Comparative efficacy of medications and compound interventions against porcine epidemic diarrhea virus replication in vitro: a systematic review and meta-analysis
Abstract
BACKGROUND: Porcine epidemic diarrhea virus (PEDV) infection induces severe intestinal disease in neonatal piglets, resulting in substantial economic losses to the swine industry. Despite the availability of vaccines, their limited efficacy and the lack of effective antiviral treatments underscore the need for alternative therapeutic approaches. Several studies have reported the antiviral activity of various drugs and compounds against PEDV. To systematically compare the efficacy of these agents, we conducted a systematic review and meta-analysis to evaluate the inhibitory effects of various drugs or compounds on PEDV replication in vitro using cell based- models. METHODS: A comprehensive literature search was conducted in PubMed, Web of Science and ScienceDirect, encompassing publications from the inception of each database to May 30,2025. Eligible studies primarily focused on the effects of pharmacological and combination interventions on PEDV replication in vitro. Changes in the tissue culture infectious dose (TCID50) served as the primary outcome measure, with standardized mean difference (SMD) used to quantify effect sizes. RESULTS: Thirty-two eligible studies involving 41 distinct drugs and 63 effect sizes were analyzed. A random-effects model revealed an overall SMD of -12.30 (95% confidence interval: -13.64 to -10.95) for the antiviral efficacy of drugs at safe concentrations. Moderate heterogeneity was observed (I²=64.2%, P < 0.001), with subgroup analyses…
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Evidence Hub reads this as a meta-analysis, done in animal, not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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