Therapeutic efficacy of four antiviral drugs in treatment of COVID-19: A protocol for systematic review and Network Meta-analysis

  1. Liang-kun Zhang
  2. Wen-chao Gu
  3. Ling Li
  4. Chen Jian

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Abstract

Introduction

The COVID-19 pandemic has resulted in a global crisis in public health, however, there are still no safe and effective drugs to resist COVID-19 until now. We will use network meta-analysis to analysis available evidence from RCTs to compare the safety and efficacy of four antiviral drugs (including Ribavirin, Arbidol, Chloroquine Phosphate and Interferon) alone or in combination, in patients with COVID-19 on the basis of standard treatment, to reveal the robustness and strength of evidence for relative efficacy against COVID-19, which will provide better evidence for future clinical decision-making.

Methods

Using English and Chinese search strategies to search 8 databases including PubMed, Web of Science, Embase, the Cochrane Library, CNKI, CBM, WANFANG Database and VIP. In addition, manual search for references in publications has been supplemented by electronic search. To enhance the effectiveness of this study, only randomized controlled trials of four antiviral drugs (Ribavirin, Arbidol, Chloroquine Phosphate, Interferon) used alone or in combination with the primary therapy shall be included.

Analysis

The nucleic acid turning negative, complete absorption of lung inflammation, adverse reactions, aggravation and death shall be the primary outcome measures; whereas temperature return to normal, hospitalization, and positive rate after discharge will be the secondary outcomes. To ensure the quality of the systematic evaluation of this study, study screening, data extraction and quality evaluation will be carried out independently by two reviewers, and any differences will be resolved through consultation between them or by a third reviewer.

Ethics and dissemination

This systematic review will evaluate the efficacy of four antiviral drugs (Ribavirin, Arbidol, Chloroquine Phosphate and Interferon) for Covid-19 in adults. Since all included data will be obtained from published articles, it does not require ethical approval and will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42022300104.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2022.04.05.22273473: (What is this?)

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

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    RandomizationReferences cited in the included publications will be manually searched to check for additional relevant randomised controlled trial reports.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data sources: Two investigators will search eight electronic databases (PubMed, Web of Science, Embase, the Cochrane Library, CNKI,
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    Cochrane Library
    suggested: (Cochrane Library, RRID:SCR_013000)
    Selection of studies: All retrieved records will be imported into EndNote (X9) to establish an information database and duplicate references will be deleted.
    EndNote
    suggested: (EndNote, RRID:SCR_014001)
    Risk of bias assessment: Two investigators will independently assess all included studies according to the Cochrane tool for assessing risk of bias[55] in randomised trials described in the Cochrane Handbook for Systematic Reviews of Interventions.
    Cochrane tool
    suggested: None
    Cochrane Handbook
    suggested: None
    Meta-analysis: We will use Stata version 17 (StataCorp, College Station, TX) to select appropriate models for network meta-analysis of each outcome indicator according to its heterogeneity.
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    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.
    • Thank you for including a protocol registration statement.

    Results from scite Reference Check: We found no unreliable references.

    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.

  2. Version published to 10.1101/2022.04.05.22273473v1 on medRxiv