Abstract
BackgroundDevelopment of a core outcome set (COS) for clinical trials for COVID-19 is urgent because of the pandemic wreaking havoc worldwide and the heterogeneity of outcomes in clinical trials.MethodsA preliminary list of outcomes was developed after a systematic review of protocols of clinical trials for COVID-19. Then, two rounds of the Delphi survey were conducted. Stakeholders were traditional Chinese medicine (TCM) experts, Western medicine (WM) experts, nurses, and the public. Patients with confirmed COVID-19 were also invited to participate in a questionnaire written in understandable language. Then different stakeholders participated in a consensus meeting by video conference to vote.ResultsNinety-seven eligible study protocols were identified from 160 clinical trials. Seventy-six outcomes were identified from TCM clinical trials and 126 outcomes were identified from WM clinical trials. Finally, 145 outcomes were included in the first round of the Delphi survey. Then, a COS for clinical trials of TCM and WM was developed. The COS included clinical outcomes (recovery/improvement/progression/death), etiology (SARS-CoV-2 nucleic-acid tests, viral load), inflammatory factor (C-reactive protein), vital signs (temperature, respiration), blood and lymphatic-system parameters (lymphocytes, virus antibody), respiratory outcomes (pulmonary imaging, blood oxygen saturation, PaO2/FiO2 ratio, arterial blood gas analysis, mechanical ventilation, oxygen intake, pneumonia severity index), clinical efficacy (prevalence of preventing patients with mild-to-moderate disease progressing to severe disease), and symptoms (clinical symptom score). Outcomes were recommended according to different types of disease. Outcome measurement instruments/definitions were also recommended.ConclusionThough there are some limitations for the research, such as insufficient patients and the public involvement, and the unbalanced stakeholders' region, the COS for COVID-19 may improve consistency of outcome reporting in clinical trials. It also should be updated with research progression.
Highlights
Since December 2019, a novel coronavirus causing pneumonia has been spreading around the world
Ninety-seven eligible study protocols were identified from 160 clinical trials
Seventy-six outcomes were identified from traditional Chinese medicine (TCM) clinical trials and 126 outcomes were identified from Western medicine (WM) clinical trials
Summary
Since December 2019, a novel coronavirus causing pneumonia has been spreading around the world. It was temporarily named “2019 novel coronavirus” on 2 January, 2020, but the World Health Organization (WHO) officially named it “coronavirus disease 2019” (COVID-19) on 11 February 2020. The coronavirus that causes COVID-19 was termed “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2) on 11 February 2020 by the WHO. COVID-19 is a global threat, so its outbreak was declared to be a pandemic on 11 March 2020 by the WHO. COVID-19 management is a major challenge for clinicians and researchers worldwide. Development of a core outcome set (COS) for clinical trials for COVID-19 is urgent because of the pandemic wreaking havoc worldwide and the heterogeneity of outcomes in clinical trials
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