Table III.
Author/title/DOI | Sample size | Mean age (years) | Gender | Type of study | Therapeutic treatment | Type: N (%) | Outcomes (recovery/mortality) | Adverse events | Quality assessment (applicable/inapplicable) | |
---|---|---|---|---|---|---|---|---|---|---|
1 | Cao et al. A trial of lopinavir–ritonavir in adults hospitalized with severe COVID-19. N Engl J Med 2020. https://doi.org/10.1056/NEJMoa2001282 | 199 | 58 | 120 M 79 F |
Randomized clinical trial | Lopinavir and ritonavir | Lopinavir and ritonavir: 50%Standard care: 50% | In hospitalized adult patients with severe COVID-19, no benefit was observed with lopinavir–ritonavir treatment beyond standard careNineteen deaths among patients who received the intervention | 14% of patients who received lopinavir–ritonavir developed gastrointestinal adverse events, including anorexia, nausea, abdominal discomfort or diarrhoea, as well as two serious adverse events (both acute gastritis)Two recipients had self-limited skin eruptions | The study addressed a focused issue Randomization with intention-to-treat analysis The population who entered the study were accounted for properly in the conclusion Not blinded The two groups who entered the study were similar and treated equally The primary outcome was specified clearly |
2 | Cao et al. Clinical features and short-term outcomes of 18 patients with coronavirus disease 2019 in intensive care unit. Intensive Care Med 2020.https://doi.org/10.1007/s00134-020-05987-7 | 41 | 49 | 30 M 11 F |
Prospective | Antibiotics and oseltamivir (orally 75 mg twice daily)Corticosteroid was given as a combined regimen if severe community-acquired pneumonia was diagnosed by physicians at the designated hospital | All patients received empirical antibiotic treatmentAntiviral (oseltamivir): 38 (93%)Systemic corticosteroid: 9 (22%) | Antiviral: 12 ICU admissions (92%) Antibiotic: 13 ICU admissions (100%) Corticosteroid: six ICU admissions (46%) |
Not reported | Adverse events not reported Treatment given not specified Types of antibiotics given not mentioned |
3 | Chen et al. Favipiravir versus arbidol for COVID-19: a randomized clinical trial. medRxiv 2020. https://doi.org/10.1101/2020.03.17.200 | 236 | 56 (25–86) | Favipiravir group:59 M 57 FArbidol group:51 M 69 F |
Randomized controlled trial | Favipiravir Arbidol |
Antiviral: 116 Antiviral: 120 |
71 patients recovered | Abnormal liver function tests, raised serum uric acid, psychiatric symptom reactions and digestive tract reactions | No effective antiviral drug was reported, and the drugs mentioned were based on the sixth edition of the guidelines of Chinese diagnosis and treatment plan of COVID-19 patients |
4 | Chen et al. Thalidomide combined with low-dose glucocorticoid in the treatment of COVID-19 pneumonia 2020. Preprints 2020; 2020020395. https://www.preprints.org/manuscript/202002.0395/v1 | 1 | 45 | F | Case report | Thalidomide and low-dose glucocorticoid. The patient was first treated with oral ofloxacin and oseltamivir, but her condition deteriorated. The patient was subsequently treated with lopinavir/ritonavir | Thalidomide inhibits the cytokine surge and regulates immune functions. In addition, it can be used to calm patients down in order to reduce oxygen consumption and relieve digestive symptoms | Not reported | Randomized controlled trials are needed | |
5 | Chen et al. Clinical study of mesenchymal stem cell treating acute respiratory distress syndrome induced by epidemic influenza A (H7N9) infection, a hint for COVID-19 treatment. Engineering 2020. https://doi.org/10.1016/j.eng.2020.02.006 | 61 | 62 | Not mentioned | Open labelled clinical trial | Oseltamivir or peramivir (according to standard therapy) and antibiotics were given based on positive blood test results | Not mentioned | 17.6% of patients in the experimental group and 54.5% of patients in the control group died | Not reported | With only 17 patients using mesenchymal stem cells, it cannot be guaranteed that every step was perfect during the phase with a single clinical trialSome patients refused to attend and some did not complete follow-up. Thus, there is still concern about the long-term safety of mesenchymal stem cell transplantation for the treatment of H7N9-induced ARDS, despite the lack of side-effects observed in this clinical trial This study was undertaken on patients with H7N9 not COVID-19 |
