Interventions for the prevention and treatment of COVID-19: a living mapping of research and living network meta-analysis

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To provide a living mapping of registered randomized trials, and to assess and rank where appropriate the relative effects of interventions for the prevention and treatment of COVID-19. Our approach has been described in Boutron 2020 and Nguyen 2020. As part of the methodological process of living systematic reviews, we will continuously (i.e. every working day) collect and critically appraise results from all eligible RCTs addressing specific clinical outcomes related to COVID-19. We will synthesize the available study results using pairwise meta-analyses and when possible and appropriate, network meta-analyses (NMAs). The interventions and the research questions considered will evolve over time and will be guided by end-users’ needs. We will report our updated evidence synthesis every week, and will make all results available on a website: www.covid-nma.com. In addition, we will update this Cochrane Review at least once every six months, or as soon as the certainty of evidence (assessed with the GRADE methodology) changes. We will wait until the accumulating evidence changes one or more of the following aspects of the review, before incorporating it and re-publishing the Cochrane Review:. the findings of one or more critical outcomes; the credibility (e.g. GRADE rating) of one or more critical outcomes; new settings, population, interventions, comparisons or outcomes studied; or new serious adverse events. We will develop a steering committee of epidemiologists, methodologists, statisticians and clinicians with content expertise. This committee will meet regularly and discuss the conduct of the project, difficulties encountered and possible changes in the protocol according to new knowledge becoming available for the disease. Changes to the protocol could include, for example, changes in the search strategy, eligibility criteria (e.g. study design), research questions for the pairwise meta-analyses, or outcomes. The steering committee will systematically discuss and achieve consensus on the changes to the protocol. The process will also evolve over time according to new knowledge available regarding COVID-19.