Systematic and Statistical Review of Coronavirus Disease 19 Treatment Trials

  1. Juan A. Siordia
  2. Michael Bernaba
  3. Kenji Yoshino
  4. Abid Ulhaque
  5. Sooraj Kumar
  6. Mario Bernaba
  7. Edward Bergin

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Abstract

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  1. Version published to 10.1007/s42399-020-00399-6
  2. ScreenIT

    SciScore for 10.1101/2020.05.16.20102095: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationKey words included: COVID-19, SARS-CoV2, randomized, controlled, human, retrospective, prospective, trial, chloroquine, hydroxychloroquine, lopinavir, ritonavir, arbidol, umifenovir, favipiravir, steroids, glucocorticoids, interferon, plasma transfusion, convalescent plasma, ivermectin, remdesivir, azithromycin, heparin, and low-molecular weight heparin.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Databases included Google Scholar and Pubmed.
    Google Scholar
    suggested: (Google Scholar, RRID:SCR_008878)
    Pubmed
    suggested: (PubMed, RRID:SCR_004846)
    Statistical analyses used the Review Manager Version 5.3 (The Cochrane Collaboration, Copenhagen, Denmark) software program.
    Cochrane Collaboration
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations to the study included both study groups allowing for other therapies (i.e. glucocorticoids and lopinavir/ritonavir), although their use was not significantly different among the groups. Remdesivir was also started late in some of the study patients. The study was also considered underpowered.[20] Favipiravir is a broad spectrum antiviral against RNA viruses. Inside infected host cells, it becomes phosphorylated into Favipiravir-RTP and inhibits viral RNA-dependent RNA polymerase.[43–44] Favipiravir also suppresses tumor necrosis factor – alpha (TNF-a) production.[45–46] The human COVID-19 trials with favipiravir are compared with two specific controls. Compared to arbidol, favipiravir reduces symptom duration.[7] Compared to lopinavir/ritonavir, favipiravir reduces viral shedding time and hastens chest CT scan improvement while having fewer side effects.[21] Favipiravir adverse effects include gastrointestinal symptoms and elevated uric acid levels.[7,21] Its safe profile has made it a preferred medical therapy for those with cardiovascular and renal disease.[47–48] Heparin has various non-anticoagulant properties including reducing IL-6-associated inflammation.[49–51] IL-6 causes hypercoagulation.[51] Levels are significantly higher in severe COVID-19 patients.[49] Heparin binds to IL-6, reducing the interaction between IL-6, SIL-6R, and sgp130.[54] This benefit may explain the meta-analysis findings showing ARDS-associated mortality benefit with early low-molecu...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.05.16.20102095v1 on medRxiv