Several clinical trials have been carried out that offer scientific evidence to confirm the efficacy or harm of the use of a drug or therapy with various patients who have suffered mild, moderate and severe symptoms of coronavirus infection. Salud Con Lupa in collaboration with Epistemonikos analyzed the 45 most used COVID-19 treatments. We created seven classifications, ranging from “standard treatment” to “unsupported by science”. We developed these categorization levels to assess the appropriateness of the covid-19 treatments up to this point in time. From September 2020 until now, we update this information weekly as new scientific evidence becomes available.
After two years since the COVID-19 pandemic started, there is already scientific consensus on which drugs under study work, and which do not, for the treatment of the disease. To follow the evolution of the evidence, in September 2020 Salud Con Lupa and Epistemonikos launched Scientifically Proven, a tool that announces the progress of the results of clinical trials of medicines against COVID-19 in the world. This effort, which is updated every week, presents 45 drugs, the most used, divided into seven categories (from “Standard treatment” to “Science does not support it”) that are very easy to understand to bring science closer to more people.
Our tool shows the medicines that can be trusted today for each stage of COVID-19 and those that lack scientific support, but are still recommended by some organizations or groups that validate conspiracy theories. While there are drugs that have shown some benefit (such as monoclonal antibodies), they are expensive, complex to administer, and, in poor nations, still very rare.
Scientific consensus is always difficult to define because there are many entities and finally one looks at the main organizations. For example, when the first organization says that hydroxychloroquine should not be used until the last one stops using it, many months go by.
We also have drugs that have been reaching a consensus that they work. Today we are very clear about the role of corticosteroids and monoclonal antibodies. The latter are antibodies that bind to SARS-CoV-2 and block it. The issue is its cost. Today there is a consensus that they are used as prevention in high-risk people who have had close contact with someone infected, but also to treat patients in early stages.
Build a database
We built a database of 25 treatments that were evaluated. The project was launched in September 2020 and updated every week until the present, which allows to see a medical evolution of the treatments.
Two years after, the list of medical evidence on the platform already gathers 45 treatments with the highest demand for use. The tool is presented in Spanish, English and Portuguese.
Contrary to scientific research articles that have an academic or scientific structure, this tool was created with the aim of guaranteeing easy navigation access, with which visualizations and tabs were integrated with the details of the therapies.
The work team involved doctors, investigative journalists and scientific journalists, as well as computer specialists, responsible for the implementation on the website under a highly usable scheme that allows users to immediately know the classification , the evolution of the evidence and navigation by type of medication or therapy.
Methodology and classification
The scale we used was developed specifically for this project and seeks to answer two questions: How ready is an intervention for clinical use? What is the state of progress of scientific research on an intervention?
In other words, the scale (seven categories) indicates what the available evidence tells us about the possible clinical use of a treatment and what is the nature, quality and possible evolution of this evidence.
All the evidence used comes from the COVID-19 Living OVerview of Evidence (L·OVE) platform, an open access platform that is updated by searching 41 electronic databases, trial registers and other sources.
What was the hardest part of this project?
How to dive the sea of evidence on COVID-19 to come up with the necessary answers before running out of air? This challenge that we face with our partner Epistemonikos. We created a solution that classifies interventions against COVID-19 according to their effectiveness, proven with the latest and best available evidence.
This is how the “Scientifically Proven” repository was born. Our tool completed more than one year in operation, being updated every week to determine the effectiveness of the different interventions against COVID-19 and, in this way, contribute to safe and informed decision-making by social and political actors, health professionals, as well as the entire Latin American and world population. Currently, the repository continues to be updated without interruptions and, in addition, it is translated into the Portuguese and English languages, in order to reach even more people throughout the world.
We have the purpose of bringing scientific evidence closer to where health decisions are made, which affect us all individually and collectively. The best way to prevent health and public health problems is by considering evidence in decisions, but for this, evidence must be properly organized and accessible. This is an example of what science and journalism can achieve together against COVID-19.
What can others learn from this project?
Before the COVID-19 pandemic, the scientific community had concerns about poor-quality science being preprinted and then widely disseminated. But now, everyday people are reading them too and the media is covering them at a rate that far outpaces pre-2020.
In Latin America, we faced a big problem: most of the journalists don’t know how to find strong scientific evidence and sources and translate it into Spanish. That is one of the most important reasons that we launched Scientifically Proven, a tool that is helpful for them and for the public. It provides a snapshot of the research on the coronavirus, but does not constitute medical endorsements. What kind of evidence do we use? The primary source of information for estimating the effect of each intervention is randomized trials. Other evidence is used as a complement, especially when there is no evidence from randomized trials.
We also always recommend consulting your doctor about treatments for COVID-19.