Read the latest HealthWatch newsletter:  Issue 112, Spring 2020

What is the effectiveness and safety of antiviral or antibody treatments for coronavirus? – a lay summary

Are there yet any safe and effective drugs we can use to fight infection with COVID-19? This review looked at the available evidence around medicines that have so far been used against coronaviruses, with the hope of identifying safe and effective treatments for the current outbreak.

  •  The team reviewed studies from around the world that have reported experience of treating patients infected with different coronaviruses. These included SARS-CoV-1, the coronavirus that caused the 2002-2003 outbreak of severe acute respiratory syndrome (SARs); MER-CoV which causes Middle East Respiratory Syndrome (MERS), a rare disease first identified in 2012; and SARS-CoV-2 – the coronavirus responsible for the current outbreak of the disease we now call COVID-19.
  • The review looked into the safety and effectiveness of treating coronaviruses with antivirals – drugs that specifically target viruses. In coronavirus, the most researched antiviral is ribavirin, a drug normally used against the hepatitis C virus. Other studies used the influenza drug oseltamivir, or combinations of two other antiviral drugs.
  • The review also looked for studies reporting experience of treating COVID-19 patients with antibiotics and steroids; and also interferons and monoclonal antibodies, which are used in cancer to boost the body’s natural defences.
  • It found the current evidence for safety and effectiveness of antiviral therapies for coronavirus infections is inconclusive, and did not point to any particular treatments that could be recommended for use against COVID-19. There was a lack of well-designed trials of coronavirus treatments overall which means the quality of evidence may not be reliable enough on which to base treatment recommendations.
  • Ribavirin, the most studied antiviral, is of questionable effectiveness in coronavirus and has been associated with worrying side effects, such as anaemia, digestive problems, and altered liver function.
  • Four randomized controlled trials testing treatments for COVID-19 have been begun in China. These are examining various combinations of antiviral medications and, in one case, antivirals used alongside traditional Chinese medicine. These trials are so far in very early stages.

Mandy Payne, 30 March 2020

This is a lay summary of a report repared for the Oxford COVID-19 Evidence Service of the Oxford Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford by Patricia Rios, Amruta Radhakrishnan, Jesmin Antony, Sonia M Thomas, Mathew Muller, Sharon E Straus, Andrea C Tricco and posted on 26th March 2020.

Disclaimer: the article has not been peer-reviewed; it should not replace individual clinical judgement and the sources cited in the original report should be checked. The views expressed in this commentary represent an interpretation by HealthWatch and do not necessarily represent those of Oxford CEBM, the NHS, the NIHR, or the Department of Health and Social Care. The views are not a substitute for professional medical advice.

 

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