• Lei Pei, Sheng Zhang, Linxi Huang, Xuqiang Geng, Linhao Ma, Weiwei Jiang, Wenfang Li, and Dechang Chen.
• Department of Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China
• Pol. Arch. Med. Wewn. 2020 Sep 30; 130 (9): 726733726-733.

IntroductionThe treatment effects of antiviral agents, glucocorticoids, antibiotics, and intravenous immunoglobulin are controversial in patients with coronavirus disease 2019 (COVID‑19).ObjectivesThis study aimed to evaluate the impact of drug therapy on the risk of death in patients with COVID‑19.Patients And MethodsThe PubMed, Embase, Web of Science, Cochrane Library, and major preprint platforms were searched to retrieve articles published until April 7, 2020. Subsequently, the effects of specific drug interventions on mortality of patients with COVID‑19 were assessed. Odds ratios (ORs) and relative risks (RRs) with corresponding 95% CIs were pooled using random effects models.ResultsOf 3421 references, 6 studies were included. Pooled results from retrospective studies revealed that antiviral agents may contribute to survival benefit (OR, 0.42; 95% CI, 0.17-0.99; P = 0.048; I2 = 82.8%), whereas a single randomized controlled trial found no effects of an antiviral agent on mortality (RR, 0.77; 95% CI, 0.45-1.3; P = 0.33). Glucocorticoid use led to an increased risk of death (OR, 2.43; 95% CI, 1.44-4.1; P = 0.001; I2 = 61.9%). Antibiotics did not significantly affect mortality (OR, 1.13; 95% CI, 0.67-1.89; P = 0.64; I2 = 0%). Similarly, intravenous immunoglobulin had a nonsignificant effect on mortality (OR, 2.66; 95% CI, 0.72-9.89; P = 0.14; I2 = 93.1%).ConclusionsWith the varied heterogeneities across interventions, the current evidence indicated a probable survival benefit from antiviral agent use and a harmful effect of glucocorticoids in patients with COVID‑19. Neither any of antibiotics nor intravenous immunoglobulin were associated with survival benefit in this population.

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