| Outcome |
Relative effect
(95% CI) |
Absolute effect
(95% CI)1 |
Certainty of the Evidence
(GRADE) |
Clinical improvement
D28 |
RR: 1.18
(0.84 - 1.65) |
157 more per 1000
(from 140 fewer to 568 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, outcome measurement and selection of the reported results Inconsistency: Serious
Inconsistency downgraded by 1 level: I²=: 75% 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
Pandit A, 2021; Bhushan S, 2021
290 participants
|
|
Interferon alpha2b
1031 per 1,000
(734 - 1000) |
Standard care
873
per 1,000 |
|
Clinical improvement
D60 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above)
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, deviation from intended intervention 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
|
| 1 trials
Pandit A, 2021
40 participants
|
|
Interferon alpha2b
0 per 1,000
( - ) |
Standard care
0
per 1,000 |
|
WHO progression score (level 7 or above)
D60 |
Outcome not yet measured or reported
|
|
All-cause mortality
D28 |
RR: 5.41
(0.26 - 111.62) |
Absolute effects were not calculated due to zero events in the control group
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization and deviation from intended intervention 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 low number of participants/events
|
| 2 trials
Pandit A, 2021; Bhushan S, 2021
290 participants
|
|
Interferon alpha2b
0 per 1,000
( - ) |
Standard care
0
per 1,000 |
|
All-cause mortality
D60 |
Outcome not yet measured or reported
|
|
Viral negative conversion
D7 |
RR: 1.30
(1.14 - 1.49) |
196 more per 1000
(from 91 more to 320 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, 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
Pandit A, 2021, Bhushan S, 2021
290 participants
|
|
Interferon alpha2b
849 per 1,000
(745 - 973) |
Standard care
653
per 1,000 |
|
Adverse events
|
RR: 1.00
(0.5 - 2.03) |
0 fewer per 1000
(from 70 fewer to 144 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention, outcome measurement and selection of the reported results Inconsistency: Not serious Indirectness: Not serious
We presume that the adverse event rates and the corresponding relative risks, are similar across diverse settings, therefore not downgraded for indirectness Imprecision: Very serious
due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
|
| 3 trials
Pandit A, 2021; Bhushan S, 2021; Mordyk A, 2021
290 participants
|
|
Interferon alpha2b
140 per 1,000
(70 - 284) |
Standard care
140
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 adequate randomization, deviation from intended intervention, outcome measurement and selection of the reported results Inconsistency: Not serious Indirectness: Not serious
We presume that the adverse event rates and the corresponding relative risks, are similar across diverse settings, therefore not downgraded for indirectness Imprecision: Very serious
no events in both groups
|
| 2 trials
Pandit A, 2021; Mordyk A, 2021
40 participants
|
|
Interferon alpha2b
0 per 1,000
( - ) |
Standard care
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