6 | Chen et al. Retrospective analysis of clinical features in 101 death cases with COVID-19. medRxiv 2020. https://doi.org/10.1101/2020.03.09.20033068 | 101 | 65.46 | 64 M 37 F |
Single centre and observational study (retrospective) | Antiviral drugs, including oseltamivir, ribavirin, lopinavir, ritonavir, ganciclovir and interferon Glucocorticoids, IV immunoglobulins and thymosin preparations Antibiotic treatment, including cephalosporins, quinolones, carbapenems, linezolid and tigecycline |
Antiviral: 61 (60.4%) Glucocorticoid: 59 (58.42%)IV immunoglobulin: 63.37% Thymosin: 44.55%Antibiotic: 101 (100%)Restricted antibiotic: 63 (62.38%)Antifungal: 23 (22.78%) |
101 patients died | Not reported | Only the critical death patients are included No comparison was made between the improvement groups |
7 | Chen et al. Clinical progression of patients with COVID-19 in Shanghai, China. J Infect 2020. https://doi.org/10.1016/j.jinf.2020.03.004 | 249 | 51 | 126 M 123 F |
Retrospective, single-centre study | Antiviral drugs (e.g. lopinavir/ritonavir, arbidol) were used in a small proportion of patients Corticosteroids were not used unless considered necessary by an expert panel (e.g. ARDS) | Not mentioned | Two patients died (0.8%) 22 patients were admitted to ICU (8.8%) Eight patients developed ARDS (3.2%) 215 patients were discharged (86.3%) |
Not reported | A small proportion the patients were still hospitalized at the time of manuscript submission. Therefore, clinical outcomes in these patients were not available and continued observations are needed SARS-CoV-2 was not tested daily for all patients. Hence, the actual time to viral clearance should be shorter than the estimated value |
8 | Chen et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395:507–13. | 99 | 55.5 | 67 M 32 F |
Retrospective, single-centre descriptive study | Antibiotic: cephalo-sporins, quinolones, carbapenems, tigecycline against meticillin-resistant Staphylococcus aureus, linezolid Antifungal Antiviral: oseltamivir, ganciclovir and lopinavir/ritonavir Glucocorticoid: methylprednisolone sodium succinate, methylprednisolone and dexamethasone- Immunoglobulin |
Antibiotic: 70 (71%) Antifungal: 15 (15%) Antiviral: 75 (76%), including oseltamivir (75 mg every 12 h, orally), ganciclovir (0.25 g every 12 h, intravenously), and lopinavir/ritonavir (500 mg twice daily, orally). The duration of antiviral treatment was 3–14 days Glucocorticoid: 19 (19%) IV immunoglobulin: 27 (27%) |
11 (11%) patients died | Not reported or NA | Suspected but undiagnosed cases were ruled out in the analyses More detailed patient information, particularly regarding clinical outcomes, was unavailable at the time of analysis |
9 | Chen et al. Epidemiological and clinical features of 291 cases with coronavirus disease 2019 in areas adjacent to Hubei, China: a double-center observational study. medRxiv 2020. https://doi.org/10.1101/2020.03.03.20030353 | 291 | 46 | 145 M 146 F |
Double-centre observational study | Antiviral including lopinavir and ritonavir Recombinant human interferon-α2b Recombinant cytokine gene-derived protein Arbidol hydrochloride Chinese medicine | Antiviral: 285 (97.9%)Lopinavir/ritonavir: 75.9% Recombinant human interferon-α2b: 45.4% Recombinant cytokine gene-derived protein: 18.9% Arbidol hydrochloride: 17.2% Chinese medicine: 281 (96.6%) |
