Effective therapeutic interventions for the treatment and prevention of coronavirus disease 2019 (COVID-19) are urgently needed. A systematic review was conducted to identify clinical trials of pharmacological interventions for COVID-19 published between 1 December 2019 and 14 October 2020. Data regarding efficacy of interventions, in terms of mortality, hospitalisation and need for ventilation, were extracted from identified studies and synthesised qualitatively.

In total, 42 clinical trials were included. Interventions assessed included antiviral, mucolytic, antimalarial, anti-inflammatory and immunomodulatory therapies. Some reductions in mortality, hospitalisation and need for ventilation were seen with interferons and remdesivir, particularly when administered early, and with the mucolytic drug, bromhexine. Most studies of lopinavir/ritonavir and hydroxychloroquine did not show significant efficacy over standard care/placebo. Dexamethasone significantly reduced mortality, hospitalisation and need for ventilation versus standard care, particularly in patients with severe disease. Evidence for other classes of interventions was limited. Many trials had a moderate-to-high risk of bias, particularly in terms of blinding; most were short-term and some included low patient numbers.

This review highlights the need for well-designed clinical trials of therapeutic interventions for COVID-19 to increase the quality of available evidence. It also emphasises the importance of tailoring interventions to disease stage and severity for maximum efficacy.

迫切需要有效的治疗干预措施来治疗和预防 2019 年冠状病毒病 (COVID-19)。进行了一项系统审查，以确定 2019 年 12 月 1 日至 2020 年 10 月 14 日期间发表的针对 COVID-19 的药物干预临床试验。从已确定的研究中提取并综合了有关干预效果（死亡率、住院率和通气需求）的数据定性地。

总共包括 42 项临床试验。评估的干预措施包括抗病毒、粘液溶解、抗疟疾、抗炎和免疫调节疗法。干扰素和瑞德西韦以及黏液溶解药物溴己新在死亡率、住院率和通气需求方面有所降低，尤其是在早期给药时。大多数关于洛匹那韦/利托那韦和羟氯喹的研究并未显示出优于标准治疗/安慰剂的显着疗效。与地塞米松相比，地塞米松显着降低了死亡率、住院率和通气需求标准护理，特别是对于患有严重疾病的患者。其他类别干预措施的证据有限。许多试验存在中度至高度偏倚风险，尤其是在盲法方面；大多数是短期的，有些患者人数较少。

本综述强调需要对 COVID-19 的治疗干预措施进行精心设计的临床试验，以提高现有证据的质量。它还强调了根据疾病阶段和严重程度调整干预措施以获得最大疗效的重要性。