Impact of COVID-19 on clinical trials and clinical research: A systematic review

Abstract

Background: The World Health Organization has reported more than 31,186,000 confirmed cases of coronavirus disease-19 (COVID-19), including 962,343 deaths, worldwide as on September 21, 2020. The current COVID-19 pandemic is affecting clinical research activities in most parts of the world. The focus on developing a vaccine for SARS-CoV-2 and the treatment of COVID-19 is, in fact, disrupting many upcoming and/or ongoing clinical trials on other diseases around the globe. On March 18, 2020, the United States Food and Drug Administration (FDA) issued an updated guideline for the conduct of clinical trials during the current health emergency situation. The potential challenges, such as social distancing and quarantines, result in study participants’ inaccessibility and trial personnel for in-person scheduled study visits and/or follow-up. Due to the sudden onset and wide-spread impact of COVID-19, its influence on the management of clinical trials and research necessitates urgent attention. Therefore, our systematic review of the literature aims to assess the impact of the COVID-19 pandemic on the conduction of clinical trials and research. The search for the relevant articles for review included the keywords "COVID-19” AND "clinical trial" in PubMed, MEDLINE, Embase, Google scholar and Google electronic databases. Key findings include: delaying subject enrollment and operational gaps in most ongoing clinical trials, which in turn has a negative impact on trial programmes and data integrity. Globally, most sites conducting clinical trials other than COVID-19 are experiencing a delay in timelines and a complete halt of operations in lieu of this pandemic, thus affecting clinical research outcomes.

Readiness to Implement Symptom Management Care Pathways in Pediatric Cancer

“…This nding is in contrast to a recent meta-analysis suggesting that trial delays and cessation were common and were a direct consequence of the pandemic. [21] Our ndings may differ because the survey was distributed later in the pandemic, when many institutions had adapted to it. Further, some institutions have made distinctions based upon whether research activities are in person vs. not in person and whether they are essential vs. not essential.…”

Imaging diagnosis of bronchogenic carcinoma (the forgotten disease) during times of COVID-19 pandemic: Current and future perspectives

“…However, the prescribed recommendations are aimed at reducing the risk of COVID-19 transmission. Since NSCLC patients are prone to be reactive during the course of treatment even if drug-induced pneumonitis is suspected, it is necessary to rule out COVID-19 related pulmonary syndrome[ 66 ]. In light of the current COVID-19 pandemic, low-dose CT of chest which was traditionally performed for bronchogenic carcinoma screening should be rescheduled especially in patients with underlying cardiopulmonary abnormalities which can put them at increased risks for mortality from COVID-19 pneumonia.…”

Clinical Research Redirection and Optimization During a Pandemic

“…The inaccessibility of trial participants and research personnel due to social distancing rules during COVID-19 led to delays in patient enrollment, and operational gaps in clinical trials may have a negative impact on data integrity. 14 Patient screening and recruitment. The success and generalizability of clinical trials depend considerably on extensive participant enrollment.…”