| Outcome |
Relative effect
(95% CI) |
Absolute effect
(95% CI)1 |
Certainty of the Evidence
(GRADE) |
Clinical improvement
D28 |
Outcome not yet measured or reported
|
|
Clinical improvement
D60 |
Outcome not yet measured or reported
|
|
Hospitalisation or death
|
RR: 0.45
(0.10 - 2.00) |
10 fewer per 1000
(from 16 fewer to 18 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, missing data and selection of the reported results Inconsistency: Not serious Indirectness: Serious
studies from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious
due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
|
| 2 trials
Roostaei A, 2021; Asgardoon M, 2021
559 participants
|
|
Levamisole
8 per 1,000
(2 - 36) |
Standard care/Placebo
18
per 1,000 |
|
WHO progression score (level 7 or above)
D28 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above)
D60 |
Outcome not yet measured or reported
|
|
All-cause mortality
D28 |
RR:
( - ) |
Zero events in both groups
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, missing data, and selection of the reported results Inconsistency: Not serious Indirectness: Serious
studies from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious
no events in both groups and low number of participants
|
| 2 trials
Asgardoon M, 2021; Roostaei A, 2021
559 participants
|
|
Levamisole
0 per 1,000
( - ) |
Standard care/Placebo
0
per 1,000 |
|
All-cause mortality
D60 |
Outcome not yet measured or reported
|
|
Viral negative conversion
D7 |
Outcome not yet measured or reported
|
|
Adverse events
|
RR:
( - ) |
Zero events in both groups
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization,and selection of the reported results Inconsistency: Not serious Indirectness: Serious
single study from a single institution therefore results in this population might not be generalizable to other settings Imprecision: Very serious
no events in both groups and low number of participants
|
| 1 trials
Roostaei A, 2021
52 participants
|
|
Levamisole
0 per 1,000
( - ) |
Standard care/Placebo
0
per 1,000 |
|
Serious adverse events
|
RR:
( - ) |
Zero events in both groups
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding missing data, outcome measurement and selection of the reported results Inconsistency: Not serious Indirectness: Serious
despite a multicentre design this is a single study from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious
no events in both groups and low number of participants
|
| 1 trials
Asgardoon M, 2021
507 participants
|
|
Levamisole
0 per 1,000
( - ) |
Standard care/Placebo
0
per 1,000 |
|
1The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
