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[OHDSI Covid19] Literature review on Covid treatment safety and efficacy

(Patrick Ryan) #1

I’m opening up this thread to be a place for the ‘lit review on covid19 candidate treatment safety and efficacy’ sub-team, led by @Daniel_Prieto and @nigehughes , can have team discussions and share progress. Thanks for all your efforts!

[OHDSI COVID-19 response] Community Update 20 March 2020
[OHDSI COVID-19 response] Community Update 20 March 2020
(Nigel Hughes) #2

Thanks Patrick!

(Nigel Hughes) #3

For the Antiviral Group:

Dear Colleagues

Thank you for volunteering to be involved in the literature review for the virtual study-a-thon next week (26-29 March).

Here is a overview of the process proposed:

  • Colleagues have kindly volunteered at Oxford to conduct the initial literature review in DMARDs and Antivirals based on the initial criteria
  • Once we have this list, a core team will condense down that output, and we then propose to use a tool called Rayyan (more details to follow, an account will be set up for you all by Jenny in cc) to coordinate the literature review, and dissemination of papers across this DL (all of you!)
    • We’ll use three categories for review, safety, antiviral efficacy and mechanism of action
  • We will then coordinate review and responses via Rayyan to conclude the literature review and output reports

We may propose to have a call perhaps on Friday afternoon around familiarity with Rayyan and the process (TBC).

Sincerely hope this is clear. I’ll also look to post this on TEAMS/OHDSI Forum, and will be in touch asap when ready for the next step.



(Paula Casajust) #4

Thanks Patrick and Nige!

(Ravi) #5

Hi All,

I am an MD with a PhD in clinical research and specialized in evidence-based medicine methods. I led the literature review panel for American College of Rheumatology guidelines for Rheumatoid Arthritis which was focused on DMARDs and biologics. I also led lit review panels for several national and international societies and developed clinical practice guidelines.
I am interested in this lit review and happy to do my bit either as a topic expert or as a lit review expert or both.


(Daniel Prieto-Alhambra) #6

Hi Ravi
If you’d like to help then that would be most useful. i think your expertise would be most useful once we have the final list of papers for full reading/review. @jenniferlane can you keep Ravi in the loop when the time comes?

(Jenny Lane) #7

The review is ready! Hooray! I’m going to be sending you all a link to the search in Rayyan (https://rayyan.qcri.org) a free tool that’s great for undertaking systematic reviews, enabling you to pair up with other reviewers, and to easily sort your references.

Whilst this a literature review rather than a systematic review, I think we’re hoping to undertake the review systematically, first looking through the titles, then the abstracts and full texts.
I’ll also send across the search terms that were used to generate it, and some guidance of how to use it. I can also do a walk through online if that helps on Friday or beforehand.

I’ll be in touch!
Best Wishes

(Ronald Herrera) #8

Thanks a lot for the great effort. I would like also to include chloroquine into the effectiveness research. There is available literature/information on the use of chloroquine from China that is likely based on donations of chloroquine. Moreover, there are discussions on considering donations at a large scale based on accelerated regulatory approvals. This could indeed change the availability of data on chloroquine treated COVID-19 patients. I definitely think that we should include as well in our discussion.


(Ana Szarfman) #9

See also

(Ana Szarfman) #10

Note that this post does not represent any official position of the FDA.

(Paula Casajust) #11

Are we supposed to start with the review using Rayyan before the meeting on Friday? Or should we wait until then?

Many thanks,


(Nigel Hughes) #12

Hi Paula

If you’re familiar with Rayyan you can proceed, if not you’re welcome to wait to the call and the demo.

If you do log in to it, you’ll see the tab Collaboration Review, and from there you can click the one assigned to you.

Click Show underneath the tab on the right, and then you’ll see all the titles in rolling list, and if you click on an entry, the bottom pane is populated with details, and if available, an abstract.

You’ll also note three buttons, Include, Maybe and Exclude - for now all you need to per entry in the upper pane is make that decision. When you click one of those three you’ll note by the corresponding entry your name in a box with traffic light colours denoting which choice you made. As more people review, more names will figure, and where there is a difference or opinion, we’ll resolve that after.

Also on the left are a number of panels with more information. Don’t worry perhaps about Duplicates as yet, but the panel underneath, Inclusion Decisions, tallies your decisions and the numbers.

I think that’s sufficient to enable you to review.

We’ll of course cover this in tomorrow’s call too.



(Miguel A. Mayer) #13

Hi Nige and everyone,

Thank you very much for this great initiative! I have a couple of doubts. As I understand at this moment there are five different threads for the lit review, is that right?
I logged in Rayyan but please Nige, could you tell me when the demo for Rayyan is planned? What time tomorrow? because I joined another thread and tomorrow we plan to have a call too.

Thanks a lot,

(Paula Casajust) #14

Dear Nige,

Thank you for your kindly description.
I will have a look on Rayyan, but I think I will wait to the call before proceeding.

Many thanks,

Paula Casajust

(Daniel Prieto-Alhambra) #15

Thanks team for the amazing response, and special thanks to @Osaid and Danielle Newby for their amazing progress with the screening of DMARDs antiviral efficacy papers!!

(Nigel Hughes) #16

Hi Miguel

Are you in the DMARDs or Antiviral group? I don’t have you down in our Antiviral group, but you are of course most welcome to our call today at 16:00 CET, and I can forward you the details (need your email address, mine is: nhughes@its.jnj.com).

Otherwise seems you have another call lined up (presumably in DMARDs group).



(Nigel Hughes) #17

Hi All

Some disappointing results with Kaletra (lopinavir/ritonavir) in the NEJM:

The study of hospitalised patients in an open label, 1:1 study showed little efficacy related to primary endpoints (time to clinical improvement from randomisation), and also of little impact on viral shedding or in viral RNA. There was a difference in ITT and modified analysis mortality, numerically, with improvement in the lop/rit patients vs. SoC.

Overall, the authors and the editorial view the results as disappointing, and though there was an improvement of one day in the median time time to clinical improvement in the lop/rit cohort, it’s unlikely to be worthwhile, considering also AEs, in this severely ill population studied, at the studied (HIV) dosage.

Whether or not earlier treatment and/or in less severe patients, or combining with other antivirals, is beneficial remains an open question?

Remarkable work by clinicians in China in the middle of the epidemic there.

(Miguel A. Mayer) #18

Hi Nige,
Thank you, actually I’m in the phenotype and definitions and evaluations group and we have a call in a hour.

(Nigel Hughes) #19

For the Antiviral Group:

I’ve emailed you all the notes from our call, and the recording to it is here

All other contacts are in the email, do keep in touch, and we’ll speak on Monday.



(Cynthia Sung) #20

Is there a link to the Call on Friday?