Two (0.7%) patients died | Not reported | Due to limitations of the retrospective study, laboratory examinations were performed according to the clinical care needs of the patients; as such, some laboratory examinations were not completed Given the short observation period, nearly half of the patients were still receiving treatment in hospital at the end of the follow-up period, and it was not possible to determine mortality and prognosis of the whole case series |
10 | Cui et al. A 55-day-old female infant infected with COVID 19: presenting with pneumonia, liver injury, and heart damage. J Infect Dis 2020. https://doi.org/10.1093/infdis/jiaa113 | 1 | 55 days | F | Case report | Inhaled interferon-α1b (15 μg, bid); amoxicillin potassium clavulanate (30 mg/kg, Q8H, ivgtt) | NA | NA | NA | Case report for infant patient Adverse events and outcomes not reported |
11 | Du et al. Clinical features of 85 fatal cases of COVID-19 from Wuhan: a retrospective observational study. SSRN 2020. https://ssrn.com/abstract=3546088 | 191 | 56 | 119 M 72 F |
Retrospective, multi-centre cohort study | Antibiotic Antiviral (lopinavir and ritonavir) Corticosteroid IV immunoglobulin |
Antibiotic: 181 (95%) Antiviral (lopinavir and ritonavir): 41 (21%) Corticosteroid: 57 (30%) IV immunoglobulin: 46 (24%) |
181 (95%) patients received antibiotics: 53 (98%) died, 128 (93%) survived (P=0.15) 41 (21%) patients received antivirals: 12 (22%) died, 29 (21%) survived (P=0.87) 57 (30%) patients received corticosteroid: 26 (48%) died, 31 (23%) survived (P=0.0005) 46 (24%) patients received IV immunoglobulin: 36 (67%) died, 10 (7%) survived (P<0.0001) 54 patients died in hospital |
Not reported | Lack of effective antivirals, inadequate adherence to standard supportive therapy, and high-dose corticosteroid use may also have contributed to the poor clinical outcomes in some patients |
12 | Gautret et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents 2020:105949. https://doi.org/10.1016/j.ijantimicag.2020.105949 | Treated: 20 Control: 16 Total: 36 |
45.1 | 15 M 21 other |
Open label non- randomized clinical trial | Hydroxychloroquine and azithromycin | Hydroxychloroquine sulfate 200 mg, three times per day for 10 days | On day 6 post inclusion, 100% of patients treated with a combination of hydroxychloroquine and azithromycin were virologicaly cured, compared with 57.1% of patients treated with hydroxychloroquine alone and 12.5% of patients in the control group | One patient stopped treatment on day 3 post inclusion due to nausea | Clinical follow-up and occurrence of side-effects were not discussed |
13 | Guan et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020. https://doi.org/10.1056/NEJMoa2002032 | 1099 | 47.9 | 41.1% F | Retrospective observational study | IV antibiotic Oseltamivir Antifungal Systemic glucocorticoid |
Antibiotic: 637 (58%) Oseltamivir: 393 (35.8%) Antifungal: 31 (2.8%) Glucocorticoid: 204 (18.6%) |
5.0% of patients were admitted to the ICU, 2.3% underwent invasive mechanical ventilation and 1.4% died among the 173 patients with severe disease | Not reported | Drug dose, frequency and duration were not included |
14 | Holshue et al. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020. https://doi.org/10.1056/NEJMoa2001191 | 1 | 35 | M | Case report | Antipyretic consisting of guaifenesin | 650 mg 600 mg |
Discharged with no symptoms | Not reported | This was only a single case study and does not represent the whole population As this was a case report, it is not certain that the positive impact on the patient's health was due to the medication taken Randomized controlled trials are needed |
15 | Huang et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395:497–506. | 41 | 49 | 30 M (73%) 11 F (27%) |
Prospective collection and analysed data for patients with pneumonia | Antiviral: 38 (93%) Antibiotic: 41 (100%) Corticosteroid: 9 (22%) |
Not mentioned | One patient was admitted to ICU Six patients died |
Not reported | As the causative pathogen has just been identified, kinetics of viral load and antibody titres were not available at the time of the study |
