Prophylaxis for COVID-19: a systematic review.
Animals
Antibodies, Monoclonal
/ therapeutic use
Antibodies, Neutralizing
/ therapeutic use
Antibodies, Viral
/ therapeutic use
Antimalarials
/ therapeutic use
Antiviral Agents
/ therapeutic use
COVID-19
/ prevention & control
Humans
Hydroxychloroquine
/ therapeutic use
Post-Exposure Prophylaxis
Pre-Exposure Prophylaxis
Randomized Controlled Trials as Topic
SARS-CoV-2
/ immunology
Vaccines
COVID-19
Prophylaxis
Randomized control trials
SARS-CoV-2
Systematic review
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
06
11
2020
revised:
30
12
2020
accepted:
09
01
2021
pubmed:
22
1
2021
medline:
20
4
2021
entrez:
21
1
2021
Statut:
ppublish
Résumé
While the landscape of vaccine and treatment candidates against the novel coronavirus disease 2019 (COVID-19) has been reviewed systematically, prophylactic candidates remain unexplored. To map pre- and postexposure prophylactic (PrEP and PEP) candidate for COVID-19. PubMed/Medline, Embase, International Committee of Medical Journal Editors and International Clinical Trials Registry Platform clinical trial registries and medRxiv. All studies in humans or animals and randomized controlled trials (RCTs) in humans reporting primary data on prophylactic candidates against COVID-19, excluding studies focused on key populations. PrEP and PEP candidate for COVID-19. Systematic review and qualitative synthesis of COVID-19 PrEP and PEP studies and RCTs complemented by search of medRxiv and PubMed and Embase for studies reporting RCT outcomes since systematic review search completion. We identified 13 studies (from 2119 database records) and 117 RCTs (from 5565 RCTs listed in the registries) that met the inclusion criteria. Non-RCT studies reported on cross-sectional studies using hydroxychloroquine (HCQ) in humans (n = 2) or reported on animal studies (n = 7), most of which used antibodies. All five completed RCTs focused on the use of HCQ as either PrEP or PEP, and these and the cross-sectional studies reported no prophylactic effect. The majority of ongoing RCTs evaluated HCQ or other existing candidates including non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, anti(retro)virals or use of vitamins and supplements. The key message from completed studies and RCTs seems to be that HCQ does not work. There is little evidence regarding other compounds, with all RCTs using candidates other than HCQ still ongoing. It remains to be seen if the portfolio of existing molecules being evaluated in RCTs will identify successful prophylaxis against COVID-19 or if there is a need for the development of new candidates.
Sections du résumé
BACKGROUND
BACKGROUND
While the landscape of vaccine and treatment candidates against the novel coronavirus disease 2019 (COVID-19) has been reviewed systematically, prophylactic candidates remain unexplored.
OBJECTIVES
OBJECTIVE
To map pre- and postexposure prophylactic (PrEP and PEP) candidate for COVID-19.
DATA SOURCES
METHODS
PubMed/Medline, Embase, International Committee of Medical Journal Editors and International Clinical Trials Registry Platform clinical trial registries and medRxiv.
STUDY ELIGIBILITY CRITERIA AND PARTICIPANTS
METHODS
All studies in humans or animals and randomized controlled trials (RCTs) in humans reporting primary data on prophylactic candidates against COVID-19, excluding studies focused on key populations.
INTERVENTIONS
METHODS
PrEP and PEP candidate for COVID-19.
METHODS
METHODS
Systematic review and qualitative synthesis of COVID-19 PrEP and PEP studies and RCTs complemented by search of medRxiv and PubMed and Embase for studies reporting RCT outcomes since systematic review search completion.
RESULTS
RESULTS
We identified 13 studies (from 2119 database records) and 117 RCTs (from 5565 RCTs listed in the registries) that met the inclusion criteria. Non-RCT studies reported on cross-sectional studies using hydroxychloroquine (HCQ) in humans (n = 2) or reported on animal studies (n = 7), most of which used antibodies. All five completed RCTs focused on the use of HCQ as either PrEP or PEP, and these and the cross-sectional studies reported no prophylactic effect. The majority of ongoing RCTs evaluated HCQ or other existing candidates including non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, anti(retro)virals or use of vitamins and supplements.
