TWO new COVID-19 articles have been published online today by the Medical Journal of Australia. Both are open access and available now.
“In the 3 months since COVID-19 emerged from Wuhan, China and spread around the world, over 1100 clinical studies have been registered globally on clinical trials registries, including over 500 randomised controlled trials. Such rapid development and launch of clinical trials is impressive but presents challenges, including the potential for duplication and competition. There is currently no known effective treatment for COVID-19. In order to focus on those studies most likely to influence clinical practice, we summarise currently registered randomised trials with a target sample size of at least 1000 participants (n=31). We have broken these trials into four categories: 1) prophylaxis; 2) treatment of outpatients with mild COVID-19; 3) treatment of hospitalised patients with moderate COVID-19; and 4) treatment of critically ill patients with COVID-19. The most common therapeutic agent being trialled currently is hydroxychloroquine (24 trials with potential sample size of over 25 000 participants), followed by lopinavir/ritonavir (7 trials) and remdesevir (5 trials). There are many current candidate drugs in pre-clinical and early phase development and these form a pipeline for future large clinical trials if current candidate therapies prove ineffective or unsafe.”
2. COVID, ACE inhibitors/ARBs, and cardiovascular diseases
“Angiotensin converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) reduce morbidity, mortality and hospitalisations from hypertension and heart failure. There are no convincing clinical data to support adverse or beneficial effects in COVID-19 patients in the face of theoretical arguments in both directions. Most authoritative national and international bodies have released statements to the effect that the beneficial effects of ACE-I and ARBs are proven, the adverse effects in COVID-19 patients are not and have advised people to continue these drugs pending evidence to the contrary.”
All MJA COVID-19 articles are available at https://www.mja.com.au/journal/covid-19.
All MJA press releases are available at https://www.mja.com.au/journal/media.
- Cate Swannell
- Medical Journal of Australia