Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

3,454 questions · 3,562 findings · 816 reviews · Headline outcomes only

No studies found 538 · 15.1%GRADE not reported 239 · 6.7%Very low 933 · 26.2%Low 1,041 · 29.2%Moderate 612 · 17.2%High 199 · 5.6%

Casirivimab/imdevimab vs placebo

Development of clinical COVID‐19 symptoms within 30 days · SARS‐CoV‐2 uninfected people without defined exposure, or with potential exposure to SARS‐CoV‐2

Casirivimab/imdevimab leads to lower development of clinical COVID‐19 symptoms within 30 days compared with placebo (high certainty).

1 finding from 1 review

Summary of findings table ‐ Corticosteroids plus standard care vs placebo or usual care

All‐cause mortality up to 30 days · hospitalised and unvaccinated individuals with a confirmed or suspected diagnosis of symptomatic COVID‐19

Summary of findings table ‐ Corticosteroids plus standard care probably leads to lower all‐cause mortality up to 30 days compared with standard care (plus/minus placebo) (moderate certainty).

1 finding from 1 review

Summary of findings table ‐ High‐dose dexamethasone (12 mg or higher) vs low‐dose dexamethasone (6 mg to 8 mg)

All‐cause mortality up to 30 days · hospitalised individuals with unknown vaccination status and a confirmed diagnosis of symptomatic COVID‐19

Summary of findings table ‐ High‐dose dexamethasone (12 mg or higher) showed no clear difference in all‐cause mortality up to 30 days compared with low‐dose dexamethasone (6 mg to 8 mg) (low certainty).

1 finding from 1 review

Summary of findings table ‐ High‐dose dexamethasone (12 mg or higher) vs low‐dose dexamethasone (6 mg to 8 mg)

All‐cause mortality up to 120 days · hospitalised individuals with unknown vaccination status and a confirmed diagnosis of symptomatic COVID‐19

It is very uncertain whether summary of findings table ‐ High‐dose dexamethasone (12 mg or higher) changes all‐cause mortality up to 120 days compared with low‐dose dexamethasone (6 mg to 8 mg) (very low certainty).

1 finding from 1 review

Summary of findings table ‐ Corticosteroids plus standard care vs placebo or usual care

All‐cause mortality up to 120 days · hospitalised and unvaccinated individuals with a confirmed or suspected diagnosis of symptomatic COVID‐19

It is very uncertain whether summary of findings table ‐ Corticosteroids plus standard care changes all‐cause mortality up to 120 days compared with standard care (plus/minus placebo) (very low certainty).

1 finding from 1 review

Summary of findings table ‐ Methylprednisolone vs dexamethasone

All‐cause mortality up to 30 days · hospitalised and unvaccinated individuals with a confirmed or suspected diagnosis of symptomatic COVID‐19

It is very uncertain whether summary of findings table ‐ Methylprednisolone changes all‐cause mortality up to 30 days compared with dexamethasone (very low certainty).

1 finding from 1 review

Intervention not reported

All‐cause mortality at day 28 · people with moderate to severe disease (WHO scale 4–9); all trials contributing results to the summary of findings table investigated…

It is very uncertain whether the intervention changes all‐cause mortality at day 28 (very low certainty).

1 finding from 1 review

Intervention not reported

Improvement of clinical status: all initial symptoms resolved (asymptomatic) at day 14 · all trials contributing results to the summary of findings table included people with mild disease (WHO scale 1 to 3)§

The intervention showed no clear difference in improvement of clinical status: all initial symptoms resolved… (low certainty).

1 finding from 1 review

Intervention not reported

QoL (physical component) at up to 28 days, measured on the PROMIS Global‐10 scale and normalized to values from 16.2, low QoL, to 67.2, maximum QoL · all trials contributing results to the summary of findings table included people with mild disease (WHO scale 1 to 3)§

The intervention showed no clear difference in qoL (physical component) at up to 28 days, measured on the PROMIS… (high certainty).

1 finding from 1 review

Intervention not reported

QoL (mental component) at up to 28 days, measured on the PROMIS Global‐10 scale and normalized to values from 21.2, low QoL, to 67.6, maximum QoL · all trials contributing results to the summary of findings table included people with mild disease (WHO scale 1 to 3)§

The intervention showed no clear difference in qoL (mental component) at up to 28 days, measured on the PROMIS… (high certainty).

1 finding from 1 review

Intervention not reported

Viral clearance at day 7 · all trials contributing results to the summary of findings table included people with mild disease (WHO scale 1 to 3)§

The intervention showed no clear difference in viral clearance at day 7 (low certainty).

1 finding from 1 review

Intervention not reported

Worsening of clinical status: participants with new need for invasive mechanical ventilation or death at day 28 · people with moderate to severe disease (WHO scale 4–9); all trials contributing results to the summary of findings table investigated…

It is very uncertain whether the intervention changes worsening of clinical status: participants with new need for… (very low certainty).

1 finding from 1 review

Intervention not reported

Improvement of clinical status: participants discharged alive at day 28 · people with moderate to severe disease (WHO scale 4–9); all trials contributing results to the summary of findings table investigated…

The intervention showed no clear difference in improvement of clinical status: participants discharged alive at day… (low certainty).

1 finding from 1 review

Intervention not reported

Viral clearance at day 7 · people with moderate to severe disease (WHO scale 4–9); all trials contributing results to the summary of findings table investigated…

The intervention showed no clear difference in viral clearance at day 7 (low certainty).

1 finding from 1 review

Intervention not reported

All‐cause mortality at day 28 · all trials contributing results to the summary of findings table included people with mild disease (WHO scale 1 to 3)§

The intervention showed no clear difference in all‐cause mortality at day 28 (moderate certainty).

1 finding from 1 review

Intervention not reported

Worsening of clinical status: admission to hospital or death within 28 days · all trials contributing results to the summary of findings table included people with mild disease (WHO scale 1 to 3)§

The intervention showed no clear difference in worsening of clinical status: admission to hospital or death within… (low certainty).

1 finding from 1 review

Inhaled corticosteroids plus standard care vs placebo or usual care

Resolution of symptoms · adults with a confirmed diagnosis of mild COVID‐19, of whom only 10% (219/2132) participants had received ≥ 1 vaccination

Inhaled corticosteroids plus standard care probably leads to higher symptom resolution: all initial symptoms resolved at day 14 compared with standard care (with or without placebo) (moderate certainty).

1 finding from 1 review