality was identified as the key "critical" outcome for all interventions. Random-effects meta-analysis was used to pool studies and provide effect estimates for the impact of treatments on mortality.

Corticosteroids, hydroxychloroquine, azithromycin, remdesivir, anti-interleukin (IL)-6 monoclonal antibodies, colchicine, lopinavir/ritonavir and interferon-β have been reviewed.

Our results found further evidence in support of the use of corticosteroids, particularly dexamethasone, and anti-IL-6 receptor monoclonal antibody therapy. These data support the need to identify additional therapies with beneficial effects on mortality.

Original languageEnglish
Article number210171
Pages (from-to)1-13
Number of pages13
JournalEuropean Respiratory Review
Volume30
Issue number162
Early online date15 Dec 2021
DOIs
Publication statusPublished - 31 Dec 2021

Keywords

  • Adult
  • Anti-Inflammatory Agents
  • Antiviral Agents/therapeutic use
  • COVID-19
  • Humans
  • Respiration, Artificial
  • SARS-CoV-2

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