16 | Huang et al. Early and critical care in severe patients with COVID-19 in Jiangsu Province, China: a descriptive study. 2020. https://doi.org/10.21203/rs.3.rs-17397/v1 | 60 | 57 | 58.3% M 42.8% other |
Multi-centre retrospective cohort study was conducted to extract and analyse epidemiological, clinical and laboratory data and treatment of 60 severe cases | Antiviral: 60 (100%) Abidor: 50 (83.3) Lopinavir/ritonavir: 41 (68.3) Interferon: 12 (20.0) Ribavirin: 7 (11.7) Oseltamivir: 2 (3.3) Fluoroquinolone: (61.7%) |
34 patients (56.7%) received IV glucocorticoids at doses ranging from 40 to 80 mg/day 28 patients (46.7%) received immunoglobulin (IgG enriched) injections for 5–9 days of immunoregulation |
50 patients improved significantly Two patients were discharged Eight patients remained in a serious condition |
Four patients who developed secondary infections received glucocorticoids | Most drug doses, frequencies and durations were not included The effect of glucocorticoids was not significant |
17 | Huang et al. Clinical characteristics of 36 non-survivors with COVID-19 in Wuhan, China. medRxiv 2020. https://doi.org/10.1101/2020.02.27.20029009 | 36 | 69.22 | 25 M (69.44%) 11 F (30.56%) |
Retrospective, single-centre study | Antibiotic: 36 (100%) Antiviral: 35 (97.22%) Glucocorticoid: 25 (69.44%) |
Not mentioned | All patients died | All patients died | Drug dose, frequency and duration were not included |
18 | Jian-ya G. Clinical characteristics of 51 patients discharged from hospital with COVID-19 in Chongqing, China. medRxiv 2020. https://doi.org/10.1101/2020.02.20.20025536 | 51 | 45 | 32 M (62.7%) 19 F (37.3%) |
Retrospective, single-centre case series | Oseltamivir (oral): 7 (13.7%) Interferon (oral): 51 (100%) Kaletra (oral): 51 (100%) Thymopentin (IM): 48 (94.1%) Traditional Chinese medicine decoction (oral): 28 (54.9%) Reduling (IV): 30 (58.8%) Xuebijing (IV): 2 (3.9%) |
Not mentioned | One patient died with shock complications | Six patients had an obvious decline in appetite . |
Drug dose, frequency and duration were not included |
19 | Liang et al. Clinical characteristics of 457 cases with coronavirus disease 2019. Available at SSRN. 2020. https://doi.org/10.2139/ssrn.3543581 | 457 | Varies | 267 M (58%) 9 pregnant women (2%) |
Systematic review | Antiviral: 352 (77%) Antibacterial: 258 (56%) Glucocorticoid: 130 (28%) |
Not mentioned | 195 patients improved and were discharged | 35 patients died | Drug dose, frequency and duration were not included |
20 | Liao et al. Epidemiological and clinical characteristics of COVID-19 in adolescents and young adults. medRxiv 2020. https://doi.org/10.1101/2020.03.10.20032136 | 46 | Not mentioned because they were two groups | 17 M (53.1) 15 F (46.9) |
Retrospective case series data | Antiviral: 46 (100.0%) Antifungal: 5 (10.9%) Glucocorticoid |
Not mentioned | 78.3% of patients were discharged | Three patients developed acute kidney injury during treatment | At the end of this study, nearly 20% of the patients were still hospitalized |
21 | Lim et al. Case of the index patient who caused tertiary transmission of coronavirus disease 2019 in Korea: the application of lopinavir/ritonavir for the treatment of COVID-19 pneumonia monitored by quantitative RT-PCR. J Korean Med Sci 2020; 35. https://doi.org/10.3346/jkms.2020.35.e79 | 1 | 54 | M | Case report | Lopinavir/ritonavir | 200 mg 50 mg (two tablets bid) |
Reduced viral load and improved clinical symptoms | The patient also complained of psychiatric symptoms such as depression, insomnia and suicidal thoughts after isolation | This was a single case and does not represent the whole population Randomized controlled trials are needed |
22 | Liu et al. Patients of COVID-19 may benefit from sustained lopinavir-combined regimen and the increase of eosinophil may predict the outcome of COVID-19 progression. Int J Infect Dis 2020. https://doi.org/10.1016/j.ijid.2020.03.013 | 10 | 42 | 6 F 4 other |
