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Theranostics 2021; 11(3):1207-1231. doi:10.7150/thno.48342 This issue Cite

Review

Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review of in vitro, in vivo, and clinical trials

Young Joo Han1, Keum Hwa Lee2, Sojung Yoon3, Seoung Wan Nam4, Seohyun Ryu3, Dawon Seong3, Jae Seok Kim5, Jun Young Lee5, Jae Won Yang5, Jinhee Lee6, Ai Koyanagi7,8, Sung Hwi Hong9, Elena Dragioti10, Joaquim Radua11,12,13, Lee Smith14, Hans Oh15, Ramy Abou Ghayda9,16, Andreas Kronbichler17, Maria Effenberger18, Daniela Kresse19, Sara Denicolò17, Woosun Kang20, Louis Jacob7,21, Hanwul Shin5, Jae Il Shin2✉

1. Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
2. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
3. Yonsei University College of Medicine, Seoul, Republic of Korea.
4. Department of Rheumatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
5. Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
6. Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
7. Research and development unit, Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
8. ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain.
9. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, USA.
10. Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
11. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain.
12. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
13. Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
14. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK.
15. School of Social Work, University of Southern California, CA, USA.
16. Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
17. Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria.
18. Department of Internal Medicine I (Gastroenterology, Hepatology, Endocrinology & Metabolism), Medical University Innsbruck, Innsbruck, Austria.
19. Department of Internal Medicine, St. Johann County Hospital, St. Johann in Tirol, Austria.
20. Department of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
21. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.

✉ Corresponding author: Dr. Jae Il Shin MD PhD, 50-1 Yonsei-ro, Seodaemun-gu, Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Republic of Korea. Tel: 82-2-2228-2050, Fax: 82-2-393-9118, E-mail: shinjiac.

Citation:
Han YJ, Lee KH, Yoon S, Nam SW, Ryu S, Seong D, Kim JS, Lee JY, Yang JW, Lee J, Koyanagi A, Hong SH, Dragioti E, Radua J, Smith L, Oh H, Ghayda RA, Kronbichler A, Effenberger M, Kresse D, Denicolò S, Kang W, Jacob L, Shin H, Shin JI. Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review of in vitro, in vivo, and clinical trials. Theranostics 2021; 11(3):1207-1231. doi:10.7150/thno.48342. https://www.thno.org/v11p1207.htm
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Abstract

Graphic abstract

Rationale: Coronavirus disease 2019 (COVID-19) has spread worldwide and poses a threat to humanity. However, no specific therapy has been established for this disease yet. We conducted a systematic review to highlight therapeutic agents that might be effective in treating COVID-19.

Methods: We searched Medline, Medrxiv.org, and reference lists of relevant publications to identify articles of in vitro, in vivo, and clinical studies on treatments for severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19 published in English until the last update on October 11, 2020.

Results: We included 36 studies on SARS, 30 studies on MERS, and 10 meta-analyses on SARS and MERS in this study. Through 12,200 title and 830 full-text screenings for COVID-19, eight in vitro studies, 46 randomized controlled trials (RCTs) on 6,886 patients, and 29 meta-analyses were obtained and investigated. There was no therapeutic agent that consistently resulted in positive outcomes across SARS, MERS, and COVID-19. Remdesivir showed a therapeutic effect for COVID-19 in two RCTs involving the largest number of total participants (n = 1,461). Other therapies that showed an effect in at least two RCTs for COVID-19 were sofosbuvir/daclatasvir (n = 114), colchicine (n = 140), IFN-β1b (n = 193), and convalescent plasma therapy (n = 126).

Conclusions: This review provides information to help establish treatment and research directions for COVID-19 based on currently available evidence. Further RCTs are required.

Keywords: COVID-19, therapeutic agent, SARS, MERS, mortality, coronavirus

Citation styles

APA
Han, Y.J., Lee, K.H., Yoon, S., Nam, S.W., Ryu, S., Seong, D., Kim, J.S., Lee, J.Y., Yang, J.W., Lee, J., Koyanagi, A., Hong, S.H., Dragioti, E., Radua, J., Smith, L., Oh, H., Ghayda, R.A., Kronbichler, A., Effenberger, M., Kresse, D., Denicolò, S., Kang, W., Jacob, L., Shin, H., Shin, J.I. (2021). Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review of in vitro, in vivo, and clinical trials. Theranostics, 11(3), 1207-1231. https://doi.org/10.7150/thno.48342.

ACS
Han, Y.J.; Lee, K.H.; Yoon, S.; Nam, S.W.; Ryu, S.; Seong, D.; Kim, J.S.; Lee, J.Y.; Yang, J.W.; Lee, J.; Koyanagi, A.; Hong, S.H.; Dragioti, E.; Radua, J.; Smith, L.; Oh, H.; Ghayda, R.A.; Kronbichler, A.; Effenberger, M.; Kresse, D.; Denicolò, S.; Kang, W.; Jacob, L.; Shin, H.; Shin, J.I. Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review of in vitro, in vivo, and clinical trials. Theranostics 2021, 11 (3), 1207-1231. DOI: 10.7150/thno.48342.

NLM
Han YJ, Lee KH, Yoon S, Nam SW, Ryu S, Seong D, Kim JS, Lee JY, Yang JW, Lee J, Koyanagi A, Hong SH, Dragioti E, Radua J, Smith L, Oh H, Ghayda RA, Kronbichler A, Effenberger M, Kresse D, Denicolò S, Kang W, Jacob L, Shin H, Shin JI. Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review of in vitro, in vivo, and clinical trials. Theranostics 2021; 11(3):1207-1231. doi:10.7150/thno.48342. https://www.thno.org/v11p1207.htm

CSE
Han YJ, Lee KH, Yoon S, Nam SW, Ryu S, Seong D, Kim JS, Lee JY, Yang JW, Lee J, Koyanagi A, Hong SH, Dragioti E, Radua J, Smith L, Oh H, Ghayda RA, Kronbichler A, Effenberger M, Kresse D, Denicolò S, Kang W, Jacob L, Shin H, Shin JI. 2021. Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review of in vitro, in vivo, and clinical trials. Theranostics. 11(3):1207-1231.

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