CONCLUSIONS
CONCLUSIONS
The key message from completed studies and RCTs seems to be that HCQ does not work. There is little evidence regarding other compounds, with all RCTs using candidates other than HCQ still ongoing. It remains to be seen if the portfolio of existing molecules being evaluated in RCTs will identify successful prophylaxis against COVID-19 or if there is a need for the development of new candidates.
Identifiants
pubmed: 33476807
pii: S1198-743X(21)00040-9
doi: 10.1016/j.cmi.2021.01.013
pmc: PMC7813508
pii:
doi:
Substances chimiques
Antibodies, Monoclonal
0
Antibodies, Neutralizing
0
Antibodies, Viral
0
Antimalarials
0
Antiviral Agents
0
Vaccines
0
Hydroxychloroquine
4QWG6N8QKH
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
532-537Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Medical Research Council
ID : MC_PC_19012
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R015600/1
Pays : United Kingdom
Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
Références
Cureus. 2020 May 28;12(5):e8342
pubmed: 32494546
Trials. 2019 Dec 30;20(1):800
pubmed: 31888725
Curr Med Sci. 2020 Jun;40(3):480-485
pubmed: 32474860
Science. 1983 May 20;220(4599):868-71
pubmed: 6189183
Cell. 2020 May 14;181(4):865-876.e12
pubmed: 32353252
Nature. 2020 Aug;584(7820):257-261
pubmed: 32512579
Am J Prev Med. 2020 Oct;59(4):493-503
pubmed: 32778354
J Med Virol. 2021 Mar;93(3):1573-1580
pubmed: 32897543
Science. 2020 Aug 21;369(6506):956-963
pubmed: 32540903
Science. 2020 Nov 20;370(6519):950-957
pubmed: 32972994
J Antimicrob Chemother. 2021 Feb 11;76(3):827-829
pubmed: 33219675
BMJ. 2009 Jul 21;339:b2535
pubmed: 19622551
Science. 2020 Jul 24;369(6502):413-422
pubmed: 32532802
BMJ. 2020 Mar 18;368:m1090
pubmed: 32188598
N Engl J Med. 2020 Aug 6;383(6):517-525
pubmed: 32492293
Trials. 2020 Apr 15;21(1):327
pubmed: 32293511
MMWR Morb Mortal Wkly Rep. 1981 Jul 3;30(25):305-8
pubmed: 6789108
J Med Virol. 2020 Jun;92(6):639-644
pubmed: 32141619
BMJ. 2020 Jul 30;370:m2980
pubmed: 32732190
Adv Integr Med. 2020 Dec;7(4):203-217
pubmed: 32837894
PLoS One. 2020 Aug 20;15(8):e0237903
pubmed: 32817689
Ann Intern Med. 2021 Mar;174(3):344-352
pubmed: 33284679
Nature. 2020 Sep;585(7826):584-587
pubmed: 32698191
Rev Med Suisse. 2020 May 6;16(692):966-967
pubmed: 32374550
Clin Infect Dis. 2021 Jun 1;72(11):e835-e843
pubmed: 33068425
Drugs Ther Perspect. 2020 May 20;:1-2
pubmed: 32837186
JAMA Intern Med. 2021 Feb 1;181(2):195-202
pubmed: 33001138
Virol J. 2020 Sep 9;17(1):136
pubmed: 32907596
Proc Natl Acad Sci U S A. 2020 Nov 24;117(47):29832-29838
pubmed: 33139569
Proc Natl Acad Sci U S A. 2020 Oct 27;117(43):26955-26965
pubmed: 33037151
New Microbes New Infect. 2020 Nov;38:100813
pubmed: 33204427
Singapore Med J. 2015 Jul;56(7):366-7
pubmed: 26243971
Panminerva Med. 2020 May 26;:
pubmed: 32456404