By Dr. Priyom Bose, Ph.D.Jun 22 2023Reviewed by Benedette Cuffari, M.Sc. Scientists worldwide are continually working to develop effective treatments and preventive measures against the severe acute respiratory syndrome coronavirus-2 , the causal agent of the ongoing coronavirus disease 2019 pandemic. Two effective COVID-19 treatments include monoclonal antibodies and small-molecule antivirals; however, these treatments are most effective when administered during the early infection phase.
Background The emergence of SARS-CoV-2 variants that escape immune protection also exhibits reduced efficacy against monoclonal antibody treatment, thus warranting more effective antivirals. Although placebo-controlled clinical trials are considered the gold standard to evaluate the effectiveness of a treatment, other approaches could be developed to accelerate the assessment process to determine effective COVID-19 therapies and ultimately reduce mortality rates.
About the study A new systematic review and meta-analysis were recently posted to the medRxiv* preprint server. Herein, researchers determine the virological effects of COVID-19 treatment and its clinical efficacy in the same trial. Studies that failed to present the outcomes of the RCTs were excluded. The RoB 2.0 tool was used to limit the risk of bias assessment.
The current study analyzed the effectiveness of treatment administered to unvaccinated COVID-19 outpatients in reducing the viral RNA levels in upper respiratory tract swabs. This reduction in SARS-CoV-2 RNA levels indicates the clinical efficacy of the treatment in preventing hospitalization and death.
No evidence was found regarding a relationship between virological outcomes at day seven and clinical outcomes. This could be because not many studies have considered this time point, whereas other studies reported insignificant viral load between control and treated groups at this time point.