COVID-19 - Coronavirus disease 2019

Interventions for Covid-19 infection: a living mapping of research and a series of living network meta-analyses – living-NMA-covid

Submission summary

Context: In December 2019, a novel coronavirus outbreak was documented in Wuhan, Hubei Province, China. Over the first 6 weeks of the new decade, this novel coronavirus, known as SARS-CoV-2, has spread from China to 20 other countries and WHO recently characterized Covid-19 as a pandemic. To overcome this pandemic, researchers are actively working to accelerate the development of diagnostics, preventive interventions, therapeutics and vaccines. Many randomized and non-randomized studies have been already set up aiming to evaluate candidate therapeutic agents that may effectively reduce symptoms and avoid deaths. This emerging situation requires an optimum planning and conduct of research as well as strategies for the appropriate transposition of research into practice. Therefore, decision makers and researchers urgently need a complete, high-quality and up-to-date synthesis of all ongoing research and research outputs as soon as they are available.

Objective: Our aim is to provide researchers and decision makers a detailed and up-to date summary of all ongoing studies evaluating interventions for preventing and treating covid-19 infection, and provide an evidence synthesis for these interventions as soon as results are available.

Design: We will perform a living mapping of ongoing research followed by a series of living network meta-analyses. Living network meta-analyses are novel approaches in which multiple treatments (three or more) are being compared using both direct comparisons of interventions within randomized controlled trials and indirect comparisons across trials based on a common comparator. Hence, through a series of living network meta-analyses, we will be able to answer questions such as: which interventions are most effective for specific outcomes related to Covid-19. The living network meta-analyses will be continually updated, incorporating relevant new evidence as soon as it becomes available.

Methods: We will systematic search clinical trials registries and electronic bibliographic databases to identify all ongoing and completed studies evaluating the impact of interventions for preventing the spread of covid-19 infection (i.e., vaccination, prophylaxis treatments, personal protective equipment (PPE), clinical practice and organization of care etc) and treating patients with covid-19 infection (i.e., specific therapeutic agents for COVID-19 such as anti-infectious agents; specific immunomodulators; non-specific immunomodulators, supportive treatments for patients admitted to the intensive care unit.) Data related to risk of bias and effect estimates will be recorded in duplicate. For each direct comparison with at least two studies providing data, we will synthesize the results using as effect measures the odds ratio (OR) for dichotomous data and the standardized mean difference (SMD) for continuous data. For the sets of studies that transitivity is likely to be plausible we will perform random effects NMA to compare the different interventions and potentially obtain a ranking of them. The evidence synthesis will be updated as soon as new evidence is available.

Conclusion: This study will provide a day-to-day updated synthesis of available evidence. Our results will be essential for researchers and decision maker when planning future trials and managing the disease. Our results and database will be publicly available on a website that will be regularly updated.

Project coordination

Isabelle Boutron (Direction de la Recherche et de l'Innovation de l' AP-HP)

The author of this summary is the project coordinator, who is responsible for the content of this summary. The ANR declines any responsibility as for its contents.

Partner

DRCI Direction de la Recherche et de l'Innovation de l' AP-HP

Help of the ANR 189,965 euros
Beginning and duration of the scientific project: April 2020 - 12 Months

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