{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:12:36Z","timestamp":1789132356160,"version":"build-2803163510"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>\n                    To assess the efficacy and safety of each therapeutic options in the treatment of COVID-19 by assessing the evidence from existing systematic reviews and meta-analyses, and to carry out an umbrella meta-analysis of all meta-analysis studies to assess the efficacy of each drug. A comprehensive search was carried out in electronic databases for systematic reviews and meta-analyses which compared the efficacy and\/or safety of therapeutic options in the treatment of COVID-19. Findings from the reviews were synthesized using tables and forest plots and the pooled estimate of effect size using the DerSimonian and Laird method was used for the updated meta-analysis. The main outcome was mortality. 285 reviews with 152 meta-analyses were included, The analysis of systematic reviews contents indicated that most reviewed drugs were as follows: chroquine\/hydroxychloroquine (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 48), tocilizumab (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 39), remdesivir (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 25), corticosteroids (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 25), JAK inhibitors (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 12), colchicine (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 11), ivermectin (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 8), anakinra (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 7), favipravir (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 7), lopinavir\/ritonavir (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 6), ACEI\/ARB (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 6), azithromycin (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 4), sofosbuvir (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 4), and Vitamin D (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 4). Findings from the included reviews suggested that tocilizumab, remdesivir, corticosteroids, JAKI, anakinra, colchicine, ivermectin, and sofosbuvir decreased the rate of mortality significantly in those taking the drugs; otherwise hydroxylchroquine increased the risk of mortality significantly, while Lopinavir\/Ritonavir had no benefit and ACEI and azithromycin decreased mortality rate not significantly. lower requirement for mechanical ventilation and intensive care unit admission and a shorter hospital length of stay was observed with the tocilizumab, JAKIs, anakinra, corticosteroids and sofosbuvir Only one third of the included reviews had 70% quality based on the AMSTAR scale assessment. The results of this study have the potential to be a useful tool for the translation of health evidence and for designing the decision support systems for evidence synthesis.\n                  <\/jats:p>","DOI":"10.4103\/jrpp.jrpp_70_25","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:00:41Z","timestamp":1787922041000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Navigating Therapeutic Frontiers: A Meta-review and Meta-analysis of COVID-19 Treatment Options"],"prefix":"10.4103","volume":"15","author":[{"given":"Sarah","family":"Mousavi","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen Bigharaz","family":"Ardekani","sequence":"additional","affiliation":[{"name":"School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awat","family":"Feizi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7]]},"reference":[{"key":"R3-20260911","doi-asserted-by":"crossref","first-page":"1087138","DOI":"10.3389\/fpubh.2022.1087138","article-title":"The impact of delayed access to COVID-19 vaccines in low- and lower-middle-income countries","volume":"10","author":"Duroseau","year":"2023","journal-title":"Front Public 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