Retrospective observational single-centre study | Lopinavir, Interferon-α2b atomization inhalation |
400 mg every twelve hours |
Oeosinophil counts presented potential as predictor of the development of COVID-19 Seven patients were discharged Three patients stopped lopinavir: two deteriorated and one was hospitalized for longer than other patients who continued taking lopinavir |
Digestive adverse effect and hypokalaemia | Small sample size |
23 | Liu et al. Epidemiological, clinical characteristics and outcome of medical staff infected with COVID-19 in Wuhan, China: a retrospective case series analysis. medRxiv 2020. https://doi.org/10.1101/2020.03.09.20033118 | 64 | 35 (29–43) | 23 M 41 F |
Single centre- retrospective-observational study | Immunoglobulin Thymosin Corticosteroid | Antibody: 23 Hormone: 33 Steroid hormone: 7 | 34 patients were discharged 30 patients were still hospitalized |
Not reported | Preliminary insight into epidemiological features and clinical outcomes Single centre |
24 | Liu et al. Detection of COVID-19 in children in early January 2020 in Wuhan, China. N Engl J Med 2020. https://doi.org/10.1056/NEJMc2003717 | Six | 3 (1–7) | 2 M 4 F |
Retrospective case series analysis | Ribavirin Oseltamivir Glucocorticoid IV immunoglobulin |
Antiviral: 2 Antiviral: 6 Steroid hormone: 4 Antibody: 1 |
Six patients recovered | Not reported | Small sample size |
25 | Liu et al. Clinical features and progression of acute respiratory distress syndrome in coronavirus disease 2019. medRxiv 2020. https://doi.org/10.1101/2020.02.17.20024166 | 109 | 55 | 59 M 50 F |
Retrospective case series analysis | Glucocorticoid IV immunoglobulin | Steroid hormone: 43 Antibody: 32 Antibiotic: 105 Antiviral: 105 |
31 patients died | Not reported | This study did not mention the names of the therapeutic treatment used among patients with ARDS |
26 | Lo et al. Evaluation of SARS-CoV-2 RNA shedding in clinical specimens and clinical characteristics of 10 patients with COVID-19 in Macau. Int J Biol Sci 2020; 16:1698–707. https://doi.org/10.7150/ijbs.45357 | 10 | 54 (27–64) | 3 M 1 teenager 6 other |
Retrospective case series analysis | Lopinavir Ritonavir |
Antiviral: 10 | Five patients were discharged Five patients were still hospitalized |
Not reported | Small sample size, so difficult to draw a definite conclusion Single centre Half of the enrolled patients were still hospitalized at the time of submission of this paper. Therefore, there may have been bias regarding the prognosis of the patients |
27 | Mo et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis 2020. https://doi.org/10.1093/cid/ciaa270 | 155 | 54 (42–66) | 86 M 69 other |
Single-centre, retrospective case series analysis | Arbidol Lopinavir and ritonavir Interferon inhalation Immune enhancer |
Antiviral: 31 Antiviral: 27 Antiviral: 30 Immune enhancer: 14 |
22 patients died | Not reported | Selection bias may have occurred, and a large-scale nationwide study is needed |
28 | Wang et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020. https://doi.org/10.1001/jama.2020.1585 | 138 | 56 (42–68) | 75 M 63 F |
Retrospective, single-centre case series | Oseltamivir Moxifloxcain Ceftriaxone Azithromycin Glucocorticoid |
Antiviral: 124 Antibacterial: 89 Antibacterial: 34 Antibacterial: 25 Glucocorticoid: 62 |
47 patients were discharged Six patients died 85 patients were still hospitalized |
Not reported | Most patients were still hospitalized at the time of manuscript submission. Therefore, there may have been bias regarding the prognosis of the patients. |
29 | Wang et al. Clinical features of 69 cases with coronavirus disease 2019 in Wuhan, China. Clin Infect Dis 2020. https://doi.org/10.1093/cid/ciaa272 | 69 | 42 (35–62) | 32 M 37 F |
Retrospective case series | - | Antiviral: 66 Antibiotic: 66 Antifungal: 8 Corticosteroid: 10 Arbidol: 36 |
44 patients were still hospitalized 18 patients were discharged Five patients died |
