LitCovid is a curated literature hub for tracking up-to-date scientific information about the 2019 novel Coronavirus. It is the most comprehensive resource on the subject, providing a central access to 16795 (and growing) relevant articles in PubMed. The articles are updated daily and are further categorized by different research topics and geographic locations for improved access. You can learn more at Chen et al. Nature (2020) or our FAQ, and download our data here.
Chen Q, Allot A, Lu Z. Keep up with the latest coronavirus research. Nature. 2020;579(7798):193.
Here are some key points from our first three presentations that are still valid.
Below are key takeaways from our fourth update, covering April 23 to May 5, during which more than 3000 COVID-related papers were published on PubMed and another 766 were released in preprint form:
We summarized the major RCTs on COVID-19 therapeutics for which we have full papers (some in preprint form) (Table 1).
Table 1. Major COVID-19 Randomized Treatment Trials to Date |
||||
Ref |
Drug Tested |
Total N |
Outcome |
Notes/Limitations |
Lopinavir/ritonavir |
199 |
No difference |
Clinical improvement, mortality, and percentage of patients with detectable viral RNA similar; median of 13 days from illness onset to randomization |
|
Favipiravir versus umifenovir |
240 |
For patients with moderate COVID, favipravir led to faster day 7 clinical recovery and resolution of fevers but no difference in need for mechanical ventilation |
Preprint report |
|
Hydroxychloroquine |
150 |
No difference |
Primary outcome of viral clearance at 28 days may not be a good endpoint; randomized late in illness course |
|
Lopinavir/ritonavir versus umifenovir versus control |
86 |
No difference for primary or secondary outcomes |
Randomized 2:2:1; open-label trial with relatively small N; primary endpoint was time to negative RT-PCR, which may not be meaningful |
|
Remdesivir |
237 |
No difference in primary outcome; trend toward mortality improvement for those started within 10 days of symptom onset |
Outbreak controlled in Wuhan before prespecified enrollment goal could be met: underpowered; majority of patients received steroids in this cohort |
We also discussed additional therapeutic data from press releases (Table 2).
Table 2. Preliminary Data on COVID-19 Randomized Treatment Trials |
||||
Ref |
Drug Tested |
Total N |
Outcome |
Notes/Limitations |
Remdesivir |
1063 |
Remdesivir group: 31% faster recovery compared with placebo; trend toward improved mortality |
Preliminary report of findings based on press release; formal report pending peer review |
|
Remdesivir |
397 |
Similar improvement in severe-disease patients who received 5 or 10 days of remdesivir |
Industry-sponsored trial (Gilead); no placebo arm |
|
Tocilizumab |
129 |
Primary outcome was need for mechanical ventilation or death; "A significantly lower proportion of patients reached the primary outcome in the tocilizumab arm." |
Open-label study (no placebo); preliminary report of findings based on press release; formal report pending peer review |
|
Sarilumab |
457 |
"Negative trends" in severe-disease group in phase 2, with "positive trends" in critical group |
Industry-sponsored trial (Regeneron/Sanofi); phase 3 trial continuing with sarilumab 400 mg versus placebo in critical group only |
The table below summarizes the key transmission findings.
Table 3. Key Findings in Mode of Transmission |
||||
Source |
RNA Detected? |
Live Virus? |
Mode of Transmission and Evidence |
|
Nasopharynx (1) |
Yes |
Yes |
Droplet confirmed |
Direct contact suspected |
Yes |
Yes |
Airborne likely in some circumstances |
||
Saliva (3) |
Yes |
Yes |
Direct contact suspected as above |
|
Yes |
Yes |
No evidence fecal-oral to date: Macaques challenged with intragastric SARS-CoV-2 were not infected (however, direct inoculation in oral mucosa suspected) |
||
Yes |
No |
No confirmed bloodborne transmissions to date |
||
Yes |
Yes |
Macaques with corneal inoculation develop infection |
||
Vertical |
Yes |
N/A |
Several cases of fetal IgM, 1 case of neonate with RNA at 16 hours (10) (11); additionally, multiple reports of placental infection (12) |
|
Semen/vaginal fluids |
Yes |
|
SARS-CoV-2 RNA has been detected in semen, including after recovery (13); most reports have not found virus in vaginal fluids, but there is a signal report with positive vaginal swabs (14) |
|
Urine (15) |
Yes |
Yes |
|
|
Cats (16) |
Yes |
Yes |
Cats can transmit SARS-CoV-2 between each other |