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10.1503/cmaj.220471

http://scihub22266oqcxt.onion/10.1503/cmaj.220471
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35878897!9328465!35878897
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suck abstract from ncbi


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pmid35878897      CMAJ 2022 ; 194 (28): E969-E980
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  • Antiviral drug treatment for nonsevere COVID-19: a systematic review and network meta-analysis #MMPMID35878897
  • Pitre T; Van Alstine R; Chick G; Leung G; Mikhail D; Cusano E; Khalid F; Zeraatkar D
  • CMAJ 2022[Jul]; 194 (28): E969-E980 PMID35878897show ga
  • BACKGROUND: Randomized trial evidence suggests that some antiviral drugs are effective in patients with COVID-19. However, the comparative effectiveness of antiviral drugs in nonsevere COVID-19 is unclear. METHODS: We searched the Epistemonikos COVID-19 L.OVE (Living Overview of Evidence) database for randomized trials comparing antiviral treatments, standard care or placebo in adult patients with nonsevere COVID-19 up to Apr. 25, 2022. Reviewers extracted data and assessed risk of bias. We performed a frequentist network meta-analysis and assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS: We identified 41 trials, which included 18 568 patients. Compared with standard care or placebo, molnupiravir and nirmatrelvir-ritonavir each reduced risk of death with moderate certainty (10.9 fewer deaths per 1000, 95% confidence interval [CI] 12.6 to 4.5 fewer for molnupiravir; 11.7 fewer deaths per 1000, 95% CI 13.1 fewer to 2.6 more). Compared with molnupiravir, nirmatrelvir-ritonavir probably reduced risk of hospital admission (27.8 fewer admissions per 1000, 95% CI 32.8 to 18.3 fewer; moderate certainty). Remdesivir probably has no effect on risk of death, but may reduce hospital admissions (39.1 fewer admissions per 1000, 95% CI 48.7 to 13.7 fewer; low certainty). INTERPRETATION: Molnupiravir and nirmatrelvir-ritonavir probably reduce risk of hospital admissions and death among patients with nonsevere COVID-19. Nirmatrelvir-ritonavir is probably more effective than molnupiravir for reducing risk of hospital admissions. Most trials were conducted with unvaccinated patients, before the emergence of the Omicron variant; the effectiveness of these drugs must thus be tested among vaccinated patients and against newer variants.
  • |*COVID-19 Drug Treatment[MESH]
  • |Adult[MESH]
  • |Antiviral Agents/therapeutic use[MESH]
  • |Humans[MESH]
  • |Network Meta-Analysis[MESH]
  • |Ritonavir/therapeutic use[MESH]


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