Utilization of Therapeutic Interventions for Coronavirus Disease-2019 (COVID-19) Hospitalized Patients and Emerging Treatment Possibilities from Clinical Trials: A Systematic Review and Meta-Analysis

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Published Apr 25, 2023
DOI: https://doi.org/10.18103/mra.v11i4.3673

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Main Article Content

Preeti Malik, MD, MPH
Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Azka Zergham, MBBS
Department of Internal Medicine, Larkin Community Hospital, FL, USA. Lakshmi Saravanan, MD(c), Department of Internal Medicine, American University of Antigua, Jabberwock Rd, Osbourn, Antigua & Barbuda.
Neel Patel, MBBS
Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Yasameen Kerakhan, MBBS
Department of Internal Medicine, Abrazo Central Campus, Phoenix, AZ, USA.
Shamima Somi, MD
Department of Internal Medicine, Grand Rehabilitation and Nursing Home, Great Neck, NY, USA.
Nagaraj Sanchitha Honganur, MBBS
Department of Internal Medicine and Cardiology, University of Illinois, Chicago, USA.
Aelia Akbar, MD, MPH
Department of Internal Medicine, Loyola University, Chicago, IL, USA. ; Pragya Jaiswal, MD, Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.
Aran Deol, MD
Department of Internal Medicine, Swedish Covenant Hospital, Chicago, IL, USA. ; Benedict Francis, MD, Department of Internal Medicine, Jackson Park Hospital, Chicago, IL, USA. ; Deep Mehta, MD, MSCR, Department of Clinical Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Richa Jaiswal, MD
Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.
Janice L. Gabrilove, MD, FACP
Department of Internal Medicine and Oncological Sciences, Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, NY, USA,
Urvish Patel, MD, MPH
Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Abstract

Background and Objective: Few small observational studies have described various therapeutic interventions utilized in coronavirus disease 2019 (COVID-19) patients based on single/multi-center experiences across the globe. Understanding the utilization of available and possible treatments to curb the COVID-19 pandemic is paramount. We aimed to identify the prevalence and disease-associated utilization of specific therapeutic reagents in hospitalized COVID-19 patients as a function of severity status.


Methods: In systematic review and meta-analysis, extracted data on treatments utilized and severity of COVID-19 hospitalized patients from observational studies using PRISMA guidelines from December 1, 2019 to August 20, 2020. The pooled prevalence and odds of treatment utilization were obtained, and created forest plots using random‐effects models. 


Results: 29 studies with 8570 COVID-19-positive patients were included. Higher odds of the utilization of steroids (pooled OR:4.47; 95%CI:3.18–6.28; p<0.00001), antibiotics (3.1;1.81–5.30; p<0.0001), and IV Immunoglobulin (IVIG) (3.76;2.11–6.72; p<0.00001) was observed in patients with severe disease. No association of remdesivir (initially administered via clinical trials and subsequently FDA-approved during this study period), lopinavir/ritonavir, or hydroxychloroquine (HCQ) treatment with the severity of disease was observed.


Conclusion: Higher utilization of steroids, lopinavir/ritonavir, antibiotics, hydroxychloroquine (HCQ), and IV Immunoglobulin (IVIG) was observed in severe COVID-19 patients. Due to limited studies on remdesivir, its accurate utilization could not be delineated. Currently, no Level A evidence favoring single-drug treatment for COVID-19 exists, and trials are needed of combination therapy to evaluate efficacy on the survival outcome.

Keywords: COVID-19, 2019-nCoV, Corticosteroids, Lopinavir/ Ritonavir, Hydroxychloroquine, Immunoglobulins, Remdesivir, and SARS-CoV-2, mortality, invasive mechanical ventilation

Article Details

How to Cite
MALIK, Preeti et al. Utilization of Therapeutic Interventions for Coronavirus Disease-2019 (COVID-19) Hospitalized Patients and Emerging Treatment Possibilities from Clinical Trials: A Systematic Review and Meta-Analysis. Medical Research Archives, [S.l.], v. 11, n. 4, apr. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3673>. Date accessed: 26 dec. 2024. doi: https://doi.org/10.18103/mra.v11i4.3673.
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Vol 11 No 4 (2023): APRIL ISSUE, Issue 4, VOl.11
Section
Review Articles

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