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乌米酚韦治疗与改善 2019 冠状病毒病患者结局无关:一项回顾性研究。

Umifenovir treatment is not associated with improved outcomes in patients with coronavirus disease 2019: a retrospective study.

机构信息

Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

Liver Research Centre, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

出版信息

Clin Microbiol Infect. 2020 Jul;26(7):917-921. doi: 10.1016/j.cmi.2020.04.026. Epub 2020 Apr 25.

Abstract

OBJECTIVES

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Umifenovir (Arbidol®) is an antiviral drug being used to treat influenza in Russia and China. This study aimed to investigate the effectiveness and safety of umifenovir for COVID-19.

METHODS

A retrospective study was performed in a non-intensive care unit (ICU) ward in Jinyintan Hospital from 2 February 2020 to 20 March 2020. COVID-19 was confirmed by real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay of pharyngeal swab specimens. The confirmed patients were divided into the umifenovir group and the control group according to the use of umifenovir. The main outcomes were the rate of negative pharyngeal swab tests for SARS-CoV-2 within 1 week after admission and the time for the virus to turn negative. The negativity time of SARS-CoV-2 was defined as the first day of a negative test if the nucleic acid of SARS-CoV-2 was negative for two consecutive tests.

RESULTS

A total of 81 COVID-19 patients were included, with 45 in the umifenovir group and 36 in the control group. Baseline clinical and laboratory characteristics were comparable between the two groups. Thirty-three out of 45 (73%) patients in the umifenovir group tested negative for SARS-CoV-2 within 7 days after admission, the number was 28/36 (78%) in the control group (p 0.19). The median time from onset of symptoms to SARS-CoV-2 turning negative was 18 days (interquartile range (IQR) 12-21) in the umifenovir group and 16 days (IQR 11-21) in the control group (p 0.42). Patients in the umifenovir group had a longer hospital stay than patients in the control group (13 days (IQR 9-17) vs 11 days (IQR 9-14), p 0.04). No deaths or severe adverse reactions were found in both groups.

DISCUSSION

Umifenovir might not improve the prognosis or accelerate SARS-CoV-2 clearance in non-ICU patients. A randomized control clinical trial is needed to assess the efficacy of umifenovir.

摘要

目的

新型冠状病毒病(COVID-19)由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起。盐酸阿比多尔(Arbidol®)是一种在俄罗斯和中国用于治疗流感的抗病毒药物。本研究旨在探讨盐酸阿比多尔治疗 COVID-19 的疗效和安全性。

方法

2020 年 2 月 2 日至 2020 年 3 月 20 日,在金银潭医院非重症监护病房(ICU)进行回顾性研究。通过实时逆转录聚合酶链反应(RT-PCR)检测咽拭子标本,确认 COVID-19。根据是否使用盐酸阿比多尔,将确诊患者分为盐酸阿比多尔组和对照组。主要结局为入院后 1 周内咽拭子 SARS-CoV-2 转阴率和病毒转阴时间。SARS-CoV-2 转阴时间定义为连续两次核酸检测阴性的第一天。

结果

共纳入 81 例 COVID-19 患者,其中盐酸阿比多尔组 45 例,对照组 36 例。两组患者的基线临床和实验室特征相似。盐酸阿比多尔组 33 例(73%)患者入院后 7 天内 SARS-CoV-2 转阴,对照组 28 例(78%)(p=0.19)。盐酸阿比多尔组从症状出现到 SARS-CoV-2 转阴的中位时间为 18 天(四分位距(IQR)12-21),对照组为 16 天(IQR 11-21)(p=0.42)。盐酸阿比多尔组的住院时间长于对照组(13 天(IQR 9-17)vs. 11 天(IQR 9-14),p=0.04)。两组均未发现死亡或严重不良反应。

讨论

盐酸阿比多尔可能不能改善非 ICU 患者的预后或加速 SARS-CoV-2 清除。需要进行随机对照临床试验来评估盐酸阿比多尔的疗效。

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