Not reported | Drug dose, frequency and duration were not included |
30 | Wu et al. Heart injury signs are associated with higher and earlier mortality in coronavirus disease 2019 (COVID-19). medRxiv 2020. https://doi.org/10.1101/2020.02.26.20028589 | 188 | 52 | 119 M 69 other |
Retrospective cohort study | - | Antibiotic: 185 Antiviral: 158 Corticosteroid: 59 |
43 patients died 145 patients were discharged 12 patients were still hospitalized |
Not reported | Drug dose, frequency and duration were not included |
31 | Wu F et al. A new coronavirus associated with human respiratory disease in China. Nature 2020; 579:265–9. | 1 | 41 | M | Epidemiological investigations | Antiviral Antibiotic Glucocorticoid Oxygen |
Oseltamivir Cefoselis Not mentioned Mechanical ventilation |
Recovered | Not reported | Applicable |
32 | Xu et al. Clinical characteristics of SARS-CoV-2 pneumonia compared to controls in Chinese Han population. medRxiv 2020. https://doi.org/10.1101/2020.03.08.20031658 | Patients: 69 Controls: 14,117 |
57 | 50.7% M 49.3% F |
Retrospective, multi-centre case series | Antiviral Antibiotic Oxygen |
Oseltamivir: 38 (55.1%) Moxifloxacin, ceftriaxone, azithromycin, tigecycline or linezolid: 31 (44.9%) Mechanical ventilation: 2 Invasive ventilator: 2 |
Three patients were discharged One patient recovered One patient died |
Six patients with a significant increase in IL6 were also treated with methylprednisolone | Applicable |
33 | Xu et al. Clinical findings in critical ill patients infected with SARS-CoV-2 in Guangdong Province, China: a multi-center, retrospective, observational study. medRxiv 2020. https://doi.org/10.1101/2020.03.03.20030668 | 45 | 56.7 | 29 M (64.4%) 16 F (35.6%) |
Multi-centre, retrospective, observational study | Antiviral: 45 (100) patients Antibacterial: 45 (100) Antifungal: 19 (42.2) Convalescent plasma: 6 (13.3) Glucocorticoid: 21 (46.7) Immunoglobulin: 28 (62.2) Albumin: 35 (77.8) |
Osehamivir ribavirin Not mentioned Not mentioned Not mentioned Not mentioned Not mentioned Not mentioned |
23 (51.1%) patients were discharged from the ICU 11 (24.2%) patients were discharged One (2.2%) patient died |
37 (82.2%) patients developed ARDS and 13 (28.9%) patients developed septic shock 20 (44.4%) patients required intubation and nine (20%) patients required extracorporeal membrane oxygenation |
At the time of study submission, half of the patients had not been discharged from the ICU; as such, it was difficult to estimate ICU stay, ventilation-free days, case fatality rate and the predictors of fatality Drug dose, frequency and duration were not included |
34 | Xu et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ 2020; 368:m606. | 62 | 41 | 35 M (56%) 27 F (44%) |
Retrospective study | Antiviral: 55 (89%) Antibiotic Corticosteroid and gamma globulin |
Interferon-α inhalation: 8 (13%) Lopinavir/ritonavir: 4 (6%) Arbidol + interferon-α inhalation: 1 (2%) Lopinavir/ritonavir + interferon-α inhalation: 21 (34%) Arbidol + lopinavir/ritonavir: 17 (28%) Arbidol + lopinavir/ritonavir + interferon-α inhalation: 4 (6%) 28 (45%) 16 (26%) |
No deaths | Not reported | At the time of study submission, most patients had not been discharged, so it was difficult to estimate the case fatality rate or the predictors of fatality |
35 | Xu et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020. https://doi.org/10.1016/S2213-2600(20)30076-X | 1 | 50 | M | Postmortem biopsies | Antiviral Antibiotic Corticosteroid |
Interferon-α2b atomization Lopinavir + ritonavir Moxifloxacin Methylprednisolone |
Died due to cardiac arrest | Chest x-ray showed progressive infiltrate and diffuse gridding shadow in both lungs. Hypoxaemia and shortness of breath worsened and patient had sudden cardiac arrest | This was a single case study and does not represent the whole population The patient refused ventilator support in the ICU repeatedly because he suffered from claustrophobia; therefore, he received high-flow nasal cannula There is a need for randomized controlled trials |
