Yousefifard Mahmoud, Zali Alireza, Mohamed Ali Kosar, Madani Neishaboori Arian, Zarghi Afshin, Hosseini Mostafa, Safari Saeed
Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.
Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Acad Emerg Med. 2020 Apr 6;8(1):e45. eCollection 2020.
The purpose of the current systematic review is to evaluate the efficacy of antiviral therapies in treatment of COVID-19. In addition, clinical trials on the efficacy of antiviral therapies in the management of Severe Acute Respiratory Syndrome coronavirus (SARS-Cov) or Middle East Respiratory Syndrome coronavirus (MERS-CoV) have also been reviewed, in order to identify potential treatment options for COVID-19.
An extensive search was performed in Medline, Embase, Scopus, Web of Science and CENTRAL databases until the end of March 15, 2020. Two independent researchers performed the screening, and finally the related studies were included.
Only one clinical trial on the efficacy of antiviral therapy in management of COVID-19 was found. The results depicted that adding Lopinavir-Ritonavir to the standard treatment regimen of patients with severe COVID-19 has no benefits. Moreover, 21 case-series and case-report studies reported the prescription of antiviral agents in COVID-19, none of which can be used to determine the efficacy of antiviral therapies in confronting COVID-19. In addition, no clinical trials were found to be performed on the efficacy of antiviral agents in the management of SARS-CoV and MERS-CoV.
The current evidence impede researchers from proposing an appropriate antiviral therapy against COVID-19, making the current situation a serious concern for international organizations such as World Health Organization (WHO). In the time of the current pandemic and future epidemics, organizations such as WHO should pursue more proactive actions and plan well-designed clinical trials so that their results can be used in managing future epidemics.
本系统评价的目的是评估抗病毒疗法治疗新型冠状病毒肺炎（COVID-19）的疗效。此外，还对抗病毒疗法治疗严重急性呼吸综合征冠状病毒（SARS-CoV）或中东呼吸综合征冠状病毒（MERS-CoV）疗效的临床试验进行了综述，以确定COVID-19的潜在治疗方案。
在Medline、Embase、Scopus、科学引文索引和Cochrane系统评价数据库中进行广泛检索，直至2020年3月15日结束。由两名独立研究人员进行筛选，最终纳入相关研究。
仅发现一项关于抗病毒疗法治疗COVID-19疗效的临床试验。结果表明，在重度COVID-19患者的标准治疗方案中加用洛匹那韦-利托那韦并无益处。此外，21项病例系列和病例报告研究报道了COVID-19中抗病毒药物的处方情况，但均无法用于确定抗病毒疗法对抗COVID-19的疗效。另外，未发现关于抗病毒药物治疗SARS-CoV和MERS-CoV疗效的临床试验。
目前的证据阻碍研究人员提出针对COVID-19的合适抗病毒疗法，这一现状引起了世界卫生组织（WHO）等国际组织的严重关切。在当前大流行及未来疫情期间，WHO等组织应采取更积极的行动，规划设计良好的临床试验，以便其结果可用于未来疫情的防控。
