SynthesisBMC infectious diseases2010
Ribavirin for Crimean-Congo hemorrhagic fever: systematic review and meta-analysis.
Synthesis in BMC infectious diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 113 citations in OpenAlex.
- Pooled it
- Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Pooled it
- Ribavirin for treating Crimean Congo haemorrhagic fever.The Cochrane database of systematic reviews · 2018Pooled it
- Seroprevalence of tick-borne infections in blood donors in Europe: a systematic review.New microbes and new infections · 2025Review
- Article
- Exploring the Potential of Iminosugars as Antivirals for Crimean-Congo Haemorrhagic Fever Virus, Using the Surrogate Hazara Virus: Liquid-Chromatography-Based Mapping of Viral N-Glycosylation and In Vitro Antiviral Assays.Pathogens (Basel, Switzerland) · 2023Article
- Hemorrhagic fever viruses: Pathogenesis, therapeutics, and emerging and re-emerging potential.Frontiers in microbiology · 2022Review
- Review
- Drug repurposing approach to combating coronavirus: Potential drugs and drug targets.Medicinal research reviews · 2021Review
- Efficacy of favipiravir (T-705) against Crimean-Congo hemorrhagic fever virus infection in cynomolgus macaques.Antiviral research · 2020Article
- Zoonotic implications of camel diseases in Iran.Veterinary medicine and science · 2020Review
- Critical View on the Usage of Ribavirin in Already Existing Psychostimulant-Use Disorder.Current pharmaceutical design · 2020Review
- Use of ribavirin in viruses other than hepatitis C. A review of the evidence.Enfermedades infecciosas y microbiologia clinica (English ed.) · 2019Review
- [Use of ribavirin in viruses other than hepatitis C. A review of the evidence].Enfermedades infecciosas y microbiologia clinica · 2019Review
- Review
- Evaluation of Crimean-Congo hemorrhagic fever suspected cases admitted to a secondary care hospital in Kastamonu, Turkey between 2014-2017.African health sciences · 2019Article
- Investigation of Crimean-Congo hemorrhagic Fever in Patients Admitted in Antani Hospital, Kabul, Afghanistan, 2017-2018.International journal of preventive medicine · 2019Article
- Diagnostic tests for Crimean-Congo haemorrhagic fever: a widespread tickborne disease.BMJ global health · 2019Article
- Therapeutic management of Crimean-Congo haemorrhagic fever.Enfermedades infecciosas y microbiologia clinica (English ed.) · 2018Review
- Favipiravir (T-705) but not ribavirin is effective against two distinct strains of Crimean-Congo hemorrhagic fever virus in mice.Antiviral research · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCrimean-Congo hemorrhagic fever epidemics often occur in areas where health services are limited, and result in high case fatality rates. Besides intensive care, ribavirin is often recommended. A solid evidence base for the use of this drug will help justify assuring access to the drug in areas where epidemics are common.
methodsWe carried out a systematic review of observational and experimental studies of people with suspected or confirmed Crimean-Congo hemorrhagic fever that included comparisons between patients given ribavirin and those not. We extracted data on mortality, hospital stay, and adverse events. Risk of bias was assessed using a standard checklist, and data were presented in meta-analytical graphs, stratified by study design, and GRADE tables presented. The risk of bias was summarised using the GRADE method.
results21 unique studies, including one randomised controlled trial of ribavirin, were included. Quality of the evidence was very low, with a Down and Black median score of 4 (maximum possible 33). Ribavirin treatment was not shown to be superior to no ribavirin treatment for mortality rate in a single RCT (RR: 1.13, 95%CI: 0.29 to 4.32, 136 participants, GRADE=low quality evidence); but ribavirin was associated with reduced mortality by 44% when compared to no ribavirin treatment in the pooled observational studies (RR: 0.56, 95%CI: 0.35 to 0.90, 955 participants; GRADE=very low quality evidence). Adverse events were more common with the ribavirin patients, but no severe adverse events were reported. No difference in length of hospital stay was reported.
conclusionsNo clear message of benefit is available from the current data on ribavirin as observational data are heavily confounded, and the one trial carried out has limited power. However, ribavirin could potentially have benefits in this condition and these results clearly indicate a pragmatic, randomised controlled trial in the context of good quality supportive care, is urgently needed and ethically justified.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.