Table 1.
Summary of clinical studies investigating proposed treatments of COVID-19.
| Investigation | Study | Country | Study type | Population (n patients) | Intervention group | Control group | Outcome | |
|---|---|---|---|---|---|---|---|---|
| Anti-viral therapies | LPV/ RTV | Cao, B. et al. [37] | China | Open-label, randomized,controlled trial | >18 years, severe COVID-19 pneumonia cases. (n = 199) | LPV/ RTV (400 mg/100 mg) orally b.i.d. plus standard care for 14 days. | Standard care only for 14 days. | No benefit was observed with LPV/ RTV beyond standard care treatment. |
| Deng, L. et al. [40] | China | Retrospective cohort study | ≥18years, confirmed COVID-19 cases, without Invasive ventilation. (n = 33) | Umifenovir (Arbidol®) (200 mg/ 8 h) plus LPV/ RTV (400 mg/100 mg) for 5–21 days. | Oral LPV/ RTV only for 5–21 days. | Better clinical, radiological and laboratorial (RT-PCR negativity) response was observed in the (Umifenovir + lPV/ RTV) group. | ||
| Remdesivir | Grein, J. et al. [36] | Multi-national | Cohort study. | Hospitalized confirmed COVID-19 cases with O2 saturation ≤ 94% or receiving O2 support. (n = 61) | Remdesivir (200 mg IV. On D1 then 100 mg daily) total duration: 10 days. | NA | Clinical improvement was observed in 68 % of patients. Total mortality rate was 13 %. | |
| CQ/HCQ | Chen, J. et al. [59] | China | Randomized pilot study | Hospitalized confirmed COVID-19 cases. (n = 30) | HCQ (400 mg / day) for 5 days plus conventional treatments. | Conventional treatment only. | Duration from hospitalization to COVID-19 nucleic acid negativity, clinical improvement, and radiological changes were comparable with the control group. | |
| Chen, Z. et al.d [63] | China | Randomized clinical trial | ≥ 18 years, COVID-19 pneumonia cases. (n = 62) | HCQ (400 mg/day) orally for 5-days. | Standard treatment only. | HCQ significantly shortened TTCR and promote the absorption of pneumonia. | ||
| Gautret, P. et al. [64] | France | open-label Non-randomized clinical trial | >12 years, hospitalized confirmed COVID-19 cases. (n = 36) | HCQ sulfate orally (200 mg t.i.d./day) for ten days | Standard treatment only. | HCQ was significantly associated with viral load reduction/disappearance in COVID-19 patients and azithromycin reinforced its effect. | ||
| -Six patients received Azithromycin (500 mg) on D1 followed by (250 mg /day) the next four days. | ||||||||
| Gautret, P. et al.d [65] | France | Observational study | Hospitalized confirmed COVID-19 cases (n = 80) | HCQ sulfate orally (200 mg t.i.d./day) for ten days plus Azithromycin (500 mg on D1 followed by 250 mg/ day) for the next four days. | NA | Rapid fall of viral load (93 % negative PCR at D8). Virus cultures from respiratory samples were negative in 97.5 % patients at D5. | ||
| Anti-viral therapies | CQ/HCQ | Tang, W. et al.d [60] | China | Open-label, randomized, controlled trial. | ≥ 18 years, Hospitalized confirmed COVID-19 cases. (n = 150) | HCQ (1200 mg/day for 3 days, then 800 mg/day) total duration: 2−3 weeks for mild/moderate or severe patients, respectively. | Standard treatment only. | HCQ did not result in a higher negative conversion rate, but more clinical improvement than the control group was observed. |
| Adjunctive Therapy | Tocilizumab | Xu, X. et al. [82] | China | Observation study | Severe or critical COVID-19 patients | Tocilizumab IV. (400 mg once)a | NA | All patients had clinical, radiological and laboratory (LYM and CRP level) improvement. |
| (n = 21) | Three patients had another 400 mg within 12 h. | |||||||
| Siltuximab | Gritti, G. et al.d [91] | Italy | Retrospective study | Confirmed COVID-19 pneumonia cases with ARDS. (n = 21) | Siltuximab IV. (11 mg /kg /day) over 1 h plus standard treatment. | NA | Potential role in improving the clinical condition (33 % of patients improved, and 43 % stabilized, while 24 % had worsening in condition. | |
| convalescent plasma | Shen, C. et al. [81] | China | Case series | Confirmed critically ill COVID-19 cases on mechanical ventilation. with (n = 5) | Convalescent plasma (400 mL) with a SARS-CoV-2 specific antibody (IgG).b | NA | Clinical improvement was reported in all patients. | |
| Viral loads became negative within 12 days after transfusion. | ||||||||
| CS + IVIG | Zhou, Zhi-Guo. et al.d [78] | China | Retrospective study | Patients who failed to respond to low-dose CS (40−80 mg/day) and IVIG (10 g/day). (n = 3) | CS (160 mg/day) plus IVIG (20 g/d).c | NA | Moderate dose of CS + IVIG reversed the continued deterioration of COVID-19 patients who failed to respond to the low-dose therapy. | |
Abbreviations: n: number, LPV/ RTV: Lopinavir/Ritonavir, b.i.d.: Twice daily, h: Hour, O2: oxygen, CQ /HCQ: Hydroxychloroquine, TTCR: Time to clinical recovery, D: Day, PCR: Polymerase chain reaction, IV: Intravenous, LYM: Lymphocytes, CRP: C-reactive protein, CS: Corticosteroids, IVIG: Intravenous Immunoglobulins.
a
Patients also received standard care including Lopinavir, methylprednisolone, and oxygen therapy.
b
All patients received antiviral agents and methylprednisolone.
c
Patients also received, as required, oxygen therapy, antiviral treatment, antibiotic treatment, extracorporeal membrane oxygenation (ECMO), and continuous renal replacement therapy (CRRT).
d
Pre-print.