Objectives
This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to investigate the clinical efficacy and safety of Janus kinase (JAK) inhibitors for COVID-19 patients.
Methods
PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched from inception to July 12, 2021. RCTs comparing the clinical efficacy and safety of JAK inhibitors with a placebo or standard care in treating COVID-19 patients were included. The primary outcome was all-cause mortality rate at day 28.
Results
Three RCTs were included in this meta-analysis. The all-cause mortality rate at day 28 was lower among the patients receiving JAK inhibitors than among the controls (4.1% [28/647] versus 7.0% [48/684], OR, 0.57; 95% CI, 0.36–0.92,
I
2
= 0). The clinical recovery rate was higher among the patients receiving JAK inhibitors than among the controls (85.1% (579/680) versus 80.0% [547/684], OR, 1.45; 95% CI, 1.09–1.93,
I
2
= 0). Additionally, the use of JAK inhibitors was associated with a shorter time to recovery than among the controls (MD, −2.84; 95% CI, −5.56 to −0.12;
I
2
= 50%). The rate of invasive mechanical ventilation (MV) was lower in the patients who used JAK inhibitors than among the controls. Finally, no significant difference was observed between the patients who used JAK inhibitors and the controls in the risk of any adverse events (OR, 0.92; 95% CI, 0.64–1.34;
I
2
= 33%) and serious adverse events (OR, 0.80; 95% CI, 0.45–1.44;
I
2
= 46%).
Conclusions
JAK inhibitors can lead to a better clinical outcome of hospitalized COVID-19 patients, and they are a safe agent in the treatment of COVID-19.
Objective
This systematic review and meta-analysis examined the efficacy of sofosbuvir-based antiviral agents against coronavirus disease 2019 (COVID-19).
Methods
PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched from inception to 15 August 2021. Studies comparing the clinical efficacy and safety of sofosbuvir-based antiviral regimens (study group) with other antivirals or standard of care (control group) in patients with COVID-19 were included.
Results
Overall, 687 patients with COVID-19 were included, of which 377 patients received sofosbuvir-based treatment. Mortality was lower in the study group than in the control group (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.30-0.79;
I
2
= 0%). The overall clinical recovery rate was higher in the study group than in the control group (OR, 1.82; 95% CI, 1.20-2.76;
I
2
= 28%). The study group presented a lower requirement for mechanical ventilation (OR, 0.33; 95% CI, 0.13-0.89;
I
2
= 0%) and intensive care unit (ICU) admission (OR, 0.42; 95% CI, 0.25-0.70;
I
2
= 0%) than the control group. Furthermore, the study group exhibited a shorter length of hospital stay (mean deviation [MD], -1.49; 95% CI, -2.62 to -0.37,
I
2
= 56%) and recovery time (MD, -1.34; 95% CI, -2.29, -0.38,
I
2
= 46%) than the control group.
Conclusions
Sofosbuvir-based treatment may help reduce mortality in patients with COVID-19 and improve associated clinical outcomes. Furthermore, sofosbuvir-based treatment was as safe as the comparator in patients with COVID-19. However, further large-scale study is warranted to validate these findings.
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