Note: The risk of bias by domain corresponds to the highest risk of bias among outcomes by domain.
The overall risk of bias corresponds to the overall highest risk of bias assessed among outcomes.
Bias | Author's judgement | Support for judgement |
Randomization |
Some concerns |
Quote: "We used mixed randomization for unpredictability in allocation sequences[25]. The allocation sequences were placed in the sealed opaque envelopes. We randomly assigned critically ill patients with COVID-19 to the treatment group and control group in a 1:1 ratio."
Comment: Allocation sequence random. Unclear allocation concealment (No information on sequentially number envelopes). |
Deviations from intervention |
Some concerns |
Comment: Single-blind study (participants were blinded, personnel was unblinded).
No participant cross-over. No information on administration of any co-intervention of interest, anticoagulants, antivirals, glucorticoids and biologics were reported. Outcome data were analyzed by using intention-to-treat analysis. |
Missing outcome data |
Low |
Comment: 17 randomized/17 analyzed. Risk assessed to be low for the outcomes: Mortality. Adverse events. Serious adverse events. |
Measurement of the outcome |
Low |
Quote: "Blinding is saved until research have been completed and the database is finally unlocked. Participants and study personnel were aware of the study-group assignments, but outcome adjudicators were not." Comment: Outcome assessors were blinded. Risk assessed to be low for the outcomes: Mortality. Adverse events. Serious adverse events. |
Selection of the reported results |
Some concerns |
Comment: There is no protocol, or pre-specified analysis plan in the appendix. Risk assessed to be "some concerns" for the outcomes: Mortality. Adverse events. Serious adverse events. |
Overall risk of bias |
Some concerns |