Eight RCTs with a total of 269 participants (138 treated and 131 in the control group) were included.
Mortality was described in 5 studies, where the overall RR was 0.6 (95% CI: 0.22, 1.75). Respiratory deterioration was reported in 3 studies, where the overall RR was 0.4 (95% CI: 0.16, 1.13).
Two studies of ventilated patients compared length of hospitalisation, days of oxygen dependence and the duration of ventilation. A third study compared days on oxygen supplementation with days on a ventilator. In this study, there were 5 ventilated patients. Two studies showed a significant reduction in the length of ventilation while the other did not. The pooled 'effect size' was -0.59 (95% CI: -1.09, -0.10) which implied a significant reduction in the duration of ventilation (p=0.01). Using the weighted mean difference method, the ribavirin-treated group had an average of 5.25 days less on mechanical ventilation (95% CI: -2.74, -7.74). These results were significant in both the fixed- and random-effects models.
The duration of oxygen-dependence was also significantly shorter in the treated group in 2 of these studies. The pooled effect size was -0.522, which was statistically significant (p=0.005). The treatment group had an average of 3.6 fewer days (95% CI: -5.56, -1.28) of oxygen-dependence.
The duration of hospitalisation favoured ribavirin with an effect size of -0.22 (95% CI: -0.7, 0.27) and a weighted mean difference of -2.48 days (95% CI: -7.49, 2.97).
Clinical improvement was the main outcome in 5 studies of non-ventilated babies. The pooled standardised effect size was 1.44 (95% CI: 1.08, 1.79), which was significant (p<0.001).
Four studies in non-ventilated patients used improvements in oxygenation as an outcome measure. However, because the measures of oxygenation were different, pooling was not possible. These studies supported findings of a shortened duration of oxygen supplementation in ribavirin recipients.