Background and Purpose: The Covid-19 is a viral infection classified as
a pandemic by the World Health Organization. There is not currently
therapy against the Sars-cov-2. We aimed to assess the best drug therapy
approach for the management of Covid-19. Experimental Approach: We did a
systematic review and meta-analysis of randomized controlled trials of
drugs used in patients with Covid-19. We performed research in the
PubMed and the Medrxiv. The trials were included if the patients were
over 12 years old, diagnosed through the rt-PCR test and who assessed as
primary outcomes or decreased mortality, or time to clinical
improvement, or hospitalization time. Random-effects meta-analysis was
used to pool individual studies. Heterogeneity was assessed using I².
The review has been registered on PROSPERO, number 179879. Key Results:
Nine trials were included for analysis. Remdesivir, mainly early after
the onset of symptoms, led to a reduction in mortality (OR, 0·85; 95%
CI, 0·05 to 0·98; P=0·045). Although this meta-analysis did not observe
a reduction using dexamethasone, the Recovery Trial indicates that it
can be an option for a patient that needs oxygen support. Our study did
not demonstrate the efficacy of any treatment to minimize the effects of
Covid-19 related to large hospital stay or time to clinical improvement.
Conclusion and Implications: Remdesivir is the only drug that can change
the course of Covid-19, reducing mortality rates. Despite this result,
other studies must evaluate the effectiveness of this and other drugs in
the management of Covid-19 mainly studies with robust methods.