Table 3. Summary of findings table for GRADE approach quality of evidence assessment for evaluated outcomes.
Population: hospitalised COVID-19 patients, Setting: hospital, Intervention: Oseltamivir alone or in combination, Comparison: supportive care, other drugs, or placebo
| Certainty assessment | Nº of patients | Effect | Certainty | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Nº of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Oseltamivir alone/combination | other drugs alone/combination | Relative (95% CI) | Absolute (95% CI) | ||
| Patient recovery (survival) from COVID-19 associted with oseltamivir therapy: Using Oseltamivir alone/combination Vs Other drugs alone/conmbination | ||||||||||||
| 5 | observational studies | seriousa | not seriousb | not serious | not serious | nonec | 124/165 (75.2%) | 541/589 (91.9%) | OR 0.88 (0.16 to 4.65) | 1 fewer per 100 (from 25 fewer to 6 more) | ***0 Moderate | CRITICAL |
| 93.0% | 1 fewer per 100 (from 22 fewer to 5 more) | |||||||||||
| Virological response rate (follow-up: 74 days; assessed with: Days) | ||||||||||||
| 1 | observational studies | seriousd | not serious | not serious | seriousd | nonec,d | In this study, oseltamivir has a mean duration of 30 days to negative conversion as against 28.40, 28,94, 26.06, and 23.43 for L/R, HCQ, corticosteroid, and arbidol respectively. | **00 Low | IMPORTANT | |||
| Laboratory response | ||||||||||||
| 1 | observational studies | seriousd | not serious | not serious | seriousd | nonec,d | In this study, the assessment of most of the laboratory parameters were in favour of the comparison groups when compared to oseltamivir group. | **00 Low | IMPORTANT | |||
| Radiologic response (assessed with: CT lung lesions) | ||||||||||||
| 2 | observational studies | seriousd | seriousd | not serious | seriousd | nonec,d | The two studies reported conflicting results on the resolution of the computerised tomographic (CT) lesions observed. One of the studies (Tan etal., 2020) reported lung lesion reduction in favour of the oseltamivir group. While the other studies revealed worsening lung lesion in the oseltamivir group. | *000 Very low | IMPORTANT | |||
| Duration of Hospitalisation associated with Oseltamivir treatment | ||||||||||||
| 4 | observational studies | seriouse | not serious | not serious | seriousf | nonec,d | 107 | 87 | - | MD 3.14 Days fewer (10.05 fewer to 3.77 more) | **00 Low | IMPORTANT |
| Safety evaluation; adverse event (assessed with: monitoring of electrocardiographic (ECG) parameters (in milliseconds)) | ||||||||||||
| 1 | observational studies | not serious | not serious | not serious | not serious | nonec,d | The monitored ECG parameters showed results in favour of the oseltamivir group when compared to other drugs. | ****High | IMPORTANT | |||
CI: confidence interval; MD: mean difference; OR: odds ratio
Explanations
a. One study (Tan et al., 2021) had serious RoB response in D1 of ROBINS-I tool assessment.
b. I2 is 74% with P value of 0.004. However, in sensitivity analysis after the removal of one study the I2 reduced to 0% with a P value of 0.81.
c. Not assessed
d. Refer to S10 File for more information
e. Three studies (Tan et al., 2020, Vahedi et al., 2020 & Tan et al., 2021) had serious RoB responses in D1 of the ROBINS-I Rob assessment.
f. Two out of the four studies have the lower boundaries of their CI below the threshold. While one of the studies has the entire CI and point estimate below the threshold.