WHO publishes updated living guideline on therapeutics and Covid-19

Based on the results of a systematic review and meta-analysis, the guideline panel makes new strong recommendations against the use of hydroxychloroquine and lopinavir/ritonavir in patients with Covid-19, regardless of disease severity.

SPS commentary:

The guideline is informed by the results of a living systematic review and meta-analysis, published separately in the BMJ.

 

For hydroxychloroquine (30 trials; n=10,921), the GRADE evidence summary suggested it probably does not reduce mortality (OR 1.11, 95% CI 0.95–1.31; 10 more deaths per 1000 patients, 95% CI: from 5 fewer to 28 more deaths per 1000 patients; moderate certainty evidence) or need for mechanical ventilation.

 

Lopinavir/ritonavir also probably does not reduce mortality (OR 1.00, 95% CI 0.82–1.20; 0 fewer deaths per 1000 patients, 95% CI from 17 fewer to 19 more deaths per 1000 patients; moderate certainty evidence) or need for mechanical ventilation (7 trials; n=74,29 participants).

 

Both treatments may increase the risk of diarrhoea and nausea/vomiting.

World Health Organization

Resource links:

Living systematic review