Interventions for treatment of COVID-19: a protocol for a living systematic review with network meta-analysis including individual patient data (The LIVING Project)

Abstract

Background: COVID-19 is a rapidly spreading virus infection that has quickly caused extensive burden to individual, families, countries, and the globe. No intervention has yet been proven effective for the treatment of COVID-19. Some randomized clinical trials assessing the effects of different drugs have been published, and more are currently underway. There is an urgent need for a living, dynamic systematic review that continuously evaluates the beneficial and harmful effects of all available interventions for COVID-19. Methods/design: We will conduct a living systematic review based on searches of major medical databases (e.g., MEDLINE, EMBASE, CENTRAL) and clinical trial registries from their inception onwards to identify relevant randomized clinical trials. We will update the literature search once a week to continuously assess if new evidence is available. Two review authors will independently extract data and perform risk of bias assessment. We will include randomized clinical trials comparing any intervention for the treatment of COVID-19 (e.g., pharmacological interventions, fluid therapy, invasive or noninvasive ventilation, or similar interventions) with any comparator (e.g., an "active" comparator, standard care, placebo, no intervention, or "active placebo") for participants in all age groups with a diagnosis of COVID-19. Primary outcomes will be all-cause mortality and serious adverse events. Secondary outcomes will be admission to intensive care, mechanical ventilation, renal replacement therapy, quality of life, and non-serious adverse events. The living systematic review will include aggregate data meta-analyses, Trial Sequential Analyses, network meta-analysis, and individual patient data meta-analyses. Risk of bias will be assessed with domains, an eight-step procedure will be used to assess if the thresholds for clinical significance are crossed, and the certainty of the evidence will be assessed by Grading of Recommendations, Assessment, Development and Evaluations (GRADE). Discussion: COVID-19 has become a pandemic with substantial mortality. A living systematic review evaluating the beneficial and harmful effects of pharmacological and other interventions is urgently needed. This review will continuously inform best practice in treatment and clinical research of this highly prevalent disease. Systematic review registration: PROSPERO CRD42020178787

Interventions for treatment of COVID-19: A living systematic review with meta-analyses and trial sequential analyses (The LIVING Project)

“…We report this systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines ( S1 Text ) [ 10 , 11 ]. The updated methodology used in this living systematic review is described in detail in The Cochrane Handbook of Systematic Reviews of Interventions [ 12 ] and our protocol [ 9 ], which was registered in the PROSPERO database (ID: CRD42020178787) prior to the systematic literature search.…”

“…The present living systematic review with aggregate meta-analyses and trial sequential analyses aims to continuously inform evidence-based guideline recommendations for the treatment of COVID-19, taking risks of systematic errors (“bias”), risks of random errors (“play of chance”), and certainty of the findings into consideration [ 9 ].…”

Vaccines to prevent COVID-19: a protocol for a living systematic review with network meta-analysis including individual patient data (The LIVING VACCINE Project)

“…There is currently no vaccine for COVID-19 (17). To control the growing COVID-19 pandemic, we currently rely on quarantine, isolation, and infection-control measures to prevent disease spread (18), and on supportive care including oxygen and mechanical ventilation for infected patients experiencing respiratory di culty (19). Today, the effects of numerous vaccines against severe acute respiratory syndrome coronavirus (SARS-COV-2) are being assessed in randomized clinical trials (17) (see Table 1).…”

“…We will identify additional references by manually searching the references of articles from the computerized databases. We will also search special COVID- 19…”

Das Coronavirus und die physiotherapeutische Praxis

“…Es wird zukünftig interessant werden, einen Abgleich zu zunehmend systematischer erarbeiteten Aussagen vorzunehmen und Evaluationen zur Effektivität zu betrachten. "Living Systematic Reviews" scheinen hier eine besondere Chance zu bieten [5]. Deutschsprachige Einträge finden sich im COVIDPhysio-Register bislang wenige.…”