36 | Yang et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020. https://doi.org/10.1016/S2213-2600(20)30079-5 | 52 | 59.7 | 35 M (67%) 17 F (33%) |
Single-centre retrospective, observational study | Vasoconstrictor Antiviral: 23 (44%) Antibacterial Glucocorticoid Immunoglobulin |
18 (35%) Oseltamivir: 18 (35%) Ganciclovir: 14 (27%) Lopinavir: 7 (13.5%). 49 (94%) 30 (58%) 28 (54%) |
32 (61.5%) patients died | Not reported | Due to the exploratory nature of the study, which was not driven by formal hypotheses, the sample size calculation was waived The researchers acknowledged that some specific information from the ICU was missing, such as mechanical ventilation settings Drug dose, frequency and duration were not included |
37 | Young et al. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA 2020. https://doi.org/10.1001/jama.2020.3204 | 18 | 47 | 9 M (50%) 9 F (50%) |
Descriptive case series | Antiretroviral Antiviral Antibiotic |
Lopinavir/ritonavir Oseltamivir Not reported |
No deaths | Not reported | Small sample size Drug dose, frequency and duration were not included |
38 | Zhang et al. Clinical characteristics of 82 death cases with COVID-19. medRxiv 2020. https://doi.org/10.1101/2020.02.26.20028191 | 82 | 72.5 | 65.9% M | Death cases | Antiviral Antibiotic Corticosteroid |
82 (100%) 82 (100%) 29 (35.3%) |
Not reported | The study was performed in one setting. No information was given about the hospital's capabilities in terms of personnel or equipment because the mortality rate from this centre was a little higher than other centres Traditional Chinese medicine was given Drug dose, frequency and duration were not included |
|
39 | Zhang et al. Clinical features and outcomes of 221 patients with COVID-19 in Wuhan, China. medRxiv 2020. https://doi.org/10.1101/2020.03.02.20030452 | 221 | 55 | 108 M (48.9%) 113 F (51.1%) |
Retrospective case study | Antiviral: 196 (88.7%) Antibiotic Corticosteroid: 115 (52.0%) |
Oseltamivir Arbidol hydrochloride Interferon-α atomization inhalation Lopinavir/ritonavir Moxifloxacin hydrochloride Piperacillin sodium tazobactam sodium Cefoperazone sulbactam Glucocorticoid: 64 (49.6%) |
12 (5.4%) patients died | Not reported | The dose and duration of IV glucocorticoid treatment showed no difference in symptomatic relief and death Drug dose, frequency and duration were not included |
40 | Zhang et al. The potential role of IL-6 in monitoring coronavirus disease 2019. https://doi.org/10.1101/2020.03.01.20029769 | 80 | 53 | 46 F (57.5%) 34 M (42.5%) |
Data collection (clinical data from patients with COVID-19 diagnosed by laboratory test in study institution) Observation of clinical manifestation |
Antibiotic: 73 (91.25%) Oseltamivir: 20 (25%) Ribavirin, ganciclovir or peramivir: 47 (58.75%) Arbidol: 49 (61.25%) Antifungal: 10 (12.5%) IV immunoglobin: 36 (45%) Corticosteroid: 29 (36·25%) |
Not mentioned | IL-6 may be used as a biomarker for disease monitoring in severe cases of COVID-19 | Not reported | Drug dose, frequency and duration were not included IL-6 and the pathogenesis of COVID-19 remains elusive |
41 | Zhou et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020. https://doi.org/10.1016/S0140-6736(20)30566-3 | 191 | 56 | 119 M (62%) 72 F (38%) |
Retrospective cohort study | Antibiotic: 181 (95%) Antiviral: 41 (21%) Corticosteroid: 57 (30%) IV immunoglobin: 46 (24%) |
Lopinavir/ritonavir | 137 patients were discharged 54 patients died |
191 patients | There was no observation of a shortening of the duration of viral shedding after lopinavir/ritonavir treatment Drug dose, frequency and duration were not included |
COVID-19, coronavirus disease 2019; SARS-CoV-2, severe acute respiratory syndrome coronavirus-2; ICU, intensive care unit; ARDS, acute respiratory distress syndrome; IL-6, interleukin-6; NA, not applicable; IV, intravenous; IM, intramuscular.